What is the IPI for risk stratification of diffuse large B-cell lymphoma (DLBCL)?

Updated: Feb 25, 2021
  • Author: Sanjay Vinjamaram, MD, MPH; Chief Editor: Emmanuel C Besa, MD  more...
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The NCCN and the European Society for Medical Oncology (ESMO) recommend use of the International prognostic index (IPI) for all patients. Age-adjusted International Prognostic Index (aa-IPI) should be used for risk stratification of patients aged 60 years and younger. [26, 79]

The IPI includes the following risk factors:

  • Age >60 years

  • Elevated serum lactate dehydrogenase (LDH) level

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

  • Stage III or IV disease

  • Extranodal involvement >1 site

Each risk factor is worth 1 point. On the basis of the IPI score, patients can be categorized as follows:

  • Low risk (0-1 point)

  • Low-intermediate risk (2 points)

  • High-intermediate risk (3 points)

  • High risk (4-5 points)

The aa-IPI includes the following risk factors (1 point is allotted for each factor) [68] :

  • Elevated LDH level
  • Stage III or IV disease
  •  ECOG performance status ≥2

Based on the aa-IPI score, patients can be categorized as follows [68] :

  • Low risk (0 points)

  • Low-intermediate risk (1 point)

  • High-intermediate risk (2 points)

  • High risk (3 points)

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