CONTENTS
- International Prognostic Index (IPI)-Prognostic scoring system for aggressive non-Hodgkin lymphoma.
- Revised International Prognostic Index (R-IPI)-Prognostic index for diffuse large B cell lymphoma
| International Prognostic Index (IPI)-Prognostic scoring system for aggressive non-Hodgkin lymphoma. |
Sum the number of risk factors
| Risk factors |
|---|
| Age > 60 years |
| Raised LDH |
| Performance status ≥ 2 |
| Ann Arbor stage ≥ 3 |
| Two or more extranodal sites of disease |
Risk group and prognosis
| Risk factors (n) | Risk category | DLBCL 3yr OS | PTCL 5yr OS |
|---|---|---|---|
| 0 – 1 | Low | 91% | 50% |
| 2 | Low-intermediate | 81% | 33% |
| 3 | High-intermediate | 65% | 16% |
| 4 – 5 | High | 59% | 11% |
- Note: It is derived from “The International Non-Hodgkin’s Lymphoma Prognostic Factors Project” . It was a multivariate analysis of survival of 2031 patients with aggressive non-Hodgkin lymphomas treated between 1982 and 1987 published in N Engl J Med 1993; 329:987-994 (link for original article)
- Several histological subtypes were included, and patients were treated with various doxorubicin-containing chemotherapy combinations and the article concluded that ” The international index and the age-adjusted international index should be used in the design of future therapeutic trials in patients with aggressive non-Hodgkin’s lymphoma and in the selection of appropriate therapeutic approaches for individual patients”
| Revised International Prognostic Index (R-IPI)-Prognostic index for diffuse large B cell lymphoma |
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 (changed as compared to IPI) |
Risk group and prognosis
| Risk factors | Prognostic group | 4 year PFS (%) |
|---|---|---|
| 0 | Good | 94 |
| 1 or 2 | Intermediate | 80 |
| 3, 4 or 5 | Poor | 53 |
- The R-IPI has been recommended over the IPI for prognostic stratification of patients with DLBCL in the rituximab era and was published as “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, 1 MARCH 2007 VOLUME 109, NUMBER 5 (link to original article)
- The revised International Prognostic Index (R-IPI) derives from a retrospective analysis of 365 patients with diffuse large B cell lymphoma (DLBCL), treated with R-CHOP chemotherapy. The NCCN-IPI was developed using a larger cohort of patients treated in the rituximab era, and appears to show superior discrimination TO R-IPI.