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 score||Risk group||% of patients||Median OS|
|< 5.7||Low||44%||Not reached*|
|5.7 to < 6.2||Intermediate||35%||51 months|
|≥ 6.2||High||21%||29 months|
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
- Hoster E, Dreyling M, Klapper W, Gisselbrecht C, van Hoof A, Kluin-Nelemans HC et al. A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma. Blood 2008; 111: 558-565.
- Romaguera JE, Fayad LE, Feng L, Hartig K, Weaver P, Rodriguez MA et al. Ten-year follow-up after intense chemoimmunotherapy with Rituximab-HyperCVAD alternating with Rituximab-high dose methotrexate/cytarabine (R-MA) and without stem cell transplantation in patients with untreated aggressive mantle cell lymphoma. Br J Haematol 2010; 150: 200-208.
- Gressin R, Caulet-Maugendre S, Deconinck E, Tournilhac O, Gyan E, Moles MP et al. Evaluation of the (R)VAD+C regimen for the treatment of newly diagnosed mantle cell lymphoma. Combined results of two prospective phase II trials from the French GOELAMS group. Haematologica 2010; 95: 1350-1357.
- Hoster E, Klapper W, Hermine O, Kluin-Nelemans HC, Walewski J, van Hoof A et al. Confirmation of the mantle-cell lymphoma International Prognostic Index in randomized trials of the European Mantle-Cell Lymphoma Network. J Clin Oncol. 2014; 32: 1338-1346.