Mantle cell lymphoma International Prognostic Index (MIPI) Calculator

Prognostic index for advanced-stage mantle cell lymphoma

The MIPI is applied at the time of diagnosis. If lymph node Ki67 proliferation index is available, use the MIPIb combined biologic index instead.

2. Determine risk group and prognosis

MIPI scoreRisk group% of patientsMedian OS
< 5.7Low44%Not reached*
5.7 to < 6.2Inter­mediate35%51 months
≥ 6.2High21%29 months
* 5 year overall survival was 60 months for the low-risk group

Commentary

The Mantle Cell Lymphoma International Prognostic Index (MIPI) derives from multivariate analysis of survival of 455 patients with mantle cell lymphoma treated between 1996 and 2004.1 Patients were treated with chemotherapies including CHOP, R-CHOP and MCP.

The MIPI is calculated using the following formula: [0.03535 × age (years)] + 0.6978 (if ECOG > 1) + [1.367 × log10(LDH/ULN)] + [0.9393 × log10(white cells per uL blood)]. A score < 5.7 indicates low-risk disease, 5.7 - 6.2 indicates intermediate risk, and > 6.2 high risk.

The proliferation index (percentage of cells Ki67 positive) was of independent prognostic relevance, and is incorporated into the “combined biologic index”, or MIPIb.

The MIPI is of prognostic relevance among patients treated with the intensive R-HyperCVAD/R-MA chemoimmunotherapy schedule,2 and among patients treated with chemotherapy followed by planned autologous stem cell transplant.3

Some authorities have recommended the simplified MIPI (s-MIPI) over the MIPI, noting that the s-MIPI is easier to calculate and has similar prognostic performance.4