CNS-IPI for Diffuse Large B-Cell Lymphoma
Central Nervous System International Prognostic Index (CNS-IPI) for DLBCL. Predicts 2-year risk of CNS relapse and guides CNS prophylaxis decisions in diffuse large B-cell lymphoma.
Score interpretation
→ CNS-IPI Low Risk (0–1): ~1% 2-year CNS relapse risk. Standard R-CHOP chemotherapy; no CNS prophylaxis required. Routine staging with PET-CT; MRI brain if neurological symptoms develop.
→ CNS-IPI Intermediate Risk (2–3): ~3% 2-year CNS relapse risk. Individual discussion re CNS prophylaxis; if high-risk features present (renal/adrenal, testicular, breast involvement), consider IT methotrexate x4 or IV HD-MTX.
→ CNS-IPI High Risk (≥4): >10% 2-year CNS relapse risk. CNS prophylaxis strongly recommended: IV high-dose methotrexate (HD-MTX) preferred over intrathecal; usually given after cycles 2 and 4 of R-CHOP; CSF staging at diagnosis; MRI brain/spine at baseline.
Interpretation bands for the CNS-IPI. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Fong Clinical Risk Score for Colorectal Cancer Recurrence · Oncology
- CRASH Score for Chemotherapy Risk Assessment in Elderly Patients · Oncology
- Ann Arbor Staging System for Lymphoma · Oncology
- Rai Staging System for CLL · Oncology
- Follicular Lymphoma International Prognostic Index (FLIPI) · Oncology
- International Staging System for Multiple Myeloma (ISS) · Oncology
- Methotrexate (Dermatology — Psoriasis) · Disease-Modifying Antirheumatic / Immunosuppressant
- Zoledronic Acid · Bisphosphonate (IV)
- Denosumab · RANK Ligand Inhibitor (Anti-resorptive)
- Sodium Cromoglicate Nasal Spray · Mast Cell Stabiliser — Allergic Rhinitis
- Methotrexate · Chemotherapy / Immunosuppressant — Head and Neck / Granulomatosis
- Olopatadine · H1 antihistamine + mast cell stabiliser
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.