{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:00:21Z","timestamp":1791234021950,"version":"4.1.0"},"reference-count":26,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Although outcomes in Hodgkin lymphoma (HL) have improved substantially, patients with advanced-stage disease, comorbidities, or relapsed\/refractory presentations can still fare poorly. Blood-based indices of systemic inflammation and nutrition are derived from routine tests, but their value beyond established prognostic models is uncertain. We examined the association of the baseline Gustave Roussy Immune Score (GRIm) and Glasgow Prognostic Score (GPS) with treatment response, progression-free survival (PFS), and overall survival (OS) in HL, focusing on their performance relative to the seven-factor International Prognostic Score (IPS-7). Methods: We retrospectively analysed 110 adults with histologically confirmed HL treated at a tertiary haematology centre between January 2015 and December 2025. GPS, GRIm, and IPS-7 were calculated from data recorded at diagnosis. Treatment response was classified as complete versus non-complete. Outcomes were assessed with Kaplan\u2013Meier analysis, log-rank tests, Cox regression, Harrell\u2019s C-index, and likelihood-ratio testing. Results: Most patients had advanced-stage disease (69.1%) and received ABVD-based treatment (94.5%); complete response was achieved in 90 (81.8%). GPS and GRIm were not significantly associated with non-complete response, whereas IPS-7 was. Over a median follow-up of 39.5 months, 28 patients (25.5%) progressed or died and 17 (15.5%) died. In univariable Cox analysis, high GRIm risk (HR = 2.68, 95% CI 1.17\u20136.14), higher GPS (HR = 2.18 per point, 95% CI 1.23\u20133.89), and higher IPS-7 (HR = 2.10 per point, 95% CI 1.59\u20132.77) predicted shorter PFS. For OS, GPS and IPS-7 were significant, whereas GRIm was not. After adjustment for IPS-7, neither GPS nor GRIm remained independently associated with PFS or OS, and adding either score to IPS-7 produced only small, non-significant gains in discrimination. Conclusions: Baseline GPS and GRIm were associated with survival on univariable analysis, particularly for PFS, but their incremental value beyond IPS-7 was limited. These scores may help describe baseline inflammatory and nutritional risk and should not be regarded as alternatives to established HL prognostic models. In particular, GPS and GRIm were not significantly associated with treatment response and should be viewed as supportive markers requiring external validation, rather than as tools that can independently guide treatment decisions.<\/jats:p>","DOI":"10.3390\/jcm15135159","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:48:32Z","timestamp":1782992912000},"page":"5159","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Glasgow Prognostic Score and Gustave Roussy Immune Score in Hodgkin Lymphoma: Survival Associations and Limited Incremental Prognostic Value Beyond the International Prognostic Score"],"prefix":"10.3390","volume":"15","author":[{"given":"Kemal","family":"Ayg\u00fcn","sequence":"first","affiliation":[{"name":"Hematology Clinic, \u0130zmir Katip \u00c7elebi University Atat\u00fcrk Training and Research Hospital, 35170 \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u015eerife","family":"Solmaz","sequence":"additional","affiliation":[{"name":"Hematology Clinic, \u0130zmir Katip \u00c7elebi University Atat\u00fcrk Training and Research Hospital, 35170 \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9767-011X","authenticated-orcid":false,"given":"Olgu","family":"Ayg\u00fcn","sequence":"additional","affiliation":[{"name":"Family Medicine, \u0130zmir City Hospital, 35170 \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130brahim","family":"Ery\u0131lmaz","sequence":"additional","affiliation":[{"name":"Family Medicine, Amasya G\u00f6yn\u00fccek District State Hospital, 05900 Amasya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tugba","family":"Cetintepe","sequence":"additional","affiliation":[{"name":"Hematology Clinic, \u0130zmir Katip \u00c7elebi University Atat\u00fcrk Training and Research Hospital, 35170 \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2448-7346","authenticated-orcid":false,"given":"Hatice Demet","family":"Kiper Unal","sequence":"additional","affiliation":[{"name":"Hematology Clinic, \u0130zmir Katip \u00c7elebi University Atat\u00fcrk Training and Research Hospital, 35170 \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alev","family":"Garip Acar","sequence":"additional","affiliation":[{"name":"Hematology Clinic, \u0130zmir Katip \u00c7elebi University Atat\u00fcrk Training and Research Hospital, 35170 \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3042-216X","authenticated-orcid":false,"given":"Eray","family":"Arslan","sequence":"additional","affiliation":[{"name":"Hematology Clinic, \u0130zmir Katip \u00c7elebi University Atat\u00fcrk Training and Research Hospital, 35170 \u0130zmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"ref_1","first-page":"116","article-title":"Hodgkin Lymphoma: A Review and Update on Recent Progress","volume":"68","author":"Shanbhag","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1002\/ajh.26717","article-title":"Hodgkin Lymphoma: 2023 Update on Diagnosis, Risk-stratification, and Management","volume":"97","author":"Ansell","year":"2022","journal-title":"Am. J. Hematol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1056\/NEJMoa1708984","article-title":"Brentuximab Vedotin with Chemotherapy for Stage III or IV Hodgkin\u2019s Lymphoma","volume":"378","author":"Connors","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"v168","DOI":"10.1093\/annonc\/mdq181","article-title":"Hodgkin\u2019s Lymphoma: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up","volume":"21","author":"Engert","year":"2010","journal-title":"Ann. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1056\/NEJM199811193392104","article-title":"A Prognostic Score for Advanced Hodgkin\u2019s Disease","volume":"339","author":"Hasenclever","year":"1998","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3048","DOI":"10.1200\/JCO.2013.53.5229","article-title":"Role of Imaging in the Staging and Response Assessment of Lymphoma: Consensus of the International Conference on Malignant Lymphomas Imaging Working Group","volume":"32","author":"Barrington","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1182\/blood-2017-07-795476","article-title":"Prognostic Value of Baseline Metabolic Tumor Volume in Early-Stage Hodgkin Lymphoma in the Standard Arm of the H10 Trial","volume":"131","author":"Cottereau","year":"2018","journal-title":"Blood"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.2967\/jnumed.119.227249","article-title":"Time to Prepare for Risk Adaptation in Lymphoma by Standardizing Measurement of Metabolic Tumor Burden","volume":"60","author":"Barrington","year":"2019","journal-title":"J. Nucl. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2633","DOI":"10.1016\/j.ejca.2011.03.028","article-title":"A Comparison of Inflammation-Based Prognostic Scores in Patients with Cancer. A Glasgow Inflammation Outcome Study","volume":"47","author":"Proctor","year":"2011","journal-title":"Eur. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1111\/bjh.15198","article-title":"The Glasgow Prognostic Score at Diagnosis Is an Independent Predictor of Survival in Advanced Stage Classical Hodgkin Lymphoma","volume":"184","author":"Witte","year":"2019","journal-title":"Br. J. Haematol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1007\/s12185-025-03935-z","article-title":"Prognostic Value of Glasgow Prognostic Score in Hematological Malignancies: A Systematic Review and Meta-Analysis","volume":"121","author":"Jiang","year":"2025","journal-title":"Int. J. Hematol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.ejca.2017.07.027","article-title":"Prospective Validation of a Prognostic Score for Patients in Immunotherapy Phase I Trials: The Gustave Roussy Immune Score (GRIm-Score)","volume":"84","author":"Bigot","year":"2017","journal-title":"Eur. J. Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2640","DOI":"10.7150\/ijms.99724","article-title":"The Gustave Roussy Immune Score (GRIm Score) as a Novel Prognostic Score for Early Breast Cancer Patients: A Real-World Retrospective Study","volume":"21","author":"Tan","year":"2024","journal-title":"Int. J. Med. Sci."},{"key":"ref_14","first-page":"e58935","article-title":"Gustave Roussy Immune Score (GRIm-Score) as a Prognostic and Predictive Score in Metastatic Colorectal Cancer","volume":"16","author":"Cotan","year":"2024","journal-title":"Cureus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s00280-024-04692-2","article-title":"The Gustave Roussy Immune Score Is a Powerful Biomarker for Predicting Therapeutic Resistance to Chemotherapy in Gastric Cancer Patients","volume":"94","author":"Nakazawa","year":"2024","journal-title":"Cancer Chemother. Pharmacol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/ijlh.14379","article-title":"Prognostic Evaluation of Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score and Hematological Indices in Classic Hodgkin Lymphoma","volume":"47","author":"Patir","year":"2025","journal-title":"Int. J. Lab. Hematol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"108","DOI":"10.3390\/hematolrep15010012","article-title":"Post-Treatment Neutrophil and Lymphocyte Counts Predict Progression-Free Survival Following First-Line Chemotherapy in Hodgkin\u2019s Lymphoma","volume":"15","author":"Tan","year":"2023","journal-title":"Hematol. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"185","DOI":"10.3390\/diagnostics15020185","article-title":"Modified Endothelial Activation and Stress Index: A New Predictor for Survival Outcomes in Classical Hodgkin Lymphoma Treated with Doxorubicin-Bleomycin-Vinblastine-Dacarbazine-Based Therapy","volume":"15","author":"Hunutlu","year":"2025","journal-title":"Diagnostics"},{"key":"ref_19","first-page":"496","article-title":"Can Gustave Roussy Immune Score predict the prognosis and survival in patients with operable colorectal cancers?","volume":"14","author":"Karakaya","year":"2023","journal-title":"Turk. J. Clin. Lab."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Erdo\u011fan, B., G\u00f6kmen, \u0130., Elpen Kodaz, C., K\u00fc\u00e7\u00fckarda, A., Divriklio\u011flu, D., Bayrak\u00e7\u0131, \u0130., Hac\u0131bekiro\u011flu, \u0130., Engin, E.\u00d6., Hac\u0131o\u011flu, M.B., and \u00d6zcan, E. (2025). Gustave Roussy Immune Score as an Independent Prognostic Factor for Treatment Response and Survival in Advanced Renal Cell Carcinoma Treated with Nivolumab in Second-Line and Beyond. Front. Oncol., 15.","DOI":"10.3389\/fonc.2025.1657053"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3305","DOI":"10.1080\/14796694.2025.2564062","article-title":"The Modified-Gustave Roussy Immune Score: Assessing Immune Prognosis in Advanced Gastric Cancer Patients at Baseline","volume":"21","author":"Ma","year":"2025","journal-title":"Future Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1007\/s00432-024-05829-9","article-title":"Correction: Prognosis of Patients with Advanced Bile Tract Carcinoma: Assessment Using the Modified-Gustave Roussy Immune Score (MGRIm-s) as a Clinico-Immunological Tool","volume":"150","author":"Ma","year":"2024","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e33334","DOI":"10.1097\/MD.0000000000033334","article-title":"Prognostic Value of Modified-Gustave-Roussy Immunity Score in Resectable Proximal Gastric Cancer","volume":"102","author":"Shi","year":"2023","journal-title":"Medicine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S1690","DOI":"10.1016\/j.annonc.2024.10.808","article-title":"777P Glasgow Prognostic Score in Diffuse Large B Cell Lymphoma: Single Institutional Observational Study","volume":"35","author":"Krishnan","year":"2024","journal-title":"Ann. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"12699","DOI":"10.2147\/JIR.S539706","article-title":"Glasgow Prognostic Score Serves as a Prognostic Factor of Clinical Outcome in Patients with Newly Diagnosed Multiple Myeloma","volume":"18","author":"Li","year":"2025","journal-title":"J. Inflamm. Res."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Witte, H.M., Bonorden, B., Riecke, A., Biersack, H., Steinestel, K., Merz, H., Feller, A.C., Bernard, V., Fetscher, S., and von Bubnoff, N. (2020). The Glasgow Prognostic Score at Diagnosis Is a Predictor of Clinical Outcome in Patients with Multiple Myeloma Undergoing Autologous Haematopoietic Stem Cell Transplantation. Cancers, 12.","DOI":"10.3390\/cancers12040921"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5159\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:38:24Z","timestamp":1783424304000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/13\/5159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":26,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["jcm15135159"],"URL":"https:\/\/doi.org\/10.3390\/jcm15135159","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]}}}