International_Prognostic_Index_for_Diffuse_Large_B_cell_Lymphoma_guideline v.1
The International Prognostic Index for Diffuse Large B-cell Lymphoma (IPI and R-IPI) estimates 4-year progression-free survival and 4-year overall survival for patients with diffuse large B-cell non-Hodgkin’s lymphoma (DLBCL).
To predict overall and progression-free survival in DLBCL based on risk factors.
Use in in CD20+ DLBCL patients. Note: IPI results are included for historical comparisons only. Variables and points: - Age ≤60=0, Age >60 years=1; - Ann Arbor stage: Stage I or II (localized disease)=0, Stage III or IV (advanced disease)=1 (III: Involvement on both sides of the diaphragm, IV: Involvement of extranodal sites); - ECOG performance status: 0 or 1=0, ≥2=1; - Serum LDH: ≤1× normal=0, >1× normal=1; - Extranodal sites: ≤1´0, >1´1. Interpretation: 0 R-IPI = Very good prognosis= 4-year overall survival, 94 %= 4-year progression-free survival, 94 %; 1-2 R-IPI= Good prognosis= 4-year overall survival, 79 %= 4-year progression-free survival, 80 %; 3-5 R-IPI= Poor prognosis= 4-year overall survival, 55 %= 4-year progression-free survival, 53 %; 0-1 IPI= Low risk group = 4-year overall survival, 82 %= 4-year progression-free survival, 85 %; 2 IPI= Low-intermediate risk group = 4-year overall survival, 81 %= 4-year progression-free survival, 80 %; 3 IPI= High-intermediate = 4-year overall survival, 49 %= 4-year progression-free survival, 57 %; 4-5 IPI= High = 4-year overall survival, 59 %= 4-year progression-free survival, 51 %;
Not to use in patients with HIV, secondary malignancies, low grade lymphoproliferative disorders, or comorbidities precluding curative therapy attempt.
1. A predictive model for aggressive non-Hodgkin's lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med. 1993;329(14):987-94. 2. Sehn LH, Berry B, Chhanabhai M, 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(5):1857-61.
OBSERVATION.basic_demographic.v1, OBSERVATION.international_prognostic_index_for_diffuse_large_b_cell_lymphoma_ipi_and_r_ipi.v0, EVALUATION.international_prognostic_index_for_diffuse_large_b_cell_lymphoma_ipi_and_r_ipi.v0
