Background Identifying patients with a higher risk of recidivate/refractory Hodgkin lymphoma (R/R HL) is a challenge that needs to be addressed. The International Prognostic System (IPS) identifies patients with a poor prognosis in advanced stages, although its relevance has decreased due to advancements in modern treatment. The interim PET‐2 scan after two chemotherapy cycles is now considered the most crucial prognostic tool, but it is only available after treatment initiation. Methods We investigate the role of clinical and inflammatory indices associated with clinical data in 212 HL patients, focusing on peripheral blood ratios. Results During follow‐up, after a median of 60 months [3–213], 157 patients (74.1%) were in complete remission, and 55 were classified as R/R. SII (platelets × neutrophils/lymphocytes) ≥ 270, IgM < 50 mg/dL, male gender, and extranodal localization correlate with higher relapse and refractory rates. Assigning one point to each variable, a new prognostic score (ME‐IPS) was developed, recognizing three risk classes. A total of 135 (63.7%) patients belonged to the low‐risk class (0–1 points), 55 (25.9%) to intermediate (2 points), and 22 (10.4%) to high (3–4 points). The median PFS for the three groups was statistically different (not achieved vs. 89 vs. 8.8 months, p < 0.001), with a 5‐year cut‐off of 83%, 67%, and 27% ( p < 0.001). ME‐IPS, validated against the traditional IPS, performs better in identifying high‐risk patients with data collected at diagnosis. Conclusion Combining the ME‐IPS model with PET‐2 may provide a more effective tool for HL prognosis, particularly in cases of advanced disease, and guide treatment decisions in clinical practice.
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Duminuco et al. (2025) studied this question.