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Clinical calculator summary

International Prognostic Index (IPI)

The original International Prognostic Index (IPI) is a five-factor additive prognostic model developed in patients with aggressive non-Hodgkin lymphoma.

Evidence-based context for fast calculator use

Purpose:
Original five-factor International Prognostic Index for prognostic stratification in aggressive non-Hodgkin lymphoma.
Population:
patients with the specific hematologic diagnosis and disease phase described by the model
Factors:
Age > 60 years?, Ann Arbor Stage III or IV?, LDH > institutional upper limit of normal?, ECOG Performance Status ≥ 2?, More than 1 extranodal disease site?
Reference:
The International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med. 1993;329(14):987-994. doi:10.1056/NEJM199309303291402.
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International Prognostic Index (IPI)

Clinical Context & Background

The original International Prognostic Index (IPI) is a five-factor additive prognostic model developed in patients with aggressive non-Hodgkin lymphoma. One point is assigned for each adverse factor: age >60 years, Ann Arbor stage III/IV, LDH above the institutional upper limit of normal, ECOG performance status >=2, and more than one extranodal disease site.
Scores 0-1, 2, 3, and 4-5 define low, low-intermediate, high-intermediate, and high risk. The displayed 5-year overall survival values of 73%, 51%, 43%, and 26% are historical observations from the original pre-rituximab cohort. They are not contemporary R-CHOP outcomes, individualized prognoses, or treatment-intensity directives.
Primary Source EvidenceThe International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med. 1993;329(14):987-994. doi:10.1056/NEJM199309303291402.
Formula Logic
Add 1 point for each of five adverse factors; total 0-5.

Reference Data

Risk GroupScoreHistorical pre-rituximab 5-year overall survival (original cohort)
Low Risk0 - 173%
Low-Intermediate251%
High-Intermediate343%
High Risk4 - 526%

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use International Prognostic Index (IPI) when original five-factor International Prognostic Index for prognostic stratification in aggressive non-Hodgkin lymphoma.
  • Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.

How To Interpret

  • Interpret the displayed result using the calculator-specific formula and reference table, spanning Low Risk through High Risk.
  • A boundary result should prompt input verification and clinical review rather than false precision.

What To Do Next

  • Confirm morphology, molecular/cytogenetic data, treatment timing, laboratory units, and the current disease-specific guideline before acting.
  • Document the inputs, result, timing, and clinical context so the assessment can be reproduced.

Limitations

  • Hematology scores are diagnosis-, phase-, and treatment-specific and should not be transferred between diseases.
  • The result supports clinician judgment and does not independently determine treatment.

Validated Population

patients with the specific hematologic diagnosis and disease phase described by the model

How to apply this result

For a representative case, verify Age > 60 years?, Ann Arbor Stage III or IV?, LDH > institutional upper limit of normal?, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.

Hematology hubContinue to related calculators and clinical workflow resources.

Calculation verification history

Verified

  1. : Production browser revalidation

    • Three source-backed original IPI cases passed through visible production controls at scores 0, 2, and 5.
    • The unsupported generic three-band gauge was absent; no unexpected N/A, literal undefined value, stale control, or browser-console error was observed.
    Download latest production check (Excel)

    Case-level evidence is retained in validation/browser-revalidation/international-prognostic-index-lymphoma-2026-08-03.json.

  2. : Local browser remediation

    • Valid original IPI results now explicitly suppress the shared three-band gauge so its four source-defined groups remain distinct.
    • Ten source-backed cases passed through visible local browser controls across 11 submissions, covering scores 0-5, all four groups, isolated factors, required-field validation, and reset/repeat behavior.
    • The existing calculator-specific audit passed 306/306. Production status remains open until this commit is deployed and the public route is revalidated.

    Local case-level remediation evidence is retained in validation/browser-production/international-prognostic-index-lymphoma.local-remediation.json.

  3. : Production browser validation

    • Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
    • Overall browser status: failed-ui-and-console. high: Every valid original IPI result displayed a generic Low Risk / Intermediate / High Risk gauge that collapses the source-defined Low, Low-Intermediate, High-Intermediate, and High groups into three labels. | 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/international-prognostic-index-lymphoma.json.

  4. : Full validation test

    • Verified all 32 factor combinations, isolated factors, scores 0-5, risk transitions, exact criterion labels, additive trace, strict invalid-input rejection, no-default/reset behavior, immutability, and exact UI serialization.

  5. : Correction history

    • Removed favorable defaults, enforced an exact five-field semantic input contract, and corrected 73%/51%/43%/26% to historical pre-rituximab original-cohort labels.

Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.

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Frequently Asked Questions

When should International Prognostic Index (IPI) be used?

Use it for patients with the specific hematologic diagnosis and disease phase described by the model when all required inputs and the intended clinical setting are confirmed.

Can International Prognostic Index (IPI) determine treatment by itself?

No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.

Evidence-based oncology decision support. Verify with clinical guidelines.