Mantle Cell Lymphoma International Prognostic Index Combined Biologic Index (MIPIb) Calculator

Combined biologic index for prognosis of advanced stage mantle cell lymphoma, incorporating Ki67 proliferation index.

Applied at the time of diagnosis. If Ki67 is not available, use the MIPI index.

2. Determine risk group and prognosis

MIPIb scoreRisk group% of patientsMedian OS
< 5.7Low28%Not reached
5.7 to < 6.5Inter­mediate47%58 months
≥ 6.5High25%37 months

Commentary

The Mantle Cell Lymphoma International Prognostic Index combined biologic index (MIPIb) was derived from multivariate analysis of survival of 220 patients with mantle cell lymphoma treated between 1996 and 2004.1 Patients were treated with chemotherapies including CHOP, R-CHOP and MCP.

When incorporated into multivariate analysis with the other MIPI prognostic factors, proliferation index (percentage of cells Ki67 positive) was of independent prognostic relevance. The MIPIb score is is calculated using the formula: [0.03535 x age (years)] + 0.6978 (if ECOG > 1) + [1.367 x log10(LDH/ULN)] + [0.9393 x log10(WBC count)] + [0.02142 x Ki-67 (%)]. A score < 5.7 indicates low risk disease, 5.7 - 6.5 indicates intermediate risk, and 6.5 or greater high risk. The MIPI retains 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