International Prognostic Index for non-Hodgkin lymphoma


Age >60 years old (1 point)

Serum lactate dehydrogenase concentartion above normal (1 point)

Ann Arbor stage III or IV (1 point)

More than one extranodal disease site (1 point)
ECOG performance scale

Performance status 0: Fully active; no performance restrictions (0 points)

Performance status 1: Strenuous physical activity restricted; fully ambulatory and able to carry out light work (0 points)

Performance status 2: Capable of all self-care but unable to carry out any work activities. Up and about >50 percent of waking hours (1 point)

Performance status 3: Capable of only limited self-care; confined to bed or chair >50 percent of waking hours (1 point)

Performance status 4: Completely disabled; cannot carry out any self-care; totally confined to bed or chair (1 point)

Total Criteria Point Count:


When applied to a group of 2031 patients with aggressive non-Hodgkin lymphoma treated with anthracycline-based regimens that did NOT include rituximab, 5 year overall survival (OS) and complete response (CR) rates were as follows:

0 to 1 point: Low risk with 73% 5 year OS and 87% CR
2 points: Low-intermediate risk with 51% 5 year OS and 67% CR
3 points: High-intermediate risk with 43% 5 year OS and 55% CR
4 to 5 points: High risk with 26% 5 year OS and 44% CR



When applied to 1063 patients treated with rituximab plus CHOP/CHOP-like chemotherapy, 3 year event-free survival (EFS), progression free survival (PFS) and complete response (CR) rates were as follows:

0 to 1 point: EFS 81%, PFS 87% and OS 91%
2 points: EFS 69%, PFS 75% and OS 81%
3 points: EFS 53%, PFS 59% and OS 65%
4 to 5 points: EFS 50%, PFS 50% and OS 59%

  • ECOG: Eastern Cooperative Oncology Group
  • NHL: Non-Hodgkin lymphoma

  1. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med. 1993 Sep 30;329(14):987-94. PubMed ID: 8141877 PubMed Logo
  2. Ziepert M, Hasenclever D, Kuhnt E, et al. Standard International prognostic index remains a valid predictor of outcome for patients with aggressive CD20+ B-cell lymphoma in the rituximab era. J Clin Oncol. 2010 May 10;28(14):2373-80. Epub 2010 Apr 12. Erratum in: J Clin Oncol. 2011 Feb 20;29(6):779. PubMed ID: 20385988 PubMed Logo
  3. Oken MM, Creech RH, Tormey DC, et al., Eastern Cooperative Oncology Group, Robert Comis M.D., Group Chair. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982 Dec;5(6):649-55. PubMed ID: 7165009 PubMed Logo


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