Sentor Thompson's Prognosis for his Marginal Zone Lymphoma, Non-Hodgkins

 Senator Thompson has a Marginal Zone Lymphoma which I think is either Stage I or II or possibly III, Low Grade(indolent) Non Hodgkins Lymphoma.

• a 5-year overall survival rate of 56% and a failure-free survival rate of only 28%. Histologic transformation to a higher-grade lymphoma occurs in more than 20% of cases. from Lymphomation.org

Staging and grading of Non Hogdkin's Lymphomas from CancerBackUp.org

Staging

The stage of non-Hodgkin lymphoma describes how many groups of lymph nodes are affected, where they are in the body, and whether other organs such as the bone marrow or liver are involved.

• Stage 1 Lymphoma is present in only one group of lymph nodes, in one particular area of the body.
• Stage 2 More than one group of lymph nodes is affected, but all the affected nodes are contained within either the upper half or the lower half of the body. The upper half of the body is above the sheet of muscle underneath the lungs (the diaphragm), and the lower half is below the diaphragm.
• Stage 3 Lymphoma is present in lymph nodes in both the upper and the lower parts of the body (ie in lymph nodes both above and below the diaphragm). The spleen is considered as a lymph node in this staging system.
• Stage 4 The lymphoma has spread beyond lymph nodes to other lymphatic organs – for example, to sites such as the bone marrow, liver or lungs.

The stage usually includes the letter A or B, which describes whether the B symptoms are present or not (eg stage 2B). Sometimes the lymphoma can start in areas outside the lymph nodes, and this is represented by the letter E, which stands for extranodal (eg stage 3AE).

Grading

For practical purposes, non-Hodgkin lymphomas are also divided into two groups: low- and high-grade. Low-grade lymphomas are usually slow-growing, and high-grade lymphomas tend to grow more quickly.
Nodal marginal zone B-cell lymphoma is a low-grade lymphoma and often develops very slowly.

More on definitions and an explanation of Staging according to the Ann Arbor Staging System

International Prognostic Index
The International Prognostic Index (IPI) was designed to further clarify lymphoma staging. The IPI predicts the risk of disease recurrence and overall survival by taking into account factors such as age, stage of disease, general health (also known as performance status), number of extranodal (other than the lymph nodes) sites, and the presence or absence of an elevated serum enzyme named lactate dehydrogenase (LDH).

Example: A patient with the following prognostic factors would have an IPI score of 5, making him or her a "high risk" patient. The individual would have a 40% chance of being relapse-free over the next 5 years, a 44% chance of complete response, and a 26% chance of surviving for 5 years.

• Age over 60 years
• Late-stage disease (Stages 3 and 4)
• More than one extranodal site
• High LDH
• Poor general health

Table 3: International Prognostic Index Scoring

Risk	IPI Score	Complete Response Rate	Relapse-free 5-Year Survival	Overall 5-Year Survival
Low	0-1	87%	70%	73%
Low/ intermediate	2	67%	50%	51%
High/ intermediate	3	55%	49%	43%
High	>4	44%	40%	26%

Senator Thompson is over 60 years of age. For his prognosis I need to know the Stage, sites outside the lymph node system, LDH( presence or absence of a serum enzyme named lactate dehydrogenase).
Since I do not know the these last items the good Senator's prognosis ranges from ~49-70%(High Intermediate to Low) see table above.

Furthermore he received Radiation and Monoclonal Antibody Therapy,

• Rituxan, a new Monoclonal Antibody Therapy, or cells engineered to hunt down the cancer by recognizing an antigen on the cancerous cell's surface and kills it without doing the harm to surrounding tissue.

for which we do not have 5 year survivablity stats on. 

 

picture from wikipedia file

Monoclonal antibodies for cancer. ADEPT, antibody directed enzyme prodrug therapy; ADCC, antibody dependent cell-mediated cytotoxicity; CDC, complement dependent cytotoxicity; MAb, monoclonal antibody; scFv, single-chain Fv fragment.^[3]

 

Senator Thompson may you stay in Remission and God's speed, Sir.

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