Dr Evens Discusses New Prognostic Model for Early-Stage Hodgkin Lymphoma

In an interview, Andrew Evens, DO, MBA, MSc, recently highlighted the development and validation of a novel prognostic tool designed specifically for patients with early-stage Hodgkin lymphoma.

Historically, early-stage disease—defined as stage I or II—has been stratified using classification systems developed in the 1960s and 70s. These older models, although helpful, were based on outdated staging methods, including surgical procedures and limited imaging technologies, and may not accurately reflect current treatment outcomes or diagnostic capabilities.

Recognizing the need for an updated and individualized model, Evens, deputy director for clinical services and chief physician officer, Rutgers Cancer Institute and Jack & Sheryl Morris Cancer Center, and his colleagues created the Early Stage International Prognostic Index (E-HIPI). This model was built using modern statistical standards, specifically the TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) framework, ensuring rigor and reproducibility.

The E-HIPI model was derived from a dataset of 3000 adult patients (aged 18 and older) with early-stage Hodgkin lymphoma. It was then validated across two separate cohorts from global cancer registries, totaling nearly 2,500 patients. Through this process, four key prognostic factors were identified:

1. Sex (male or female)
2. Maximal tumor diameter (the largest tumor size in centimeters)
3. Hemoglobin level
4. Albumin level

Importantly, the model treats continuous variables—like tumor size or lab values—not as binary categories, but with their full numeric range to capture more precise risk predictions.

The result is a clinically useful, individualized prediction tool that estimates two-year progression-free survival, a key marker of cure in Hodgkin lymphoma. The E-HIPI tool is available through online calculators, allowing providers to enter patient-specific data and generate tailored risk assessments to guide care.