This study sought to quantify variant patterns in nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) using a three tier scoring system assessing five parameters, namely: (a) percentage of nodularity scored from 100 % to < 75%, (b) T cell rich areas (< 20% to > 50%), (c) type of nodules, (d) dendritic network, intact or lost, and (e) extranodular distribution of lymphocyte predominant cells (< 15% to > 50%), with final scores from 0 to 10. In the 72 patients assessed, the 5-year disease-free survival (DFS) in patients with score ≤ 6 was 92% vs. 20% in those with scores > 6. The 5-year overall survival was 100% in patients with scores ≤ 6 and 87% in those with scores > 6. In the multivariate Cox regression analysis, scores > 6 and stage impacted DFS. This scoring system was effective in stratifying patients with NLPHL with variant patterns and could be used for the management of patients.
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