Statistical & Clinical Analysis
IPI & R-IPI Score Formula: Diffuse Large B-Cell Lymphoma Prognostic Index (0 to 5)
Calculate Margaret Shipp’s landmark 5-factor International Prognostic Index (IPI, 0–5: Age > 60, Stage III–IV, LDH > ULN, ECOG >= 2, Extranodal sites > 1) across standard 4-tier IPI and Sehn’s 3-tier Rituximab R-IPI.
Five universal lymphoma clinical factors (APLES) across both classic 4-tier IPI and R-CHOP 3-tier R-IPI!
Published by the International Non-Hodgkin’s Lymphoma Prognostic Factors Project led by Margaret A. Shipp et al. (1993, New England Journal of Medicine — 2,031 aggressive NHL patients), the International Prognostic Index (IPI, mnemonic APLES, 0–5 points) assigns +1 point each for: Age > 60 years, ECOG Performance Status >= 2, Serum LDH > 1 × ULN, Extranodal involvement > 1 site, and Ann Arbor Stage III or IV!
Classic IPI defines four risk groups: Low (0–1), Low-Intermediate (2), High-Intermediate (3), and High Risk (4–5, where Pola-R-CHP vs R-CHOP and CNS prophylaxis assessments are routinely anchored in IPI >= 2–3 trials), while Laurie H. Sehn et al. (2007, Blood) regrouped the exact same 0–5 sum for R-CHOP immunochemotherapy into Very Good (R-IPI 0), Good (R-IPI 1–2), and Poor (R-IPI 3–5)!
| IPI Factor Sum (0–5) | Classic 4-Group Shipp IPI (1993) | 3-Group Sehn R-IPI (R-CHOP Era) |
|---|---|---|
| 0 Factors | Low Risk (0–1) | Very Good (> 90% 4-Yr PFS/OS) |
| 1–2 Factors | 1 = Low; 2 = Low-Intermediate | Good (~80% 4-Yr OS) |
| 3 Factors | High-Intermediate Risk | Poor (~55%–60% 4-Yr OS) |
| 4–5 Factors (e.g., 4) | High Risk (4–5) | Poor — Clinical Trial / Intensified Regimen Consideration |
Total 5-Factor Shipp Aggressive Lymphoma IPI Score (0 to 5)
Sums Age > 60, ECOG >= 2, LDH > ULN, Extranodal > 1, and Stage III–IV across B2:B6.
=IF(OR(MIN(B2:B6) < 0, MAX(B2:B6) > 1), "Each IPI Factor Must Be 0 or 1", SUM(B2:B6))Classic 4-Tier Shipp IPI Risk Group Classifier (Low, Low-Int, High-Int, High)
Maps IPI 0–1 -> Low, 2 -> Low-Intermediate, 3 -> High-Intermediate, and 4–5 -> High Risk.
=IF(OR(MIN(B2:B6) < 0, MAX(B2:B6) > 1), "Each IPI Factor Must Be 0 or 1", IF(SUM(B2:B6) >= 4, "High Risk (IPI 4–5)", IF(SUM(B2:B6) = 3, "High-Intermediate Risk (IPI 3)", IF(SUM(B2:B6) = 2, "Low-Intermediate Risk (IPI 2)", "Low Risk (IPI 0–1)"))))Try the example
Use the original values or change them to test your understanding.