Revised International Prognostic Index (R-IPI)
Prognostic index for diffuse large B cell lymphoma
1. Sum the number of risk factors
|Age > 60 years|
|Two or more extranodal sites of disease|
|Ann Arbor stage ≥ 3|
|ECOG performance status 3 or higher|
2. Determine risk group and prognosis
|Risk factors||Prognostic group||4 year PFS (%)|
|1 or 2||Intermediate||80|
|3, 4 or 5||Poor||53|
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.
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
- Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood 2007; 109: 1857-61.
- 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
- Zhou Z, Sehn LH, Rademaker AW, Gordon LI, Lacasce AS, Crosby-Thompson A HC et al. An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood 2014; 123: 837-42.