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Prognostic factors in advanced Hodgkin's disease--can they guide therapeutic decisions?

Advanced Hodgkin's disease is usually defined according to the Ann Arbor clinical staging system. Patients often have stage III disease (involvement of lymph nodes on both sides of the diaphragm) or stage IV disease (involvement of one or more extranodal sites) at the time of presentation, and such patients constitute about 30 percent of those with newly diagnosed Hodgkin's disease. But the Ann Arbor staging system does not always identify patients with advanced Hodgkin's disease adequately. After treatment with a combination of chemotherapy and radiotherapy, patients with stage IIIA disease (no systemic symptoms, which include fever, night sweats, and weight . . .