The Cardiovascular
ToolsCalculators

International Prognostic Index for Diffuse Large B-cell Lymphoma (IPI and R-IPI)

Five-factor index (with rituximab-era revision) predicting survival in DLBCL.

International Prognostic Index for Diffuse Large B-cell Lymphoma (IPI and R-IPI)
Age >60 years
Ann Arbor stage III or IV
ECOG performance status >=2
LDH above the upper limit of normal
More than 1 extranodal site of disease
Result0 points

IPI: Low risk. R-IPI (rituximab era): Very good risk.

IPI risk group
Low
R-IPI risk group
Very good

When to use

  • Estimating prognosis at diagnosis of diffuse large B-cell lymphoma before or after the introduction of rituximab-based therapy.

Formula

One point each for: age >60, Ann Arbor stage III/IV, ECOG PS >=2, elevated LDH, >1 extranodal site. IPI groups: Low 0-1, Low-intermediate 2, High-intermediate 3, High 4-5. R-IPI groups: Very good 0, Good 1-2, Poor 3-5.

Pearls and pitfalls

  • The R-IPI redistributes the same five factors into three prognostic groups with better separation in patients treated with R-CHOP.

References

  1. International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med. 1993;329(14):987-94.
  2. Sehn LH, Berry B, Chhanabhai M, et al. Blood. 2007;109(5):1857-61.