What it is
The Childhood Hodgkin International Prognostic Score (CHIPS) is a simple four-point prognostic index for intermediate-risk paediatric Hodgkin lymphoma. It was derived from 1,103 patients on the Children’s Oncology Group AHOD0031 trial (treated with ABVE-PC chemotherapy ± radiation) and estimates 4-year event-free survival (EFS) from four baseline features available at diagnosis. It supports response-based decisions about whether to intensify therapy.
Formula
CHIPS assigns one point each for four independent predictors:
- Stage IV disease
- Large mediastinal mass
- Albumin < 3.5 g/dL
- Fever (B-symptom)
The total (0–4) maps to 4-year EFS. Because the stage-4 group is small, score 4 is grouped with score 3:
| CHIPS | 4-year EFS |
|---|---|
| 0 | 93.1% |
| 1 | 88.5% |
| 2 | 77.6% |
| 3 (and 4) | 69.2% |
The calculator returns the EFS estimate, the grouped CHIPS category, and a low/moderate/high severity band (0–1 low, 2 moderate, ≥3 high).
When to use it
- At diagnosis of intermediate-risk paediatric/adolescent Hodgkin lymphoma, to estimate prognosis and inform response-based treatment intensification.
- As a structured, reproducible way to communicate risk to the family and the multidisciplinary tumour board, and to stratify patients in clinical-trial enrolment.
- To benchmark an individual patient’s profile against the published AHOD0031 outcome bands when counselling on prognosis.
Worked example
A 14-year-old has stage IV disease, a large mediastinal mass, albumin 3.1 g/dL (<3.5), but no fever.
That is 3 positive factors → CHIPS 3, mapping to a 69.2% 4-year EFS — the high-risk band, flagging a candidate for intensified, response-adapted therapy.
Pitfalls
- Population matters. CHIPS was derived and best validated in intermediate-risk disease on ABVE-PC. It has not been validated for low-risk patients, all high-risk regimens, or every modern protocol — extrapolate cautiously.
- It estimates EFS, not survival. Event-free survival is not overall survival; relapse after a salvageable event is not captured here.
- Albumin and fever are state-dependent. Use the baseline, at-diagnosis values; an acute intercurrent illness can transiently move both.
- Scores 3 and 4 are grouped because stage-IV-heavy combinations were too few to separate reliably — don’t over-read a “4.”
- Not a treatment selector by itself. CHIPS feeds into, but does not replace, full COG/protocol risk stratification and interim-response assessment.
Run it: [Childhood Hodgkin Int'l Prognostic Score (CHIPS)](/calculator/chips)
Decision support for qualified clinicians only — verify against current primary guidelines and your clinical judgement.