ASH 2022: Updated Index Improves Prognostication for Survival in Advanced-Stage Hodgkin Lymphoma

Models that have historically been used to predict survival outcomes in advanced-stage classical Hodgkin lymphoma (A-HL) are outdated and less useful in the modern treatment era. Members of the Hodgkin Lymphoma International Study for Individual Care (HoLISTIC) Consortium, therefore, sought to develop a new model for prognostication of outcomes in A-HL using modern data. Andrew Evens, DO, MBA, MMSc, one of the contributing authors for the publication detailing these results is an LRF Scientific Advisory Board member.

The prognostic model, known as the Advanced-Stage Hodgkin Lymphoma International Prognostication Index (A-HIPI), was developed using data from more than 4,000 patients treated in eight international clinical trials from 1996 to 2012. The primary outcomes for prognostication were five-year overall and progression-free survival. Variables found to be predictive of these outcomes included age, sex, disease stage, presence of bulk disease, lymphocyte count, and hemoglobin and albumin concentrations.

The A-HIPI model was externally validated using a sample of more than 1,500 patients included in HL registries from Canada, the United States, and Australia. Compared with historical models, the researchers reported that the A-HIPI model showed modest improvement in prediction of five-year progression-free survival and meaningful enhancement in the predictive capacity for overall survival. The investigators noted that there is additional room for improvement in future models, which could also include treatment regimen, imaging results, and treatment-related late effects.
An online calculator will be made available to physicians to simplify the application of the A-HIPI model in
the clinic.

This study also included contributions from LRF SAB members Jonathan Friedberg, MD, MMSc of the University of Rochester Medical Center; Brian K. Link, MD of the University of Iowa; and Kerry J. Savage, MD, MSc, FRCPC of BC Cancer, Vancouver.