International Prognostic Index (IPI) for DLBCL
International Prognostic Index for diffuse large B-cell lymphoma (DLBCL). Predicts overall survival and guides treatment intensity with R-CHOP or similar regimens.
Score interpretation
IPI 0–1: Low risk. 5-year overall survival ~73% with R-CHOP.
→ Standard R-CHOP × 6 cycles. Consider 4 cycles in low-risk stage I/II (modified R-CHOP-14 or R-CHOP-21). Clinical trial enrolment where available. PET-CT after 2–3 cycles.
IPI 2: Low-intermediate risk. 5-year OS ~51%.
→ R-CHOP × 6 cycles standard. Consider CNS prophylaxis if high-risk sites (testis, breast, kidney, adrenal). Interim PET-CT. Haematology/lymphoma MDT.
IPI 3: High-intermediate risk. 5-year OS ~43%.
→ R-CHOP × 6–8 cycles. Discuss clinical trial eligibility. Consolidation ASCT in selected patients. CNS prophylaxis (intrathecal MTX or high-dose IV MTX). Lymphoma MDT.
IPI 4–5: High risk. 5-year OS ~26%.
→ Intensive therapy (DA-EPOCH-R or R-CHOP with augmentation). ASCT if CR1 achieved in eligible patients. Clinical trial strongly encouraged. Palliative discussion if not fit for intensive therapy.
Interpretation bands for the IPI. Apply clinical judgement and local guidance.
References
- A Predictive Model for Aggressive Non-Hodgkin's Lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med. 1993;329(14):987–994.
Related
Curated clinical cross-links plus same-class fallbacks.
- Ann Arbor Staging for Lymphoma · Lymphoma
- CNS International Prognostic Index (CNS-IPI) for DLBCL · Lymphoma
- NCCN-IPI for Diffuse Large B-Cell Lymphoma · Lymphoma
- MALT Lymphoma International Prognostic Index (MALT-IPI) · Lymphoma
- Mantle Cell Lymphoma International Prognostic Index (MIPI) · Lymphoma
- R-IPI — Revised International Prognostic Index for DLBCL · Lymphoma
- Sodium Cromoglicate Nasal Spray · Mast Cell Stabiliser — Allergic Rhinitis
- Olopatadine · H1 antihistamine + mast cell stabiliser
- Hydroxycarbamide (Hydroxyurea) · Cytoreductive agent / Sickle cell disease / CML
- Crizanlizumab · P-selectin Inhibitor — Sickle Cell Disease
- Obinutuzumab · Anti-CD20 Monoclonal Antibody — CLL / Follicular Lymphoma
- Voxelotor · Haemoglobin S Polymerisation Inhibitor — Sickle Cell Disease
- 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.