What is the International Prognostic System (IPS) for Hodgkin lymphoma (Hodgkin disease)?

Updated: Sep 12, 2018
  • Author: Bradley W Lash, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The most commonly used prognostic system is the International Prognostic System (IPS), which uses the following variables to The most commonly used prognostic system is the International Prognostic System (IPS), which uses the following variables to determine prognosis [31] :

  • Serum albumin less than 4 g/dL

  • Hemoglobin less than 10.5 g/dL

  • Male sex

  • Age of 45 years or older

  • Stage IV disease (Ann Arbor classification)

  • White blood cell (WBC) count greater than 15,000/mm3

  • Absolute lymphocyte count less than 600/mm3, less than 8% of the total WBC count, or both

Each of the above variables is assigned 1 point. The total number of points for prognostic factors is used to determine risk. When applied to a group of 5141 patients with Hodgkin lymphoma the IPS produced the following groups of 5-year survival rates [31] :

  • 0 prognostic factors: 84%

  • 1 prognostic factor: 77%

  • 2 prognostic factors: 67%

  • 3 prognostic factors: 60%

  • 4 prognostic factors: 51%

  • 5 or more prognostic factors: 42%

These results have been validated in other populations as well, including in patients undergoing stem cell transplant. [32, 33] However this scoring system is most applicable to patients with advanced-stage disease (stages III and IV).


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