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
Male sex
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 patients5 year PFS* (%)5 year OS* (%)
≥ 574256

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