How is risk stratified in non-Hodgkin lymphoma (NHL)?

Updated: Feb 25, 2021
  • Author: Sanjay Vinjamaram, MD, MPH; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

In addition to staging, risk stratification is important in patients with NHL. Prospectively validated scoring systems that can be used to determine prognosis include the International Prognostic Index (IPI) for patients with diffuse large B-cell lymphoma and the Follicular Lymphoma International Prognostic Index, (FLIPI) for patients with follicular B-cell lymphomas. The greater the number of risk factors present, the higher the risk.

The IPI for NHL is as follows:

  • Age older than 60 years

  • ECOG grade greater than or equal to 2

  • Elevated LDH value

  • Two or more extranodal sties

  • Ann Arbor stage III or IV

The FLIPI score is as follows:

  • Number of nodal sites of 5 or more

  • Elevated LDH value

  • Age 60 years or older

  • Ann Arbor stage III–IV

  • Hemoglobin value less than 12 g/dL


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