What are Prognostic Factors?

Prognostic Factors in Lymphoma

Brain scan with lymphoma. Credit: BSIP/UIG / Getty Images

What are Prognostic Factors?

Prognosis is the prior knowledge of outcome of a disease. To be able to determine how a disease is likely to behave, with or without treatment, it is necessary to know certain facts about the disease. These are called prognostic factors.

Factors that predict for a better outcome are called 'good' or 'favorable' prognostic factors. Those that predict for worse outcomes are called 'poor' prognostic factors.

For some diseases and conditions, such as non-Hodgkin lymphomas, the factors are scored to give a prognostic index.

Prognostic Factors in Lymphoma

For cancers like lymphoma, many factors determine the outcome for each patient. Some are directly related to the disease, such as the disease stage at diagnosis, how large the disease is in its spread in the body, or which organs are involved. Other factors depend on the person involved - the age at diagnosis, the sex of the individual, or his or her capacity to tolerate intensive treatment.

Outcomes are also dependent on the exact type of treatment received. Different treatments don't lead to the same results, some have a larger rate of success while others do not. By knowing the prognostic factors and ranking them in prognostic indexes, your doctor can choose the most effective treatment course.

Prognostic Factors for Follicular Lymphoma: The factors are grouped and scored in the Follicular Lymphoma International Prognostic Index, FLIPI.

These include disease stage, number of lymph node sites involved, blood test results for LDH and hemoglobin and the patient's age. The scoring of these prognostic factors results in three prognostic groups: low risk, intermediate risk and high risk. Studies show the survival rate at five years and 10 years based on the risk score, with a 91% five-year survival rate for the low-risk score compared with 53% for the high-risk prognostic score group.

Prognostic Factors for High Grade (Aggressive) Non-Hodgkin Lymphoma: These are scored in the International Prognostic Index (IPI). They include age, LDH blood test result, performance status (how much help is needed with daily activities), stage, and involvement of organs outside the lymph system. The scores of the IPI are used to give a prognosis on a scale from low to high, with low being good. The index has been revised for people receiving rituximab, dividing the scores into three risk groups of very good, good, and poor. About 95% of people in the very good risk group lived at least four years.

Prognostic Factors for Hodgkin Lymphoma: The prognostic factors include the disease stage, B symptoms (weight loss, fevers, drenching night sweats), number and size of lymph node masses, involvement of organs outside the lymph system, white blood cell count, red blood cell count, lymphocyte count, blood albumin level, erythrocyte sedimentation rate, age and sex.

These factors and scores will help guide your doctor to the best treatment regimen for your lymphoma.

They cannot predict completely what your survival rate will be or how successful your treatment will be, but they are guides based on the best current research.


American Cancer Society. Survival rates and factors that affect prognosis (outlook) for non-Hodgkin lymphoma. Updated 01/22/16. http://www.cancer.org/cancer/non-hodgkinlymphoma/detailedguide/non-hodgkin-lymphoma-factors-prognosis

American Cancer Society. Survival rates for Hodgkin disease by stage. Updated 02/09/2016. http://www.cancer.org/cancer/hodgkindisease/detailedguide/hodgkin-disease-survival-rates

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