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The International Prognostic Score (IPS) for advanced Hodgkin lymphoma is a prognostic scoring system based upon the total number of seven potential unfavourable features at diagnosis. It predicts 5-year rates of freedom from progression (FFP) The 5-year FFP for patients with zero factors is 84%. Each additional factor lowers the 5-year FFP rate by 7%, such that the 5-year FFP for a patient with 5 or more factors is 42%. The prognostic score is also predictive of overall survival at 5 years.r

The seven prognostic factors are:

  • serum albumin less than 40 g/L
  • haemoglobin less than 105 g/L
  • male
  • age greater than or equal to 45 years
  • stage IV disease (according to the Ann Arbor Staging System)
  • white cell count greater than or equal to 15 x 109/L
  • lymphocyte count less than 0.6 x 109/L or less than 8% of the white cell count
Prognostic score
(number of factors)
Total percentage of patients (%) Freedom from progression (FFP)
at 5 years (%)
Overall survival at 5 years (%)
0 7 84 89
1 22 77 90
2 29 67 81
3 23 60 78
4 12 51 61
 More than 5 7 42 56

© NEJM 1998

Over time outcomes have improved with newer chemotherapy regimes and novel agents. Moccia et al.r analysed the outcomes for 740 patients treated with ABVD and compared the results for FFP and OS with the study by Hasenclever et al.r with the improved outcomes evident in the table below.

© JCO 2012

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19 Jan 2020