What is the MCL global Prognostic Index (MIPI)?

Updated: Mar 15, 2019
  • Author: Muhammad Rashid Abbasi, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

The European Society for Medical Oncology (ESMO) recommends the 2008 MCL International Prognostic Index (MIPI) for risk stratification. [35]  The MIPI includes the following risk factors [36] :

  • Age: 50-59 (1 point); 60-69 (2 points); ≥70 (3 points)

  • Eastern Cooperative Oncology Group (ECOG) performance status ≥2 (2 points)

  • Lactate dehydrogenase level (ratio to upper limit of normal): 0.67-0.99 (1 point); 1.00-1.49 (2 points); ≥1.50 (3 points)

  • White blood cell count (× 109/L): 6700-9999 (1 point); 10,000-14,999 (2 points); ≥15,000 (3 points)

Based on the MIPI score, patients can be categorized as follows [36] :

  • Low risk (0-3 points)

  • Intermediate risk (4-5 points)

  • High risk (≥6 points)

In addition, both the NCCN and ESMO recommend assaying Ki-67 proliferative antigen to evaluate cell proliferation. Low Ki-67 (< 30%) is associated with a more favorable prognosis; however, it is not used to guide treatment decisions. [8, 35]


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