{"doi":"10.1002/hon.70093_126","title":"126 | THE EARLY‐STAGE CLASSIC HODGKIN LYMPHOMA INTERNATIONAL PROGNOSTICATION INDEX (E‐HIPI): AN INDIVIDUALIZED PREDICTION MODEL UTILIZING OBJECTIVE AND CONTINUOUS VARIABLES","abstract":"A. Rodday and S. K. Parsons equally contributing author. Background: Early-stage classic Hodgkin lymphoma (cHL) has historically been classified as favorable or unfavorable. However, the importance of these factors has not been rigorously examined in the modern era, and the variables used are dichotomized, subjective or difficult to measure. Leveraging patient (pt)-level data from global clinical trials and registries within the HoLISTIC consortium (Hodgkin Lymphoma International STudy for Individual Care: www.hodgkinconsortium.com), we developed and validated the early-stage cHL International Prognostication Index (E-HIPI) to predict 2-year (yr) progression-free survival (PFS) utilizing objective, continuous, and readily measurable variables. Methods: The model was developed in 3000 pts ages 18–65 yrs with untreated early-stage cHL pts from 4 seminal phase III clinical trials (CCTG-ECOG, EORTC H9, RAPID and EORTC H10). External validation was performed in two separate cohorts, totaling 2360 contemporaneously-treated pts from 5 international cancer registries (BC Cancer, Princess Margaret, Iowa/Mayo SPORE, Stanford Registry and Danish National Lymphoma Registry). The primary outcome of 2-yr PFS was estimated using a Cox model with pre-treatment variables selected using backward elimination. Following rigorous TRIPOD recommendations (Ann Int Med. 2015), we performed internal validation to decrease overfitting, and internal-external validation, where each clinical trial was left out 1 at a time to account for between-trial heterogeneity. Furthermore, external validation assessed discrimination and calibration, the latter for the accuracy of absolute risk estimates and the ability of the model to predict outcomes in other cohorts. Results: The median age in the development cohort was 31.2 yrs; 77.4% had stage II disease. The estimated 2-yr PFS was 93.7%. Variables retained in the model were sex and the continuous values of maximum tumor diameter (MTD), hemoglobin, and albumin (Figure). Although the number of nodal groups was considered as a potential predictor (analyzed as a continuous, categorical or binary variable), it was not associated with PFS. The optimism-corrected C-statistic in the development cohort was 0.63 (95% CI: 0.60 to 0.69). The 2-yr PFS was slightly lower in validation cohorts 1 (90.3%) and 2 (91.6%). In validation cohort 1, the C-statistic was 0.63. The calibration slope was near 1, but overall calibration indicated underprediction, which improved by updating the intercept. Performance was similar in validation cohort 2. An interactive web application for E-HIPI calculator and interpretation will be provided. Conclusions: Employing objective and continuous variables across > 5300 pts, we developed and validated the first prediction model for early-stage cHL. Male sex, decreasing hemoglobin or albumin, and increasing MTD were associated with worse PFS. The E-HIPI provides robust and meaningful prediction to improve prognostication and individualized clinical decision-making. Research funding declaration: Funding provided by the National Cancer Institute of the National Institutes of Health: R01 262265-03 (Modeling Multi-Source Data in Hodgkin Lymphoma). Keywords: diagnostic and prognostic biomarkers; Hodgkin lymphoma; Hodgkin lymphoma (Pediatric, Adolescent, and Young Adult) No potential sources of conflict of interest.","journal":"Hematological Oncology","year":2025,"id":568565,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9616,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1473412,"name":"Angie May Rodday","orcid":null,"position":1,"is_corresponding":false},{"id":239734,"name":"Matthew J. Maurer","orcid":"0000-0002-1867-0526","position":2,"is_corresponding":false},{"id":784025,"name":"Jenica Upshaw","orcid":"0000-0001-5801-5481","position":3,"is_corresponding":false},{"id":660701,"name":"Nicholas Counsell","orcid":"0000-0002-0688-9192","position":4,"is_corresponding":false},{"id":1472848,"name":"Sabrina Rossetti","orcid":"0000-0002-9337-5885","position":5,"is_corresponding":false},{"id":479432,"name":"Chih‐Hung Chang","orcid":"0000-0002-7910-4704","position":6,"is_corresponding":false},{"id":1473413,"name":"Zhongguang Cui","orcid":null,"position":7,"is_corresponding":false},{"id":1472849,"name":"Qiaojun Xiang","orcid":"0000-0002-3328-1297","position":8,"is_corresponding":false},{"id":715614,"name":"Raphael Mwangi","orcid":"0000-0002-9004-9099","position":9,"is_corresponding":false},{"id":262219,"name":"Ranjana H. Advani","orcid":"0000-0002-3219-2292","position":10,"is_corresponding":false},{"id":1019645,"name":"Marc André","orcid":"0000-0001-7101-810X","position":11,"is_corresponding":false},{"id":1472850,"name":"Andrea Gallamini","orcid":"0000-0002-2054-7412","position":12,"is_corresponding":false},{"id":1472851,"name":"Alex E. Hay","orcid":"0000-0002-9015-8973","position":13,"is_corresponding":false},{"id":401866,"name":"David Hodgson","orcid":"0000-0003-4687-4582","position":14,"is_corresponding":false},{"id":34872,"name":"Richard T. Hoppe","orcid":"0000-0003-0125-0194","position":15,"is_corresponding":false},{"id":870106,"name":"Martin Hutchings","orcid":"0000-0003-3873-1741","position":16,"is_corresponding":false},{"id":567386,"name":"Peter Johnson","orcid":"0000-0003-2306-4974","position":17,"is_corresponding":false},{"id":262608,"name":"Eric Mou","orcid":"0000-0002-9865-4517","position":18,"is_corresponding":false},{"id":1144534,"name":"Stephen Opat","orcid":"0000-0002-0308-6458","position":19,"is_corresponding":false},{"id":1473414,"name":"John Raemaekers","orcid":null,"position":20,"is_corresponding":false},{"id":296280,"name":"Kerry J. Savage","orcid":"0000-0002-5835-9863","position":21,"is_corresponding":false},{"id":539568,"name":"Susan K. Parsons","orcid":"0000-0003-0282-6490","position":22,"is_corresponding":false},{"id":631916,"name":"John Radford","orcid":"0000-0001-7898-2786","position":23,"is_corresponding":false},{"id":262607,"name":"Andrew M. Evens","orcid":"0000-0002-6900-1824","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:56:52.212268Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}