Revised International Prognostic Index (R-IPI)

Prognostic index for diffuse large B cell lymphoma

1. Sum the number of risk factors

Risk factors
Age > 60 years
Raised LDH
Two or more extranodal sites of disease
Ann Arbor stage ≥ 3
ECOG performance status 3 or higher

2. Determine risk group and prognosis

Risk factorsPrognostic group4 year PFS (%)
0Good94
1 or 2Inter­mediate80
3, 4 or 5Poor53

The revised International Prognostic Index (R-IPI)1 derives from a retrospective analysis of 365 patients with diffuse large B cell lymphoma (DLBCL), treated with R-CHOP chemotherapy.

Compared with the original IPI,2 the R-IPI provides a simpler risk classification (with three categories rather than four).

The R-IPI has been recommended over the IPI for prognostic stratification of patients with DLBCL in the rituximab era, although the IPI also retains relevance.3 The NCCN-IPI was developed using a larger cohort of patients treated in the rituximab era, and appears to show superior discrimination.4

ECOG: Eastern Cooperative Oncology Group performance status scale
IPI: International Prognostic Index
LDH: Lactate dehydrogenase
PFS: Progression Free Survival
R-IPI: Revised International Prognostic Index