PMID- 31872362 OWN - NLM STAT- MEDLINE DCOM- 20200129 LR - 20210106 IS - 1432-0584 (Electronic) IS - 0939-5555 (Print) IS - 0939-5555 (Linking) VI - 99 IP - 2 DP - 2020 Feb TI - The classic prognostic factors in advanced Hodgkin's lymphoma patients are losing their meaning at the time of Pet-guided treatments. PG - 277-282 LID - 10.1007/s00277-019-03893-7 [doi] AB - The International Prognostic Score (IPS) is the most commonly used risk stratification tool for patients with advanced Hodgkin lymphoma (HL). It incorporates seven clinical parameters independently associated with a poorer outcome: male sex, age, stage IV, hemoglobin level, white blood cell and lymphocyte counts, and albumin level. Since the development of the IPS, there have been significant advances in therapy and supportive care. Recent studies suggest that the IPS is less discriminating due to improved outcomes with ABVD therapy. The aim of the present study was to asses if classic prognostic factors maintain their prognostic meaning at the time of response-adapted treatment based on interim PET scans. We evaluated the prognostic significance of IPS in the 520 advanced stage HL patients enrolled in the PET-guided, HD0801 trial in which PET2-positive patients underwent a more intense treatment with an early stem-cell transplantation after 2 cycles of ABVD. We observed that in these patients, the IPS completely loses its prognostic value together with all the single parameters that contribute to the IPS. Furthermore, neutrophils, monocytes, lymphocytes, and the ratio among them also no longer had any predictive value. We believe that the substantial improvement in survival outcomes in PET2-positive patients treated with early autologous transplantation could explain the complete disappearance of the residual prognostic significance of the IPS. FAU - Bari, Alessia AU - Bari A AD - UO Terapie Mirate in Oncoematologia ed Osteoncologia, Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Universita' di Modena e Reggio Emilia, Modena, Italy. FAU - Marcheselli, Raffaella AU - Marcheselli R AD - Fondazione Italiana Linfomi, Onlus, Alessandria, Italy. FAU - Sacchi, Stefano AU - Sacchi S AD - UO Terapie Mirate in Oncoematologia ed Osteoncologia, Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, Universita' di Modena e Reggio Emilia, Modena, Italy. stefano.sacchi@unimore.it. FAU - Re, Alessandro AU - Re A AD - SC Ematologia ASST Spedali Civili, Brescia, Italy. FAU - Pagani, Chiara AU - Pagani C AD - SC Ematologia ASST Spedali Civili, Brescia, Italy. FAU - Tucci, Alessandra AU - Tucci A AD - SC Ematologia ASST Spedali Civili, Brescia, Italy. FAU - Botto, Barbara AU - Botto B AD - Struttura Complessa Ematologia, AOU Citta della salute e della scienza di Torino, Turin, Italy. FAU - Vitolo, Umberto AU - Vitolo U AD - Struttura Complessa Ematologia, AOU Citta della salute e della scienza di Torino, Turin, Italy. FAU - Molinari, Anna Lia AU - Molinari AL AD - Unita Operativa di Ematologia, Ospedale degli Infermi di Rimini, Rimini, Italy. FAU - Puccini, Benedetta AU - Puccini B AD - SOD Ematologia AOU Careggi, Florence, Italy. FAU - Pulsoni, Alessandro AU - Pulsoni A AD - Dipartimento di Biotecnologie Cellulari ed Ematologia, Sapienza Universita di Roma, Rome, Italy. FAU - Santoro, Armando AU - Santoro A AD - Humanitas Clinical and Research Center - IRCCS, Humanitas Cancer Center, via Manzoni 56, 20089, Rozzano, Milan, Italy. AD - Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele - Milan, Italy. FAU - Tani, Monica AU - Tani M AD - U.O.C di Ematologia Ospedale Santa Maria delle Croci, Ravenna, Italy. FAU - Nassi, Luca AU - Nassi L AD - Department of Translational Medicine, Universita del Piemonte Orientale Amedeo Avogadro, Azienda Ospedaliero-Universitaria Maggiore della Carita, 28100, Novara, Italy. FAU - Meli, Erika AU - Meli E AD - Ematologia, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. FAU - Pavone, Vincenzo AU - Pavone V AD - A.O. C. Panico-U.O.C Ematologia e Trapianto, Tricase, Lecce, Italy. FAU - Bonfichi, Maurizio AU - Bonfichi M AD - Div. di Ematologia, IRCCS Policlinico S. Matteo di Pavia, Pavia, Italy. FAU - Evangelista, Andrea AU - Evangelista A AD - Unit of Clinical Epidemiology, AOU Citta' della Salute e della Scienza di Torino and CPO Piemonte, Turin, Italy. FAU - Gioia, Daniela AU - Gioia D AD - Fondazione Italiana Linfomi, Onlus, Alessandria, Italy. FAU - Levis, Alessandro AU - Levis A AD - Fondazione Italiana Linfomi, Onlus, Alessandria, Italy. FAU - Zinzani, Pierluigi AU - Zinzani P AD - Policlinico S.Orsola-Malpighi, Istituto di Ematologia "Seragnoli", Bologna, Italy. CN - Fondazione Italiana Linfomi (Onlus) LA - eng PT - Clinical Trial PT - Journal Article PT - Multicenter Study DEP - 20191223 PL - Germany TA - Ann Hematol JT - Annals of hematology JID - 9107334 RN - 11056-06-7 (Bleomycin) RN - 5V9KLZ54CY (Vinblastine) RN - 7GR28W0FJI (Dacarbazine) RN - 80168379AG (Doxorubicin) RN - ABVD protocol SB - IM EIN - Ann Hematol. 2021 Jan;100(1):303-304. PMID: 33219839 MH - Adult MH - Antineoplastic Combined Chemotherapy Protocols/*administration & dosage MH - Autografts MH - Bleomycin/administration & dosage MH - Dacarbazine/administration & dosage MH - Disease-Free Survival MH - Doxorubicin/administration & dosage MH - Female MH - *Hodgkin Disease/diagnostic imaging/mortality/therapy MH - Humans MH - Male MH - Middle Aged MH - Neoplasm Staging MH - Positron-Emission Tomography MH - *Stem Cell Transplantation MH - Survival Rate MH - Vinblastine/administration & dosage PMC - PMC6976582 OTO - NOTNLM OT - Absolute monocyte count OT - Hodgkin lymphoma OT - International Prognostic Score OT - Neutrophil lymphocyte ratio OT - PET COIS- All authors declare that they have no conflict of interest EDAT- 2019/12/25 06:00 MHDA- 2020/01/30 06:00 PMCR- 2019/12/23 CRDT- 2019/12/25 06:00 PHST- 2019/04/08 00:00 [received] PHST- 2019/12/06 00:00 [accepted] PHST- 2019/12/25 06:00 [pubmed] PHST- 2020/01/30 06:00 [medline] PHST- 2019/12/25 06:00 [entrez] PHST- 2019/12/23 00:00 [pmc-release] AID - 10.1007/s00277-019-03893-7 [pii] AID - 3893 [pii] AID - 10.1007/s00277-019-03893-7 [doi] PST - ppublish SO - Ann Hematol. 2020 Feb;99(2):277-282. doi: 10.1007/s00277-019-03893-7. Epub 2019 Dec 23.