International Prognostic Index (IPI)

Select clinical features to calculate the IPI score, stratifying diffuse large B-cell lymphoma (DLBCL) into prognostic categories.

Age

Ann Arbor stage

LDH level

Performance status (ECOG)

Extranodal sites

IPI score

3

Risk group

High risk

Estimated 5-year survival: 55%

IPI predicts outcomes for DLBCL treated with immunochemotherapy. Incorporate molecular markers (e.g., cell of origin, double-hit status) and patient factors to individualize care.

How to Use This Calculator

1

Gather baseline clinical data

Confirm age, Ann Arbor stage, LDH level relative to upper limit of normal, ECOG performance status, and number of extranodal sites.

2

Select the appropriate category for each factor

Each adverse factor contributes 1 point. The calculator automatically sums the IPI score.

3

Interpret prognosis and plan management

Use the risk group to inform discussions on prognosis, intensity of therapy, and clinical trial consideration alongside molecular data.

Formula

IPI score = (Age >60) + (LDH elevated) + (ECOG ≥2) + (Stage III/IV) + (≥2 extranodal sites)

Risk groups: 0 (Low), 1 (Low-intermediate), 2 (High-intermediate), 3–5 (High)

Approximate 5-year survival with R-CHOP therapy: 87%, 75%, 63%, 55% respectively.

Full Description

The International Prognostic Index (IPI) stratifies diffuse large B-cell lymphoma outcomes based on age, LDH, performance status, stage, and extranodal involvement. Despite advances with rituximab, the IPI remains foundational for risk assessment, guiding therapy intensity and clinical trial eligibility. Molecular subtypes (GCB vs ABC), MYC/BCL2 status, and PET response should complement IPI in modern practice.

Frequently Asked Questions

Does the IPI account for molecular features?

No. Incorporate COO classification, double-hit status, and genomic data for comprehensive risk assessment.

What if LDH is borderline elevated?

Use the laboratory upper limit of normal. Values above ULN count as elevated and add 1 point.

How does age factor in younger patients?

Age ≤60 scores 0. For young patients, consider age-adjusted IPI (aaIPI) or NCCN-IPI variants.

Should I use PET-CT results in scoring?

Stage determination relies on imaging (including PET). Interim PET response modifies prognosis but is not part of the baseline IPI score.