The Cardiovascular
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CNS International Prognostic Index (CNS-IPI)

Risk of CNS relapse in diffuse large B-cell lymphoma.

CNS International Prognostic Index (CNS-IPI)
Age > 60 years
LDH above upper limit of normal
ECOG performance status > 1
Ann Arbor stage III or IV
> 1 extranodal site involved
Kidney and/or adrenal gland involvement
Result0 points

Low risk; approximate 2-year CNS relapse ~0.6 %.

Risk group
Low risk
Approx. 2-year CNS relapse
~0.6 %

When to use

  • Estimating CNS relapse risk in DLBCL to inform CNS prophylaxis decisions.

Formula

One point each: age > 60, elevated LDH, ECOG > 1, stage III/IV, > 1 extranodal site, kidney/adrenal involvement. Range 0–6; 0–1 low, 2–3 intermediate, 4–6 high.

Pearls and pitfalls

  • Kidney/adrenal involvement is weighted as its own factor beyond the standard IPI components.

References

  1. Schmitz N, et al. J Clin Oncol. 2016;34(26):3150-6.