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Mantle Cell Lymphoma International Prognostic Index (MIPI)

Mantle Cell Lymphoma International Prognostic Index (MIPI)
Age
years
ECOG performance status
LDH ÷ upper limit of normal (ratio)
x ULN
White blood cell count
cells/µL
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When to use

  • Estimating overall survival at diagnosis of mantle cell lymphoma using four routinely available variables.
  • Risk-stratifying patients before selecting induction intensity or clinical trial eligibility.

Formula

MIPI = 0.03535×age(yrs) + 0.6978×(1 if ECOG≥2 else 0) + 1.367×log10(LDH/ULN) + 0.9393×log10(WBC in cells/µL). Low risk <5.7, intermediate 5.7-<6.2, high ≥6.2.

Pearls and pitfalls

  • A biological version (MIPI-b) adds Ki-67 proliferation index and further refines risk in the rituximab era.
  • Developed and validated in patients with advanced-stage disease treated in prospective German/European trials.

References

  1. Hoster E, et al. Blood. 2008;111(2):558-565.
  2. Hoster E, et al. J Clin Oncol. 2014;32(13):1338-1346.