International Prognostic Index


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International Prognostic Index

scale employed in the prognostication of non-Hodgkin lymphoma; based on presence or absence of five components including older age, advanced stage, LDH elevation, more than one extralymphatic site of involvement, and poor performance status of the patient.
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of cases (%) N:22 Gender Male 14 (63.6) Female 8 (36.4) Age Median (min-max) 47 (25-77) Localization Gastric 7 (31.8) Small intestine 11 (50) Colon 4 (18.2) Histological Type DLBHL ** 19 (86.4) MCL *** 1 (4.5) Follicular Lymphoma 1 (4.5) Lymphocytic Lymphoma 1 (4.5) Stage I 4 (18.2) II 13 (59.1) IV 5 (22.7) IPI * Low-risk 13 (59.1) Intermediate 5 (22.7) High 4 (18.2) B symptoms Yes 6 (27.4) No 16 (72.6) LDH level High 11 (50) Normal 11 (50) * IPI: International Prognostic Index, ** DLBCL: diffuse large B cell lymphoma *** MCL: Mantle cell lymphoma Table 3.
Rademaker et al., "An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era," Blood, vol.
Standard International Prognostic Index remains a valid predictor of outcome for patients with aggressive CD20+ B-cell lymphoma in the rituximab era.
International Prognostic Index for aggressive non-Hodgkin's lymphoma is valid for all malignancy grades.
Broussais-Guillaumot et al., "Plasma TNF-a and IL-10 level-based prognostic model predicts outcome of patients with diffuse large B-cell lymphoma in different risk groups defined by the International Prognostic Index," Archivum Immunologiae et Therapiae Experimentalis (Warsz), vol.
The International Prognostic Index (IPI) has been the primary prognostic model used in the management of patients with DLBCL since its publication in 1993 [8].
Further management of non-Hodgkin lymphomas depends on the International Prognostic Index (IPI) which includes age over 60 years, elevated level of serum lactate dehydrogenase (LDH), Eastern Cooperative Oncology Group (ECOG) performance status, lymph nodes involvement, and extranodal sites of disease [13].
International prognostic index (IPI) is a well-established prognostic tool for DLBCL.6 In recent years, interim and end-of-treatment (EOT) positron emission tomography/ computed tomography (PET/CT) scan has been investigated as predictor of prognosis.7 PET/CT provides both anatomic and functional information which leads to more accurate staging and ultimately better choice of treatment.8 Therefore, its use is growing for tumour staging and evaluating the response to treatment in NHL.9 On the basis of these findings, the International Working Group response criteria incorporated PET for assessment of response in aggressive NHL.10
Younger age and early stage, which are part of the international prognostic index (IPI), are independent prognostic factors affecting overall and disease-free survival.
Concordant but not discordant bone marrow involvement in diffuse large B-cell lymphoma predicts a poor clinical outcome independent of the International Prognostic Index. Blood 2007; 110 (4): 1278-82.

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