Comparison and combination of prognostic scores for nodular lymphocytepredominant Hodgkin lymphoma: an analysis from the German Hodgkin Study Group

Abstract

The LP-IPS including four (age, stage, splenic involvement, hemoglobin; 1 point for each factor) and the GHSG score comprising three (sex, albumin, variant histopathological growth pattern (GP); 2 points for sex, 1 point for albumin and variant GP) risk factors represent prognostic tools for nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). A comparison of the scores has not been conducted until now. We thus performed an analysis comprising 583 NLPHL patients treated within GHSG studies. In addition to the LP-IPS and the original GHSG score, a modified GHSG score (GP DE replacing GP CDEF as risk factor variant GP) was also investigated. Low-risk vs high-risk groups were defined as 0-1 vs 2-4 points for the LP-IPS and 0-2 vs 3-4 points for the GHSG scores. Regarding progression-free survival (PFS) and overall survival (OS), Cox regression analyses revealed hazard ratios (HR) for the high-risk vs low-risk groups of 2.71 (95%-CI: 1.76-4.18) and 8.24 (95%-CI: 3.7-18.34) for the LP-IPS, 1.59 (95%-CI: 1.04-2.45) and 2.45 (95%-CI: 1.1-5.45) for the original and 1.97 (95%-CI: 1.25-3.09) and 4.15 (95%-CI: 1.86-9.23) for the modified GHSG score. The combination of the LP-IPS and the modified GHSG score (low-risk/low-risk vs high-risk/high-risk) resulted in high HR for the high-risk/high-risk group in terms of both PFS (HR: 3.74; 95%-CI: 2.09-6.7) and OS (HR: 13.52; 95%-CI: 5.03-36.35). Thus, the LP-IPS represents the most reliable standalone risk score for NLPHL. The combination of the LP-IPS and the modified GHSG score may help to further characterize specific risk groups.