Background: Identifying patients with a higher risk of recidivate/refractory Hodgkin lymphoma (R/R HL) is a challenge that needs to be addressed. The International Prognostic System (IPS) identifies patients with a poor prognosis in advanced stages, although its relevance has decreased due to advancements in modern treatment. The interim PET-2 scan after two chemotherapy cycles is now considered the most crucial prognostic tool, but it is only available after treatment initiation. Methods: We investigate the role of clinical and inflammatory indices associated with clinical data in 212 HL patients, focusing on peripheral blood ratios. Results: During follow-up, after a median of 60 months [3-213], 157 patients (74.1%) were in complete remission, and 55 were classified as R/R. SII (platelets × neutrophils/lymphocytes) ≥ 270, IgM < 50 mg/dL, male gender, and extranodal localization correlate with higher relapse and refractory rates. Assigning one point to each variable, a new prognostic score (ME-IPS) was developed, recognizing three risk classes. A total of 135 (63.7%) patients belonged to the low-risk class (0-1 points), 55 (25.9%) to intermediate (2 points), and 22 (10.4%) to high (3-4 points). The median PFS for the three groups was statistically different (not achieved vs. 89 vs. 8.8 months, p < 0.001), with a 5-year cut-off of 83%, 67%, and 27% (p < 0.001). ME-IPS, validated against the traditional IPS, performs better in identifying high-risk patients with data collected at diagnosis. Conclusion: Combining the ME-IPS model with PET-2 may provide a more effective tool for HL prognosis, particularly in cases of advanced disease, and guide treatment decisions in clinical practice.
Hodgkin-Inflammatory-Based Model ME-IPS Is a New Inflammatory-Based Prognostic Model Calculated at Diagnosis: Results From a Real-Life Study
Del Fabro, VittorioWriting – Original Draft Preparation
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2025-01-01
Abstract
Background: Identifying patients with a higher risk of recidivate/refractory Hodgkin lymphoma (R/R HL) is a challenge that needs to be addressed. The International Prognostic System (IPS) identifies patients with a poor prognosis in advanced stages, although its relevance has decreased due to advancements in modern treatment. The interim PET-2 scan after two chemotherapy cycles is now considered the most crucial prognostic tool, but it is only available after treatment initiation. Methods: We investigate the role of clinical and inflammatory indices associated with clinical data in 212 HL patients, focusing on peripheral blood ratios. Results: During follow-up, after a median of 60 months [3-213], 157 patients (74.1%) were in complete remission, and 55 were classified as R/R. SII (platelets × neutrophils/lymphocytes) ≥ 270, IgM < 50 mg/dL, male gender, and extranodal localization correlate with higher relapse and refractory rates. Assigning one point to each variable, a new prognostic score (ME-IPS) was developed, recognizing three risk classes. A total of 135 (63.7%) patients belonged to the low-risk class (0-1 points), 55 (25.9%) to intermediate (2 points), and 22 (10.4%) to high (3-4 points). The median PFS for the three groups was statistically different (not achieved vs. 89 vs. 8.8 months, p < 0.001), with a 5-year cut-off of 83%, 67%, and 27% (p < 0.001). ME-IPS, validated against the traditional IPS, performs better in identifying high-risk patients with data collected at diagnosis. Conclusion: Combining the ME-IPS model with PET-2 may provide a more effective tool for HL prognosis, particularly in cases of advanced disease, and guide treatment decisions in clinical practice.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
