A-HIPI Clinical Prediction Model Improves Prediction of Outcomes for Patients With Advanced-Stage Classic Hodgkin Lymphoma

Advanced-Stage Hodgkin Lymphoma International Prognostic Index (A-HIPI)

The development and validation of a contemporary clinical prediction model for patients with advanced-stage classic Hodgkin lymphoma (cHL) identified several novel nonlinear relationships and improved the prediction of patient outcomes, according to a study recently published in the Journal of Clinical Oncology. 

Although the International Prognostic Score (IPS) has been used to predict clinical outcomes of patients with cHL for 25 years, Dr Angie Mae Rodday and colleagues stated, “analyses have documented suboptimal performance of the IPS among contemporarily treated patients.” Due to this, Dr Rodday et al developed a contemporary clinical prediction model for cHL by using multisource individual data. 

4,022 newly diagnosed advance-stage adult cHl patients with a median age of 33 years (ranging from 18 to 65 years) from 8 international phase 3 trials were studied for model development. 1,431 contemporaneously treated cHL patients from 4 real-world registries were used to test external validation. 

Piecewise linear splines were used to evaluate nonlinear relationships between predictor variables and outcomes. Using Cox proportional hazard models, overall survival (OS) and 5-year progression-free survival (PFS) were estimated. The contemporary model, named the Advanced-Stage Hodgkin Lymphoma International Prognostic Index (A-HIPI), included age, stage, absolute lymphocyte count, and albumin levels as variables in predicting patient outcomes. 

After following patients for a median of 62 months, results found that by 5 years, 21% of patients experienced progression, relapse, or death (n=858), and 7% died (n=278). The A-HIPI was found to have better accuracy in predicting patient outcomes compared to other prognostic tools. A-HIPI was validated in an external cohort and found to be effective in predicting PFS and OS, as it demonstrated superior discrimination for OS and improved calibration for PFS and OS compared to previous prognostic tools. Optimism-corrected c-statistics in A-HIPI for 5-year PFS and OS were 0.590 and 0.720, respectively. An online calculator was developed to help further estimate individual patient outcomes. 

In conclusion, Dr Rodday et al successfully developed and validated A-HIPI, a contemporary model used to aid outcome predictions among patients with cHL, as well as an online calculator used to further assist clinicians in estimating prognosis. Dr Rodday et al stated that A-HIPI “may also inform the development of similar methods, treatment models, and analytic algorithms for other cancers and diseases.” 

Source:

Rodday AM, Parsons SK, Upshaw JN, et al. The advanced-stage hodgkin lymphoma international prognostic index: development and validation of a clinical prediction model from the hoLISTIC consortium. J Clin Oncol. December 10, 2022; doi:https://doi.org/10.1200/jco.22.02473