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Revised International Prognostic Index (R-IPI) for DLBCL

The R-IPI regroups the 5 IPI factors for DLBCL treated with R-CHOP: 0 factors = very good (4-year PFS 94%, OS 94%), 1–2 = good (PFS 80%, OS 79%), 3–5 = poor (PFS 53%, OS 55%).

Age (years)
Ann Arbor stage: Stage I; Stage II; Stage III; Stage IV
LDH above upper limit of normal (yes/no, +1)
ECOG performance status: ECOG 0; ECOG 1; ECOG 2; ECOG 3; ECOG 4
Number of extranodal sites

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Interpretation

Result	Meaning
0	Very good (4-y OS 94%)
1–2	Good (79%)
3–5	Poor (55%)

Formula

Count of IPI factors: age >60 · stage III/IV · LDH > ULN · ECOG ≥2 · >1 extranodal site. 0 very good · 1–2 good · 3–5 poor.

Clinical pearls

Derived retrospectively in British Columbia patients treated with R-CHOP.
The NCCN-IPI (0–8) gives finer separation at the high-risk end.

Examples

r-ipi 65 stage III ldh high ecog 1 extranodal 0 revised ipi 50 yo stage I normal ldh ecog 0 no extranodal disease

FAQ

What is the difference between IPI and R-IPI?

They use the same 5 factors, but the R-IPI groups them into 3 categories (0, 1–2, 3–5) validated in patients treated with R-CHOP.

Evidence

Sehn LH et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with DLBCL treated with R-CHOP. Blood 2007;109:1857–61.

Hematology & Oncology · Reviewed 2026-10-14 · Methodology