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Staging evaluation for NHL

Staging evaluation for NHL. Ann Arbor Staging system is applicable to both Hodgkin’s disease and NHL. Ann Arbor Staging System. Source: p. 691. Ann Arbor Staging System. Staging for our patient: Stage III1B. Source: p. 691. To manely. the patient is possibly Stage III1B

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Staging evaluation for NHL

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  1. Staging evaluation for NHL Ann Arbor Staging system is applicable to both Hodgkin’s disease and NHL

  2. Ann Arbor Staging System Source: p. 691

  3. Ann Arbor Staging System Staging for our patient: Stage III1B Source: p. 691

  4. To manely • the patient is possibly Stage III1B • Premise : Stage III1 • Bilateral cervical lymphadenopathy • Mass in R axilla – (another region) • Spleen involved • Premise : Stage B • Although history does not satisfy strictly the description, the patient cannot fall under A because still he is symptomatic.

  5. Ancillary procedures for Primary staging • CBC • ESR • LDH • ß2- microglobulin • Serum protein electrophoresis • Chemistry studies reflecting major organ function • CT scans (chest, abdomen, pelvis) • Bone marrow biopsy Source: p. 692

  6. To manely • All these (in black) are used in evaluation of Hodgkin’s disease and is also applicable to NHL • The blue ones are added for evaluation of NHL • (sorry sa background… parahindi mo malimoterasin un slide hehe)

  7. International Prognostic Index (IPI)for NHL • A powerful predictor of outcome in all subtypes of NHL • Scoring: based on presence or absence of • 5 adverse prognostic factors • may have none or all 5 of these Source: p. 692

  8. To manely • The following slides will help eval for presence of prognostic factors. • Based on the case, the patient did not have prognostic factors according to Karnofsky and ECOG • Serum LDH should be requested • Just discuss briefly the next two tables • For the IPI table, the patient only has the age w/c is 70 as the prognostic factor • Consider LDH if elevated, for the last slide. Tnx!

  9. ECOG PERFORMANCE STATUS* http://ecog.dfci.harvard.edu/general/perf_stat.html

  10. KARNOFSKY PERFORMANCE STATUS SCALE DEFINITIONS RATING (%) CRITERIA http://www.hospicepatients.org/karnofsky.html

  11. International Prognostic Index (IPI)for NHL Source: p. 692

  12. IPI for Patient (Pre treatment)

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