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Clinical calculator summary

Original continuous Mantle Cell Lymphoma International Prognostic Index

A four-factor continuous prognostic equation for advanced-stage mantle cell lymphoma.

Evidence-based context for fast calculator use

Purpose:
Assign the source-defined low, intermediate, or high MIPI group from pretreatment values.
Population:
Original derivation: advanced-stage mantle cell lymphoma trial participants able to tolerate moderately intensive chemotherapy.
Factors:
Age, ECOG performance status, LDH relative to ULN, WBC count
Reference:
Hoster et al. Blood. 2008;111:558-565; erratum Blood. 2008;111:5761.
HomeOriginal Continuous MIPI (Mantle Cell Lymphoma)
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Original Continuous MIPI (Mantle Cell Lymphoma)

years
U/L
U/L
x10^9/L

Clinical Context & Background

This page implements the original continuous Mantle Cell Lymphoma International Prognostic Index (MIPI), not the simplified MIPI, biologic MIPI (MIPI-b), or combined MIPI-c.
The original model was derived in 455 trial participants with advanced-stage mantle cell lymphoma who could tolerate moderately intensive chemotherapy. Age in the derivation cohort ranged from 34 to 86 years. Ages 18-120 are accepted as a product safety guard, with a visible applicability warning outside 34-86 years.
The displayed survival figures are historical observations from the original 1996-2004 cohort, not current individualized survival predictions. MIPI supports prognostic stratification and does not independently select treatment.
Formula Logic
Original continuous MIPI: WBC cells/microliter = WBC (x10^9/L) x 1000 Score = (0.03535 x age) + (0.6978 x I[ECOG > 1]) + (1.367 x log10[LDH / ULN]) + (0.9393 x log10[WBC cells/microliter]) Low risk: score < 5.7 Intermediate risk: score >= 5.7 and < 6.2 High risk: score >= 6.2

Reference Data

Risk GroupContinuous MIPI scoreHistorical original-cohort observation
Low Risk< 5.7Median OS not reached; observed 5-year OS 60%
Intermediate Risk>= 5.7 and < 6.2Median OS 51 months
High Risk>= 6.2Median OS 29 months

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

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

When To Use

  • Use for baseline prognostic stratification in advanced-stage mantle cell lymphoma when all four pretreatment variables are available.
  • Enter WBC in x10^9/L; the calculator converts it internally to cells/microliter for the original continuous equation.

How To Interpret

  • Classify the unrounded continuous score: low <5.7, intermediate >=5.7 and <6.2, high >=6.2.
  • Treat the displayed survival figures as historical original-cohort observations, not individualized current predictions.

What To Do Next

  • Document the four inputs, institutional LDH ULN, full score, risk group, and any applicability warning.
  • Integrate MIPI with pathology, disease extent, fitness, patient goals, and current disease-specific guidance; do not use it alone to select treatment.

Limitations

  • The derivation cohort age range was 34-86 years; results outside that range carry an applicability warning.
  • The model was developed in advanced-stage disease and a historical treatment era; it is not the simplified, biologic, or combined MIPI.

Validated Population

Advanced-stage mantle cell lymphoma in the original European MCL Network trial cohort; age 34-86 years.

Unit conversion matters

A WBC entry of 10 x10^9/L is converted to 10,000 cells/microliter before log10 is applied.

Calculation verification history

Verified
  1. : Production browser revalidation

    • Three source-backed cases passed through visible production controls at continuous MIPI 4.11, 6.12, and 9.80.
    • Low, Intermediate, and High groups rendered on first submission.
    • No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
    Download latest production check (Excel)

    Case-level evidence is retained in validation/browser-revalidation/mipi-mantle-cell-lymphoma-index-2026-08-03.json.

  2. : Boundary-safe display and positive laboratory guards corrected and browser-revalidated locally

    • Raw scores below 5.7 or 6.2 that round to the next cutoff now display <5.70 or <6.20; exact cutoff classifications retain their ordinary display.
    • LDH, LDH ULN, and WBC now visibly enforce the existing strictly-positive engine contract before calculation.
    • The age-18 result rendered immediately on a fresh route load and after reset; ten visible-browser cases passed across 11 submissions and the original equation remains 241/241 verified.

    Case-level local remediation evidence is retained in validation/browser-production/mipi-mantle-cell-lymphoma-index.local-remediation.json; the original production finding remains retained separately.

  3. : Production browser validation

    • Ten source-backed cases were exercised on the public production route through visible browser controls; 7/10 case records passed their expected-versus-observed assertions across 12 visible submissions.
    • Overall browser status: failed-ui-and-console. high: Raw scores immediately below 5.7 and 6.2 are correctly classified using full precision but displayed as `5.70 Low Risk` and `6.20 Intermediate Risk`, contradicting the visible reference cutoffs that map >=5.7 to Intermediate and >=6.2 to High. | high: The first completed age-18 lower-bound submission produced no result and no required-field message. An immediate identical supplemental reproduction returned the correct 4.11 Low Risk result and warning. | 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/mipi-mantle-cell-lymphoma-index.json.

  4. : Browser input adapter corrected and reverified

    • Accepted finite number values already normalized by the shared calculator form while retaining strict malformed-input rejection.
    • No equation, cutoff, unit, classification, or applicability rule changed; calculator-specific verification and the calculator-wide browser-input audit passed.
  5. : Full validation test

    • Verified independent low, intermediate, and high cases; exact raw thresholds; all ECOG states; age guards and applicability warnings; positive laboratory domains; invalid inputs; trace; public history wiring; and displayed precision across 241 checks.
  6. : Correction history

    • Fixed the WBC unit conversion: values entered in x10^9/L are now multiplied by 1000 before log10, as required by the corrected original continuous equation.
    • Removed the silent ECOG default, enforced complete valid inputs, added the age 18-120 product guard, and flagged ages outside the 34-86-year derivation cohort.

    Included in the current validation report.

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

Which MIPI version is implemented?

The original continuous four-factor MIPI. This page does not calculate simplified MIPI, MIPI-b, or MIPI-c.

What WBC unit should I enter?

Enter WBC in x10^9/L. The calculator multiplies by 1000 to obtain cells/microliter before applying the logarithmic term required by the corrected original equation.

Why is there an age applicability warning?

The original derivation cohort included ages 34-86 years. The product accepts adult ages 18-120 but flags results outside the source population.

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