International Prognostic Score (Hasenclever Index)
Prognostic score for advanced Hodgkin lymphoma
1. Sum the number of risk factors
|IPS risk factors|
|Serum albumin < 40 g/L|
|Hemoglobin < 10.5 g/dL|
|Ann Arbor Stage IV|
|Age ≥ 45 years|
|White cell count ≥ 15 x109/L|
|Lymphocyte count < 0.6 x109/L|
2. Determine prognosis
|Risk factors (n)||% of patients||5 year PFS* (%)||5 year OS* (%)|
The International Prognostic Score (Hasenclever Index) was developed from a multivariate analysis of survival of 4695 patients with newly-diagnosed advanced Hodgkin disease, treated with combination chemotherapies between 1983 and 1992.1 75% of patients received an anthracycline-containing regimen, and a further 20% received MOPP or a similar regimen.
The seven adverse prognostic factors identified each carried a similar impact: Each factor reduced the 5 year progression-free survival by ~ 8%.
The Hasenclever Index retains prognostic relevance among patients treated uniformly with ABVD/COPP or with the more intensive BEACOPP regimens.2 It also helps determine prognosis among patients with relapsed or refractory Hodgkin lymphoma undergoing autologous stem cell transplant.3
ABVD/COPP: doxorubicin (Adriamycin), bleomycin, vinblastine, dexamethasone / cyclophosphamide, vincristine (Oncovin), procarbazine, prednisone
BEACOPP: bleomycin, etoposide, doxorubicin (Adriamycin), cyclophosphamide, vincristine (Oncovin), procarbazine, prednisone
IPS: international prognostic score
MOPP: mechlorethamine, vincristine (Oncovin), procarbazine, prednisone
OS: overall survival
PFS: progression free survival
- Hasenclever D and Diehl V. A prognostic score for advanced Hodgkin’s disease. International Prognostic Factors Project on Advanced Hodgkin’s Disease. New Engl J Med 1998; 339: 1506-1514.
- Diehl V, Franklin J, Pfreundschuh M, Lathan B, Paulus U, Hasenclever D et al. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin’s disease. New Engl J Med 2003; 348: 2386-2395.
- Sirohi B, Cunningham D, Powles R, Murphy F, Arkenau T, Norman A et al. Long-term outcome of autologous stem-cell transplantation in relapsed or refractory Hodgkin’s lymphoma. Ann Oncol 2008; 19: 1312-1319