International Prognostic Index (IPI)
Prognostic scoring system for aggressive non-Hodgkin lymphoma
1. Sum the number of risk factors
|Age > 60 years|
|Performance status ≥ 2|
|Ann Arbor stage ≥ 3|
|Two or more extranodal sites of disease|
2. Determine risk category and prognosis
|Risk factors (n)||Risk category||DLBCL 3yr OS2||PTCL 5yr OS3|
|0 - 1||Low||91%||50%|
|4 - 5||High||59%||11%|
The original International Prognostic Index (IPI) was based upon multivariate analysis of survival of 2031 patients with aggressive non-Hodgkin lymphomas treated between 1982 and 1987.1 Several histological subtypes were included, and patients were treated with various doxorubicin-containing chemotherapy combinations.1
Although the NCCN-IPI and the Revised International Prognostic Index (R-IPI) have been developed for diffuse large B cell lymphoma (DLBCL) in the rituximab era, the original IPI appears to retain some prognostic significance.2 The original IPI is also of prognostic relevance in other aggressive lymphomas, including peripheral T cell lymphoma not otherwise specified (PTCL-NOS)3 and Burkitt lymphoma.4
DLBCL: diffuse large B cell lymphoma
EFS: event-free survival
LDH: Lactate dehydrogenase
OS: overall survival
PTCL: peripheral T cell lymphoma
- A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. New Engl J Med 1993; 329: 987-994.
- Ziepert M, Hasenclever D, Kuhnt E, Glass B, Schmitz N, Pfreundschuh M et al. Standard International prognostic index remains a valid predictor of outcome for patients with aggressive CD20+ B-cell lymphoma in the rituximab era. J Clin Oncol 2010; 28: 2373-2380.
- Weisenburger DD, Savage KJ, Harris NL, Gascoyne RD, Jaffe ES, MacLennan KA et al. Peripheral T-cell lymphoma, not otherwise specified: a report of 340 cases from the International Peripheral T-cell Lymphoma Project. Blood 2011; 117:3402-3408.
- Mead GM, Sydes MR, Walewski J, Grigg A, Hatton CS, Pescosta N. An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt’s lymphoma: results of United Kingdom Lymphoma Group LY06 study. Ann Oncol 2002; 13: 1264-1274.