Clinical calculator summary
Original Follicular Lymphoma International Prognostic Index (FLIPI-1)
Clinical calculator summary
Original Follicular Lymphoma International Prognostic Index (FLIPI-1)
Five-factor additive prognostic index for follicular lymphoma at initial diagnosis.
Evidence-based context for fast calculator use
- Purpose:
- Assign the original FLIPI-1 prognostic group from a complete baseline assessment.
- Population:
- Patients with follicular lymphoma at initial diagnosis represented in the original 1985-1992 development dataset.
- Factors:
- Age >=60 years, Ann Arbor stage III-IV, Hemoglobin <120 g/L, LDH above institutional ULN, More than 4 involved nodal areas
- Reference:
- Solal-Céligny P, et al. Blood. 2004;104(5):1258-1265.
FLIPI (Follicular Lymphoma)
Clinical Context & Background
One point each: age >=60 years + Ann Arbor stage III-IV + hemoglobin <120 g/L (<12.0 g/dL) + LDH > institutional ULN + involved nodal areas >4.Reference Data
| Risk Group | Score | Historical 5-year / 10-year overall survival |
|---|---|---|
| Low Risk | 0 - 1 | 90.6% / 70.7% |
| Intermediate Risk | 2 | 77.6% / 50.9% |
| High Risk | 3 - 5 | 52.5% / 35.5% |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use at initial follicular lymphoma diagnosis after the five source-defined baseline factors are known.
- Count involved nodal areas using the publication method: cervical, axillary, inguino-crural, para-aortic/iliac, celiac/mesenteric, and ancillary regions; bilateral involvement counts as two areas.
How To Interpret
- Sum the five adverse factors and map the exact 0-5 total to low, intermediate, or high risk.
- Treat the displayed 5- and 10-year overall survival values as historical observations from the original pre-rituximab-era model-development cohort.
What To Do Next
- Document all five factor responses, the total, the risk group, and the assessment date so the result can be reproduced.
- Assess treatment indication and selection separately using the full clinical context and current guidance; FLIPI-1 is prognostic, not a treatment rule.
Limitations
- This implementation is the original FLIPI-1 and must not be interpreted as FLIPI2, m7-FLIPI, PRIMA-PI, or a relapse-specific model.
- Historical cohort survival observations are not individualized contemporary predictions and do not replace clinical judgment.
Validated Population
The original FLIPI development population diagnosed in 1985-1992 and its external confirmation cohort; use is limited to initial-diagnosis follicular lymphoma prognostic stratification.
Interpret the group as historical prognosis
A score of 2 maps to intermediate risk and historical 5-year and 10-year overall survival observations of 77.6% and 50.9%; it does not prescribe treatment.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed FLIPI-1 cases passed through visible production controls at scores 0, 2, and 5.
- The former numeric-radio form-boundary failure and invalid-result gauge were absent; no unexpected N/A, literal undefined value, stale control, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/flipi-lymphoma-prognosis-2026-08-03.json.
: Local browser remediation verified; production retest pending
- Updated the FLIPI-1 form adapter to accept exact numeric 0/1 radio values while preserving the strict five-factor engine.
- Ten local visible-browser cases passed across scores 0-5, all three groups, alternate single-factor branches, required-field feedback, and reset/repeat behavior.
- The production finding remains open until deployment and public revalidation.
Local diagnostic evidence is retained in validation/browser-production/flipi-lymphoma-prognosis.local-remediation.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 1/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
- Overall browser status: failed-calculation-ui-and-console. critical: Every complete FLIPI-1 profile rendered N/A / Invalid Input with the exact-five-factor error. A supplemental maximum-score reproduction showed all five production radio groups checked immediately before Calculate. | medium: Invalid FLIPI result cards displayed a generic Low Risk / Intermediate / High Risk gauge despite the unavailable result. | medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/flipi-lymphoma-prognosis.json.
: Full validation test
- Verified all 32 valid combinations, each factor, score/group boundaries 1/2 and 2/3, scores 4 and 5, ten semantic source thresholds, historical outcome mapping, additive trace, strict invalid-input rejection, no-default behavior, immutability, and exact UI serialization.
: Correction history
- Removed favorable defaults and permissive object-value coercion, required all five exact binary inputs, restored the publication's exact 5-year and 10-year outcome precision, added the nodal-area counting definition and hemoglobin units, and labeled outcomes as historical pre-rituximab-era cohort observations. No valid-input point-formula mismatch was found.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Related Tools
Frequently Asked Questions
Does age 60 count as an adverse factor?
Yes. The model-construction text and Table 4 define age 60 years or older as adverse.
How are involved nodal areas counted?
Use the publication regions: cervical, axillary, inguino-crural, para-aortic/iliac, celiac/mesenteric, and ancillary areas. Bilateral involvement counts as two areas.
Do the survival percentages predict an individual patient's current outcome?
No. They are historical observations from the original pre-rituximab-era model-development cohort.
Evidence-based oncology decision support. Verify with clinical guidelines.