ICML 2025 | Insights into the Early-stage Hodgkin Lymphoma International Prognostication Index (E-HIPI)

So we’re very excited to present in a couple hours here at the Lugano meeting ICML. The E-HIPI is the acronym. It stands for the Early-Stage Hodgkin Lymphoma International Prognostic Index. We had published the advanced stage HIPI or the A-HIPI a couple years ago in the JCO journal. So this was of course looking at early-stage disease, in other words stage 1 and 2 disease, again through the HoLISTIC consortium, looking at over almost 5,500 patients in total in a development and validation cohorts. And there has been a classification scheme used for the last 40 or 50 years, whether the EORTC or German Hodgkin study group, but believe it or not that came out of the 1970s and even some early 1960s data when we were doing staging laparotomy, not even x-rays or CT scans, and doing radiation, basically whole-body radiation. And it’s been helpful to help subdivide patients, but there really is not a prediction tool to have factors to put in for individual patients that’s robust and validated. So that’s what the E-HIPI was. We did a very large development cohort analysis using really rigorous sophisticated statistical modeling methods called the TRIPOD guidelines. It’s really one that’s just rigorous and transparent and reproducible. And then we did validations on multiple large real world cancer survivorship cohorts. And the long story short is we came out with four critical factors. One, gender or sex and female gender was a favorable prognostic factor. And then three adverse prognostic factors were not surprisingly a large maximal tumor diameter, whether the chest or anywhere else, usually in the mediastinum. But really importantly, we didn’t just dichotomize these continuous variables, because when you take a continuous variable like age or like size of a mass from one to 15 centimeters if you just do one cut point you lose a lot of statistical power and you really can’t study linearity on that so we did it every centimeter was a different point and then also a low hemoglobin and a low albumin so those four factors came out in the final model and not only was it able to develop a calculator for individual patient risk but also able to stratify it different groups. We have a model and a calculator for that, but also risk stratification and comparing amongst other patients. So it’s a step in the process to really inform with fairly contemporary treatment, chemotherapy, radiation, what are the key prognostications that providers and patients can consider.

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