Inflammation-based scores and their dynamic changes as prognostic indicators in classical hodgkin lymphoma

Classical Hodgkin lymphoma (cHL) is characterized by a prominent inflammatory microenvironment. However, the prognostic relevance of inflammation-based markers and their changes during treatment remains unclear. We evaluated baseline and interim inflammatory parameters in patients with cHL treated with ABVD.

This retrospective single-center study included 112 newly diagnosed patients with cHL treated with ABVD between 2012 and 2025. CAR, GPS, and mGPS were assessed at diagnosis and interim evaluation. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan-Meier and Cox regression methods.

CRP, CAR, GPS, and mGPS decreased significantly during treatment (all p < 0.001), while higher baseline inflammatory scores were associated with advanced-stage disease (all p < 0.001). The 5-year PFS and OS rates were 77% and 95%, respectively. Baseline CAR, GPS, and mGPS were not independently associated with PFS. In the post-interim analysis, failure to achieve complete response (CR), higher CRP, and higher CAR were associated with poorer subsequent PFS. Interim CAR remained associated with PFS after adjustment for disease stage (HR 1.568, 95% CI 1.025-2.398; p = 0.038), but not after adjustment for interim response. Failure to achieve CR remained independently associated with poorer PFS after adjustment for stage and CAR (p = 0.012).

Inflammation-based markers appear to reflect disease burden in cHL and improve during treatment. Although baseline markers showed limited prognostic value, higher interim CAR was associated with poorer subsequent PFS beyond disease stage, an association attenuated after accounting for treatment response. Dynamic assessment of systemic inflammation during treatment may therefore provide additional prognostic information in cHL.