MDCalc

International Prognostic Index for Diffuse Large B-cell Lymphoma (IPI and R-IPI)

Predicts overall and progression-free survival in DLBCL based on risk factors.

Note: IPI results are included for historical comparisons only. Use in CD20+ DLBCL patients. Do not use in patients with HIV, secondary malignancies, low grade lymphoproliferative disorders, or comorbidities precluding curative therapy attempt.

Age
Ann Arbor stage III-IV
III: Involvement on both sides of the diaphragm, IV: Involvement of extranodal sites
Serum LDH level >1× normal
>1 extranodal site
Bone marrow, GI tract, liver, lung, CNS, skin, testes, Waldeyer’s ring

Result:

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Management

Patients with poor prognosis should be strongly considered for clinical trial enrollment and tertiary center referral for investigational therapy.

Critical Actions

Correct staging and selecting correct performance status are the most potentially difficult factors.