Childhood Hodgkin International Prognostic Score (CHIPS) Predicts event-free survival in Hodgkin Lymphoma: A Report from the Children’s Oncology Group
This study aimed to develop a predictive model for event-free survival (EFS) using upfront clinical data in a retrospective cohort of pediatric/adolescent Hodgkin lymphoma (HL) patients. The predictive model was then used for risk stratification. This study was sponsored by COG/NCI.
This study included 1103 intermediate-risk HL patients registered on COG AHOD0031 who were randomized between an experimental arm or to standard therapy. Patients randomized to the experimental arms were excluded. Independent predictors of EFS were identified and used to create a prognostic score called the Childhood Hodgkin International Prognostic Score (CHIPS). Half of the patient cohort was used as a training group, and the other half was used to validate the CHIPS.
The following criteria were found to be independent predictors of EFS with similar hazard ratios (1.56-2.7): stage 4 disease, large mediastinal mass, low albumin, and fever. 4-year EFS corresponded to a CHIPS score of 0, 1, 2, and 3, respectively: 93.1%, 88.5%, 77.6%, and 69.2%. The CHIPS was able to identify sub-cohorts with different EFS outcomes (EFS 91.5% with CHIPS 0 or 1, EFS 74.9% for CHIPS 2 or 3).
This score was tested in a limited cohort of intermediate-risk patients and therefore might not be extrapolated to low risk or high risk patients. With evolving and improved therapies for HL, it is difficult to say whether this score will still be valid.