A 45-year-old woman presents with mediastinal mass, fever, night sweats, and pruritus. Biopsy shows Reed-Sternberg cells in a background of eosinophils, plasma cells, and lymphocytes — mixed cellularity subtype. LDH is elevated, stage IIIB. Which prognostic scoring system is used to determine treatment intensity in advanced classical Hodgkin lymphoma?
- A FLIPI (Follicular Lymphoma International Prognostic Index)
- B International Prognostic Score (IPS) ✓
- C IPI (International Prognostic Index)
- D MIPI (Mantle Cell Lymphoma International Prognostic Index)
Correct answer: B. International Prognostic Score (IPS)
Explanation
The International Prognostic Score (IPS) — also called Hasenclever score — is used specifically for advanced classical Hodgkin lymphoma and incorporates 7 adverse factors: albumin <4, haemoglobin <10.5, male sex, age ≥45, Stage IV, leukocytosis ≥15,000, lymphopenia <600. FLIPI is for follicular lymphoma, IPI for diffuse large B-cell lymphoma, and MIPI for mantle cell lymphoma.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.