Evidence map›Paper›PMID 40536772›Full record

ArticleNEJM evidence2025

An Individualized Prediction Model for Early-Stage Classic Hodgkin's Lymphoma.

Angie Mae Rodday, Andrew M Evens, Matthew J Maurer, Jenica N Upshaw, Nicholas Counsell, Sara Rossetti, Cheryl Chang, Zhu Cui, Qingyan Xiang, Raphael Mwangi and 14 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in NEJM evidence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Classical Hodgkin Lymphoma Today.Mediterranean journal of hematology and infectious diseases · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Angie Mae RoddayInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston.
Andrew M EvensDivision of Blood Disorders, Rutgers Cancer Institute, New Brunswick, NJ.
Matthew J MaurerDivision of Clinical Trials and Biostatistics and Division of Hematology, Mayo Clinic, Rochester, MN.
Jenica N UpshawInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston.
Nicholas CounsellCancer Research UK and University College London Cancer Trials Centre, Cancer Institute, University College London, London.
Sara RossettiDepartment of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen.
Cheryl ChangStanford Cancer Institute, Stanford University, CA.
Zhu CuiDivision of Hematology/Oncology, Tufts Medical Center, Boston.
Qingyan XiangInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston.
Raphael MwangiDivision of Clinical Trials and Biostatistics and Division of Hematology, Mayo Clinic, Rochester, MN.
Ranjana AdvaniStanford Cancer Institute, Stanford University, CA.
Marc AndreDepartment of Hematology, CHU UCL Namur, Yvoir, Belgium.
Andrea GallaminiResearch and Innovation Department, Antoine Lacassagne Cancer Center, Nice, France.
Annette E HayDepartment of Medicine, Queen's University, Kingston, ON, Canada.
David C HodgsonDepartment of Radiation Oncology, Princess Margaret Cancer Centre and University of Toronto, Toronto, ON.
Richard T HoppeDepartment of Radiation Oncology, Stanford University, CA.
Martin HutchingsDepartment of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen.
Peter JohnsonSchool of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
Eric MouDivision of Hematology, Oncology, and Blood and Marrow Transplant, Carver College of Medicine, University of Iowa, Iowa City.
Stephen OpatLymphoma Research Group, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.
John RaemaekersEuropean Organisation for Research and Treatment of Cancer - Lymphoma Group, Brussels.
Kerry J SavageUniversity of British Columbia and the Department of Medical Oncology, British Columbia Cancer, Centre for Lymphoid Cancer, Vancouver, BC, Canada.
Susan K ParsonsInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston.
John RadfordUniversity of Manchester, Christie NHS Foundation Trust, and NIHR Manchester Biomedical Research Centre, Manchester, United Kingdom.

Funding

NCIC Clinical Trials Group - Canadian Collaborating Clinical Trials NetworkU10CA180863 · NCI · QUEEN'S UNIVERSITY AT KINGSTON · PI Janet Ellen Dancey · 2014 to 2026
$40.4M
Modeling Multi-Source Data in Hodgkin LymphomaR01CA262265 · NCI · TUFTS MEDICAL CENTER · PI Andrew M Evens, Susan Kenyon Parsons · 2022 to 2026
$3.6M
NCI NIH HHS R01 CA262265NCI NIH HHS U10 CA180863
6 · The paper itself

Abstract

backgroundA predictive model for early-stage classic Hodgkin's lymphoma (cHL) does not exist. Leveraging patient-level data from large clinical trials and registries, we developed and validated a model that we term the Early-Stage cHL International Prognostication Index (E-HIPI) to predict 2-year progression-free survival (PFS).

methodsWe developed the model using the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) guidelines in 3000 adults with newly diagnosed early-stage cHL from four international phase III clinical trials conducted from 1994 to 2011. External validation was performed in two cohorts, totaling 2360 treated patients from five international cHL registries (1996 to 2019). Two-year PFS was estimated using a Cox model with pretreatment variables selected using backward elimination. Internal validation corrected for overfitting. External validation assessed discrimination and calibration. The final model was also compared against European Organisation for Research and Treatment of Cancer (EORTC) favorable or unfavorable status.

resultsThe median age in the development cohort was 31.2 years; 77.4% had stage II disease. The estimated 2-year PFS was 93.7%. Final variables retained in the model were sex and continuous values of maximum tumor diameter (MTD), and levels of hemoglobin and albumin. The optimism-corrected C statistic in the development cohort was 0.63 (95% confidence interval, 0.60 to 0.69). Two-year PFS was lower in the validation cohorts 1 (90.3%) and 2 (91.6%). In validation cohort 1, the C statistic was 0.63 and the calibration slope was near 1, but overall calibration indicated underprediction, which improved on updating the intercept. The performance was similar in validation cohort 2. In addition, higher-risk E-HIPI scores were associated with worse outcomes in both the EORTC unfavorable and favorable subgroups. When included altogether in one Cox model, the E-HIPI was associated with PFS, whereas EORTC favorable or unfavorable status was not. Online risk calculators were developed (https://rtools.mayo.edu/holistic_ehipi/).

conclusionsUtilizing objective, continuous, and readily available variables, we developed and validated a new prediction model for early-stage cHL. Male sex, lower hemoglobin or albumin levels, and higher MTDs were associated with worse PFS. (Funded by the National Cancer Institute; grant number, NCI R01 CA 262265-04.).

Indexed as

Hodgkin DiseaseAdultFemaleHumansMaleMiddle AgedNeoplasm StagingPrognosisProgression-Free SurvivalProportional Hazards ModelsYoung Adult

Identifiers

PMID40536772
PMCPMC12498259

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.