Easier and more explanatory indices by integrating leukocyte lymphocyte ratio (LLR) and prognostic nutritional index (PNI) to IPS systems in cases with classical Hodgkin lymphoma

•In this study, leukocyte lymphocyte ratio (LLR) and prognostic nutritional index (PNI) were integrated to IPS-3 system and 2 scores named as IPS-4 were created; IPS-4 with PNI and IPS-4 with LLR.•There was an acceptable agreement between IPS-3 and IPS-7 groups and IPS-4.•These findings need to be confirmed with other studies and the incorporation of pre-therapy PET/CT metabolic parameters including total lesion glycolysis and total metabolic tumor volume to IPS-4 scores may be more informative and may help to predict response to first-line therapy.