PROGNOSTIC MARKERS OF DISEASE-ACTIVITY IN HODGKINS-DISEASE

The erythrocyte sedimentation rate (ESR), liver alkaline phosphatase ( ALP), serum copper (Cu) and urinary nucleoside excretion (UNs) have be en proposed as independent prognostic markers in Hodgkin's Disease (HD ). However, their prognostic value has not satisfactorily been directl y compared to recognised clinical prognostic factors. One hundred and sixty-eight patients with HD had the above markers performed prior to initial treatment. At a median follow-up of 10.9 yrs, the predicted 10 year relapse free survival(RFS) and overall survival (OS) for the ent ire cohort is 64% and 66%, respectively. In general, patients with ele vated markers were significantly less likely to achieve CR, remain in CR and survive. However, multivariate analysis revealed this was due t o the association of elevated markers with stage and constitutional sy mptoms. Following therapy, elevated markers were also correlated with evidence of clinically detectable disease. We conclude that although U Ns, Cu, ALP and ESR reflect disease activity, they do not provide inde pendent information beyond that of clinical assessment.