Clinical calculator summary
NCCN International Prognostic Index
Clinical calculator summary
NCCN International Prognostic Index
Five-factor additive prognostic index for newly diagnosed DLBCL in the rituximab era.
Evidence-based context for fast calculator use
- Purpose:
- Assign a source-defined NCCN-IPI risk group from a complete baseline assessment.
- Population:
- Patients with newly diagnosed de novo DLBCL treated with rituximab-based immunochemotherapy in the original study setting.
- Factors:
- Age, LDH ratio to institutional ULN, Ann Arbor stage, ECOG performance status, Major extranodal sites
- Reference:
- Zhou et al. Blood. 2014;123(6):837-842. doi:10.1182/blood-2013-09-524108.
NCCN-IPI (Lymphoma)
Clinical Context & Background
Add source-defined points for five factors; total 0-8.Reference Data
| Risk Group | Score | Observed 5-year overall survival (original development cohort) |
|---|---|---|
| Low Risk | 0 - 1 | 96% |
| Low-Intermediate Risk | 2 - 3 | 82% |
| High-Intermediate Risk | 4 - 5 | 64% |
| High Risk | 6 - 8 | 33% |
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 baseline for prognostic stratification after a diagnosis of newly diagnosed de novo DLBCL and complete staging.
- Confirm age, the LDH ratio using the same institution's ULN, Ann Arbor stage, ECOG performance status, and the specified extranodal sites before calculating.
How To Interpret
- Map the exact 0-8 total to the source-defined risk group.
- Treat 96%, 82%, 64%, and 33% as observed 5-year overall survival in the original development cohort, not as an individualized prognosis.
What To Do Next
- Document the five inputs, total, risk group, assessment date, and clinical context so the result can be reproduced.
- Integrate the prognostic group with pathology, staging, molecular findings, comorbidity, patient goals, and current disease-specific guidance; do not use NCCN-IPI alone to select treatment.
Limitations
- The model was developed for de novo DLBCL in the rituximab era and should not be transferred to another histology or disease setting without supporting evidence.
- Cohort survival observations do not determine an individual patient's outcome or treatment intensity.
Validated Population
Newly diagnosed de novo DLBCL in the original NCCN development cohort; external validation was performed in a population-based British Columbia cohort.
Interpret the total, not a single factor
A total of 4 maps to the high-intermediate group and the original development-cohort observation of 64% 5-year overall survival; it is not a patient-specific survival prediction.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed NCCN-IPI cases passed through visible production controls at scores 0, 4, and 8.
- The unsupported generic three-band gauge was 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/nccn-ipi-lymphoma-prognostic-index-2026-08-03.json.
: Local browser remediation
- Valid NCCN-IPI results now explicitly suppress the shared three-band gauge so the four source-defined groups remain distinct.
- Ten source-backed cases passed through visible local browser controls across 11 submissions, covering totals 0-8, all four groups, every age/LDH category, required-field validation, and reset/repeat behavior.
- The existing calculator-specific audit passed 581/581. 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/nccn-ipi-lymphoma-prognostic-index.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-ui-and-console. high: Every valid result displayed a generic Low Risk / Intermediate / High Risk gauge even though NCCN-IPI has four source-defined groups. The gauge collapses Low-Intermediate and High-Intermediate into one unlabeled middle band. | 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/nccn-ipi-lymphoma-prognostic-index.json.
: Full validation test
- Verified all 96 valid combinations, exact 0-8 totals and risk transitions, age and LDH boundary serialization, cohort observations, matched rows, additive trace, strict invalid-input rejection, no-default/reset behavior, immutability, and exact UI serialization.
: Correction history
- Removed favorable defaults and enforced strict inputs, clarified the LDH >1 to <=3 x ULN boundary, and relabeled 5-year survival values as development-cohort observations rather than individualized prognosis.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Frequently Asked Questions
What is the exact LDH boundary?
A ratio at or below 1 x ULN scores 0; a ratio above 1 through 3 x ULN scores 1; a ratio above 3 x ULN scores 2.
Are the displayed 5-year survival percentages individualized estimates?
No. They are observed outcomes in the original development cohort for each risk group and are not individualized prognoses.
Does NCCN-IPI determine treatment?
No. It supports prognostic stratification and must be interpreted with the complete clinical assessment and current disease-specific guidance.
Evidence-based oncology decision support. Verify with clinical guidelines.