title: Stage IV and age over 45 years are the only prognostic factors of the International Prognostic Score for the outcome of advanced Hodgkin lymphoma in the Spanish Hodgkin Lymphoma Study Group series.
abstract: The International Prognostic Score (IPS) is the most widely used system to date for identifying risk groups for the outcome of patients with advanced Hodgkin lymphoma, although important limitations have been recognized. We analyzed the value of the IPS in a series of 311 patients with advanced classical Hodgkin lymphoma (cHL) (Ann Arbor stage III, IV or stage II with B symptoms and/or bulky masses) treated with first-line chemotherapy including adriamycin (adriamycin, bleomycin, vinblastine, dacarbazine [ABVD] or equivalent variants). In univariate and multivariate analyses, stage IV disease and age ≥ 45 years were the only factors with independent predictive significance for overall survival (OS) (p = 0.002 and p < 0.001, respectively). Stage IV was still significant for freedom from progression (FFP) (p = 0.001) and age ≥ 45 years was borderline significant (p = 0.058). IPS separates prognostic groups, as in the original publication, but this is mainly due to the high statistical significance of stage IV and age ≥ 45 years. Moreover, the combination of these two factors enables a simpler system to be constructed that separates groups with different FFP and OS. In conclusion, in our series, stage IV and age ≥ 45 years are the key prognostic factors for the outcome of advanced cHL.
authors.affiliation: Hospital Ramón y Cajal ,  Madrid ,  Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Guisado-Vasco
authors.forename: Reyes
authors.initials: R
authors.lastname: Arranz-Saez
authors.forename: Miguel
authors.initials: M
authors.lastname: Canales
authors.forename: Araceli
authors.initials: A
authors.lastname: Cánovas
authors.forename: José
authors.initials: J
authors.lastname: Garcia-Laraña
authors.forename: Ramón
authors.initials: R
authors.lastname: García-Sanz
authors.forename: Andrés
authors.initials: A
authors.lastname: Lopez
authors.forename: José Luis
authors.initials: JL
authors.lastname: López
authors.forename: Marta
authors.initials: M
authors.lastname: Llanos
authors.forename: José Maria
authors.initials: JM
authors.lastname: Moraleda
authors.forename: José
authors.initials: J
authors.lastname: Rodriguez
authors.forename: Consuelo
authors.initials: C
authors.lastname: Rayón
authors.forename: Pilar
authors.initials: P
authors.lastname: Sabin
authors.forename: Antonio
authors.initials: A
authors.lastname: Salar
authors.forename: Ana
authors.initials: A
authors.lastname: Marín-Niebla
authors.forename: Manuel
authors.initials: M
authors.lastname: Morente
authors.forename: Pedro
authors.initials: P
authors.lastname: Sánchez-Godoy
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Tomás
authors.forename: Alfonso
authors.initials: A
authors.lastname: Muriel
authors.forename: Victor
authors.initials: V
authors.lastname: Abraira
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Piris
authors.forename: Juán F
authors.initials: JF
authors.lastname: Garcia
authors.forename: Carlos
authors.initials: C
authors.lastname: Montalban
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D016896:Treatment Outcome; D055815:Young Adult