Unfavorable disease is based on risk factors, for example Presence of bulky disease ≥ 4 nodal sites involved Age > 50 years Erythrocyte sedimentation rate (ESR) > 50 mm / hour with no B symptoms or > 30 mm / hour with B symptoms (weight loss, fever, or night sweats) Risk factors in advanced-stage Hodgkin lymphoma include Male sex Age > 45 years Signs of tumor-induced inflammation (low albumin, anemia, leukocytosis, and lymphopenia) However, selection of which risk factors to use in estimating prognosis is still subject to revision.