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Andrew Evens: Hodgkin Lymphoma International Study for Individual Care

Andrew M. Evens/X

Jun 21, 2025, 15:22

Andrew Evens: Hodgkin Lymphoma International Study for Individual Care

Andrew Evens, Deputy Director for Clinical Services at Rutgers Cancer Institute, shared a post on X:

“We are pleased to publish the next output via the HoLISTIC consortium (Hodgkin Lymphoma International STudy for Individual Care):

The E-HIPI (Early-Stage Hodgkin International Prognostic Index) prediction model for early-stage Hodgkin lymphoma.

Early-stage cHL has been classified into favorable and unfavorable subgroups for the past 40-50 years. The EORTC prognostication data stem from historical clinical trials of pts treated from 1964-1980, when staging laparotomy & mantle field RT alone were commonly performed.

Using Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) guidelines in 3000 early-stage cHL patients from 4 phase III clinical trials with external validation from 2 cohorts, totaling 2360 pts from 5 global cHL registries.

Final variables retained in the model were sex and continuous values of maximum tumor diameter (MTD), and levels of hemoglobin and albumin. The optimism-corrected C statistic in the development cohort was 0.63.

We analyzed variables as CONTINUOUS factors. Statistically, dichotomization of variables is discouraged in prognostic models as it significantly diminishes statistical power (eg, age below for each CM change) and it may conceal clinically meaningful non-linear associations.

In validation cohort 1, the C statistic was 0.63 and the calibration slope was near 1 with underprediction, which improved on updating the intercept. Calibration is critical as it reflects agreement b/t predictions and observed outcomes and accuracy of absolute risk estimates.

Additionally, higher-risk E-HIPI scores were associated with worse outcomes in both the EORTC unfavorable and favorable subgroups.

And when included altogether in one Cox model, the E-HIPI was associated with PFS, whereas EORTC favorable or unfavorable status was not.

Finally, an interactive online tool for the E-HIPI that generates 2-year PFS in an individualized “risk calculator,” and also dynamic applications for “risk comparison” and “risk stratification” across user-defined cut-off points.

We thank all co-authors (esp. Dr’s Rodday, Parsons and Radford) who developed this model over the past 15 months as well as the entire HoLSITIC consortium members for their incredible collaboration. The data commons contains >30K individual cases with much more work planned!”

Andrew Evens: Hodgkin Lymphoma International Study for Individual Care