Who are the high-risk patients with Hodgkin's disease?

The opinions concerning the prognosis of relapsing Hodgkin's disease (HD) are conflicting, although a number of clinical and biological parameters have been Identified. One reason is the rarity of large scale studies, another is the variability of populations and pretreatments In this particular disease, all factors that influence the relative weight of these parameters. Conversely, a large number of prognostic studies have been published in newly diagnosed HD, whether they concerned advanced or localized patients. Surprisingly, not so many parameters are common to these studies. Therefore, prognostic indexes are hardly usable, except if taken with great prudence. These uncertainties hamper the possibilities of conducting ample controlled studies designed to assess the best treatment modalities for high-risk HD, for both advanced or localized patients.