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Summary  We developed a novel simulation model integrating multiple data sets to project long‐term outcomes with contemporary therapy for early‐stage Hodgkin lymphoma ( ESHL ), namely combined modality therapy ( CMT )  versus  chemotherapy alone ( CA ) via  18 F‐fluorodeoxyglucose positron emission tomography response‐adaption. The model incorporated 3‐year progression‐free survival ( PFS ), probability of cure with/without relapse, frequency of severe late effects (LEs), and 35‐year probability of  LE s. Furthermore, we generated estimates for quality‐adjusted life years ( QALY s) and unadjusted survival (life years,  LY ) and used model projections to compare outcomes for  CMT  versus  CA  for two index patients. Patient 1: a 25‐year‐old male with favourable  ESHL  (stage  IA ); Patient 2: a 25‐year‐old female with unfavourable  ESHL  (stage  IIB ). Sensitivity analyses assessed the impact of alternative assumptions for  LE  probabilities. For Patient 1,  CMT  was superior to  CA  ( CMT  incremental gain = 0·11  QALY s, 0·21  LY s). For Patient 2,  CA  was superior to  CMT  ( CA  incremental gain = 0·37  QALY s, 0·92  LY s). For Patient 1, the advantage of  CMT  changed minimally when the proportion of severe  LE s was reduced from 20% to 5% (0·15  QALY s, 0·43  LY s), whereas increasing the severity proportion for Patient 2's  LE s from 20% to 80% enhanced the advantage of  CA  (1·1  QALY s, 6·5  LY s). Collectively, this detailed simulation model quantified the long‐term impact that varied host factors and alternative contemporary treatments have in ESHL.

Early‐stage Hodgkin lymphoma in the modern era: simulation modelling to delineate long‐term patient outcomes