World's first online blood cancer risk calculator developed by UK scientists

The world's first online calculator has been developed by UK and US scientists - to predict if a patient's rare blood cancer is likely to return within two years. The giant leap in medical science has been created for patients with Hodgkin lymphoma, a cancer affecting white blood cells called lymphocytes in the lymphatic system.

This world’s first predictive model is designed specifically for patients with early-stage classic Hodgkin lymphoma (cHL) and has been hailed "a step-change for the personalised treatment of this form of the disease." The revolutionary tool known as 'E-HIPI' - the culmination of two whole decades of work - can predict with a high level of accuracy if a patient will relapse in the next two years.

The online calculator looks at patient factors including sex, tumour size, and levels of haemoglobin and albumin in the blood to assess the patient’s likelihood of the disease making a comeback.

The research, published in NEJM Evidence, draws on clinical trial data from 3,000 patients on four international clinical trials between 1994 and 2011 - then validated by a further 2,360 patients treated over a similar time period.

It's a collaboration between The University of Manchester and The Christie NHS Foundation Trust in the UK - and the USA's RWJBarnabas Health and Rutgers Cancer Institute in New Jersey and Tufts Medical Center in Boston.

Professor John Radford, Professor of Medical Oncology at The University of Manchester and Consultant Medical Oncologist at The Christie NHS Foundation Trust, told us: "This is the culmination of two decades of work.

"We wanted to find a better way to predict the outcome of people with early-stage Hodgkin lymphoma following treatment.

"Until now we have lacked a robust tool but we can now forecast how well individual patients are likely to respond to treatment, offering hope for more tailored and effective therapies."

As co-author of the study and one of the UK’s leading lymphoma experts, Professor Radford added: "Crucially the new tool can estimate a patient's likelihood of remaining cancer-free two years after treatment which is a real game-changer.

"For some patients, it may mean avoiding overtreatment and its long-term side effects. For others, it may flag the need for closer monitoring or more intensive therapy."

The lymphatic system is part of our germ and disease-fighting immune system that includes the spleen and bone marrow - as well as lymph nodes in the abdomen, groin, pelvis, chest, underarms and neck.

Although relatively rare, with an incidence of 3 in 100,000 people, Hodgkin lymphoma is the most common type of cancer diagnosed in adolescents aged 15-19 years old.

Teenagers aside, it mostly affects people aged between 20 and 40, and those over 75. Around 2,100 Britons are diagnosed with it each year and it's one of two broad types of lymphoma - the other being non-Hodgkin lymphoma.

The main treatments used are chemotherapy, followed by radiotherapy or chemotherapy alone. Surgery isn't generally used as a treatment for the condition.

Overall, around 8 out of 10 people with Hodgkin lymphoma live at least 5 years and most of these will be cured. However, there's a risk of long-term problems after treatment, including infertility and an increased risk of developing another type of cancer in the future.

Dr Andrew Evens, System Director of Medical Oncology and Oncology Lead at RWJBarnabas Health Medical Group, said: "Early-stage classic Hodgkin lymphoma is a highly curable cancer, particularly among young adults.

"However, despite high survival rates and significant advances in treatment, we’ve lacked a validated tool to assess outcomes and estimate a patient’s individual risk of relapse.

"Through this global collaboration we developed a robust, dynamic, and data-driven model that has the potential to improve long-term outcomes for patients worldwide."

This research was made possible by the HoLISTIC Consortium – an international group of experts working together to improve the treatment of Hodgkin lymphoma.

The Consortium’s shared resources enabled the development and testing of the E-HIPI too and with more data the Consortium will continue to improve the model to help doctors make better treatment decisions in the future.

Dr Susan Parsons at Tufts Medical Center and co-founder of the HoLISTIC and co-senior author of the study said: "Key risk factors identified included being male, having lower haemoglobin or albumin levels, and presenting with a larger maximum tumour diameter.

"These findings did not surprise us, but the strength of the E-HIPI lies in combining them into a single, quantitative tool.

"While the prognosis for early-stage Hodgkin lymphoma remains excellent, not all patients respond equally to treatment.

"For the first time, doctors can now make risk predictions based on a patient’s individual profile, rather than relying solely on broad demographic groupings."

In the development cohort from 1994 and 2011, the model estimated a two-year progression-free survival (PFS) rate of 93.7%.

Validation cohorts showed slightly lower rates (90.3% and 91.6%), reflecting real-world diversity in patient populations. The study is funded by the National Cancer Institute in the United States.

Importantly, E-HIPI performed well across both groups, outperforming the widely used EORTC (European Organisation for Research and Treatment of Cancer) criteria.

Dr Angie Mae Rodday at Tufts Medical Center explained: "When we compared our model to existing classification systems, it had better performance and was more strongly related to patient outcomes.

"The smart calculator we developed as a result of this work is accurate, accessible, easy-to-use and is completely free for patients and clinicians.

"The model’s simplicity is also one of its greatest strengths and it is expected to be adopted widely and quickly."

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