Zhou et al reported a new International Prognostic Index (IPI) based on the National Comprehensive Cancer Network (NCCN) database. The authors are from NCCN member institutions.
Patient selection: diffuse large B-cell lymphoma
Parameters:
(1) age in years
(2) LDH as multiple of the upper limit of normal (ULN)
(3) Ann Arbor stage
(4) extranodal disease (lung, CNS, GI tract, liver, bone marrow)
(5) ECOG performance status
Parameter
Finding
Points
age in years
<= 40 years of age
0
41 to 60 years of age
1
61 to 75 years of age
2
> 75 years of age
3
LDH
<= upper limit of normal (ULN)
0
1.01 to 3 times ULN
1
> 3 times ULN
2
Ann Arbor Stage
I or II
0
III or IV
1
extranodal disease
absent
0
present
1
ECOG performance status
0 or 1
0
2, 3 or 4
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the worse the prognosis.
Total Score
Risk Group
5 year overall survival
0 or 1
low
96%
2 or 3
low intermediate
82%
4 or 5
high intermediate
64%
6 to 8
high
33%
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