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Stages of Adult Hodgkin Lymphoma

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    Stage IV

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    Stage IV adult Hodgkin lymphoma. Cancer is found outside the lymph nodes throughout one or more organs (a); or outside the lymph nodes in one organ and has spread to lymph nodes far away from that organ (b); or in the lung, liver, or bone marrow.

    In stage IV, the cancer:

    • is found outside the lymph nodes throughout one or more organs, and may be in lymph nodes near those organs; or
    • is found outside the lymph nodes in one organ and has spread to areas far away from that organ; or
    • is found in the lung, liver, bone marrow, or cerebrospinal fluid (CSF). The cancer has not spread to the lung, liver, bone marrow, or CSF from nearby areas.

    Adult Hodgkin lymphoma may be grouped for treatment as follows:

    Early Favorable

    Early favorable adult Hodgkin lymphoma is stage I or stage II, without risk factors.

    Early Unfavorable

    Early unfavorable adult Hodgkin lymphoma is stage I or stage II with one or more of the following risk factors:

    • A tumor in the chest that is larger than 1/3 of the width of the chest or at least 10 centimeters.
    • Cancer in an organ other than the lymph nodes.
    • A high sedimentation rate (in a sample of blood, the red blood cells settle to the bottom of the test tube more quickly than normal).
    • Three or more lymph nodes with cancer.
    • Symptoms such as fever, weight loss, or night sweats.

    Advanced Favorable

    Advanced favorable adult Hodgkin lymphoma is stage III or stage IV with three or fewer of the following risk factors:

    • Being male.
    • Being aged 45 years or older.
    • Having stage IV disease.
    • Having a low blood albumin (protein) level (below 4).
    • Having a low hemoglobin level (below 10.5).
    • Having a high white blood cell count (15,000 or higher).
    • Having a low lymphocyte count (below 600 or less than 8% of the white blood cell count).

    Advanced Unfavorable

    Advanced unfavorable Hodgkin lymphoma is stage III or stage IV with four or more of the following risk factors:

    • Being male.
    • Being aged 45 years or older.
    • Having stage IV disease.
    • Having a low blood albumin (protein) level (below 4).
    • Having a low hemoglobin level (below 10.5).
    • Having a high white blood cell count (15,000 or higher).
    • Having a low lymphocyte count (below 600 or less than 8% of the white blood cell count).

    This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

    WebMD Public Information from the National Cancer Institute

    Last Updated: February 25, 2014
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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