International prognostic Index (IPI)

Additional Information

Score Description

The original International Prognostic Index (IPI) was based upon multivariate analysis of survival of 2031 patients with aggressive non-Hodgkin-lymphomas treated between 1982 and 1987. Several histological subtypes were included, and patients were treated with various doxorubicin-containing chemotherapy combinations. Although the NCCN-IPI and R-IPI have been developed for diffuse large B cell lymphoma (DLBCL) in the rituximab era, the original IPI appears to retain some prognostic significance. The original IPI is also of prognostic significance in other aggressive lymphomas, including peripheral T cell lymphoma not otherwise specified (PTCL-NOS) and Burkitt lymphoma.

Definition

Stages
Low risk: 5-year survival of 73% 0–1 points
Low–Intermediate risk: 5-year survival of 51% 2 points
Intermediate-High risk: 5-year survival of 43% 3 points
High risk: 5-year survival of 26% 4–5 points
Points per true condition
Age > 60 years 1
Performance status ≥ 2 1
LDH > reference range 1
Ann Arbor stage ≥ 3 1
≥ 2 extranodal sites of disease 1

Further Reading

  1. 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.
  2. Ziepert 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.
  3. Weisenburger DD et al. Peripheral T-cell lymphoma, not otherwise specified: a report of 340 cases from the International Peripheral T-cell Lymphoma Project. Blood 2011; 117:3402-3408.
  4. Mead GM et al. An international evaluation of CODOX-M and CODOX-M alternating with IVAC in adult Burkitt’s lymphoma: results of United Kingdom Lymphoma Group LY06 study. Ann Oncol 2002; 13: 1264-1274.