Bone Marrow in Hodgkin’s

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Use this calculator to calculate probability of Bone Marrow Involvement in Hodgkin’s Disease.

Does patient have B symptoms?
Hemoglobin < 13 g/dL (< 130 g/L) if male or < 11.5 g/dL (< 115 g/L) if female
WBC Count (x 109 cells/L)
Iliac or inguinal disease

About this calculator

Although bone marrow involvement is generally rare in Hodgkin’s lymphoma (4% to 14% of patients), the demonstration of involvement has prognostic and therapeutic implications. This clinical prediction rule identifies patients with low, standard, or high-risk for bone marrow involvement. Physicians should make their own decision as to whether a bone marrow biopsy should be completed for each individual patient based on the referral pattern to their hospital and the treatment strategies applied.

In the study reported below, one option suggested by the authors would be to avoid staging bone marrow biopsies in patients in the “low-risk” group, offer a unilateral biopsy in standard-risk patients, and pursue bilateral biopsies in high-risk patients. However, this approach has not been prospectively validated.

This clinical prediction rule is found in: Vassilakopoulos et al. Development and validation of a clinical prediction rule for bone marrow involvement in patients with Hodgkin lymphoma. Blood 105:1875-1880. (2005)


QxMD Hematology contributing author: Dr. Matthew Cheung, MD, SM, FRCP(C)