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Blood, 1 March 2005, Vol. 105, No. 5, pp. 1875-1880. Prepublished online as a Blood First Edition Paper on November 9, 2004; DOI 10.1182/blood-2004-01-0379. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-01-0379v1 105/5/1875    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Vassilakopoulos, T. P. Articles by Pangalis, G. A. Search for Related Content PubMed PubMed Citation Articles by Vassilakopoulos, T. P. Articles by Pangalis, G. A. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Development and validation of a clinical prediction rule for bone marrow involvement in patients with Hodgkin lymphoma Theodoros P. Vassilakopoulos, Maria K. Angelopoulou, Nikos Constantinou, Themistoklis Karmiris, Panayiotis Repoussis, Paraskevi Roussou, Marina P. Siakantaris, Penelope Korkolopoulou, Marie-Christine Kyrtsonis, Styliani I. Kokoris, Maria N. Dimopoulou, Eleni Variamis, Nora-Athina Viniou, Konstantinos Konstantopoulos, Evangelia M. Dimitriadou, Athina Androulaki, Efstratios Patsouris, Ipatia A. Doussis-Anagnostopoulou, Panayiotis Panayiotidis, Vassiliki A. Boussiotis, Christos Kittas, and Gerassimos A. Pangalis From the Haematology Section, First Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece; the Hematology Clinic, Theagenion Cancer Hospital, Thessaloniki, Greece; the Hematology and Lymphoma Clinic, Evangelismos Hospital, Athens, Greece; the Hematology Clinic, Peripheral General Anticancer Hospital-Metaxa-Piraeus, Piraeus, Greece; the Third Department of Internal Medicine, National and Kapodistrian University of Athens, Sotiria Hospital, Athens, Greece; the Department of Pathology, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece; and the Department of Histology and Embryology, National and Kapodistrian University of Athens, Athens, Greece. We developed a clinical prediction rule for bone marrow involvement (BMI) in Hodgkin lymphoma based on 826 patients and validated it in 654 additional patients. Independent prognostic factors for BMI were x1, B symptoms; x2, stage III/IV prior to bone marrow biopsy; x3, anemia; x4, leukocytes fewer than 6 x 109/L; x5, age 35 years or older; and x6, iliac/inguinal involvement. Each factor was graded as xi = 1, if present, or xi = 0, if absent. A simplified score Zs = 8x1 + 6x2 + 5x3 + 5x4 + 3x5 + 3x6 – 8 was assigned to each patient. The sensitivity, specificity, and positive and negative predictive value of this prediction rule was 97.8%, 51.5%, 10.6%, and 99.8%, respectively. In the validation group, they were 98.1%, 40.3%, 12.7%, and 99.6%. According to Zs value, 3 risk groups for BMI were defined: low risk (Zs < 0, 44% of patients, 0.3% risk), standard risk (Zs, 0-9; 37% of patients; 4.2% risk), and high risk (Zs 10, 20% of patients, 25.5% risk). Patients with low risk (stage IA/IIA without anemia and leukopenia; stage IA/IIA, younger than 35 years, with either anemia or leukopenia but no inguinal/iliac involvement; and stage IIIA/IVA without any of these 4 risk factors) do not need bone marrow (BM) biopsy. Patients with standard risk should be staged with unilateral biopsy, but patients with high risk may benefit from bilateral biopsy. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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