Ann Arbor Staging for Lymphoma
Staging system for Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) based on the number and location of involved lymph node regions and extranodal sites. Guides treatment planning.
Score interpretation
Stage I: Single nodal region or extralymphatic site. Excellent prognosis in HL.
→ HL: ABVD × 2–4 cycles + radiotherapy (involved-field). NHL: RCHOP × 3–4 cycles ± radiotherapy. PET-CT for response assessment. Haematology/lymphoma MDT.
Stage II: Multiple nodal regions same side of diaphragm. Good prognosis overall.
→ HL: ABVD × 4 cycles ± radiotherapy depending on response. NHL: R-CHOP × 6 cycles standard. PET-CT interim and end-of-treatment. Lymphoma MDT.
Stage III: Both sides of diaphragm involved. Advanced disease.
→ HL: ABVD or BEACOPP × 6 cycles depending on risk. NHL: R-CHOP × 6 cycles. CNS prophylaxis if indicated. ASCT in relapse setting. Clinical trial.
Stage IV: Disseminated involvement of extralymphatic organs. Advanced stage.
→ HL: Escalated BEACOPP or ABVD depending on fitness. NHL: R-CHOP × 6–8 cycles. ASCT if eligible. Palliative care if not fit for intensive therapy. Clinical trial enrolment encouraged.
Interpretation bands for the Ann Arbor Stage. Apply clinical judgement and local guidance.
References
- Carbone PP, et al. Report of the Committee on Hodgkin's Disease Staging Classification. Cancer Res. 1971;31(11):1860–1861.
- Lister TA, et al. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting. J Clin Oncol. 1989;7(11):1630–1636.
Related
Curated clinical cross-links plus same-class fallbacks.
- International Prognostic Index (IPI) for DLBCL · Lymphoma
- CNS International Prognostic Index (CNS-IPI) for DLBCL · Lymphoma
- NCCN-IPI for Diffuse Large B-Cell Lymphoma · Lymphoma
- MALT Lymphoma International Prognostic Index (MALT-IPI) · Lymphoma
- Mantle Cell Lymphoma International Prognostic Index (MIPI) · Lymphoma
- R-IPI — Revised International Prognostic Index for DLBCL · Lymphoma
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.