International Prognosis Index

It looks like I don’t qualify for the Enzastauarin clinical trial. My IPI is too low, which turns out to be a good thing.


IPI stands for International Prognosis Index. It was developed 15 years ago by oncologists as a clinical tool to help predict the prognosis of patients with aggressive Non-Hodgkin’s Lymphoma. In the Index, one point is assigned for each of these risk factors:


  • Age greater than 60 years
  • Stage III or IV disease
  • Elevated serum LDH
  • ECOG/Zubrod performance status of 2, 3, or 4
  • More than 1 extranodal site

The total points correlate to the following risk groups:


  • Low risk (0-1 points) – 5-year survival of 73%
  • Low-intermediate risk (2 points) – 5-year survival of 51%
  • High-intermediate risk (3 points) – 5-year survival of 43%
  • High risk (4-5 points) – 5-year survival of 26%  

These correlations may be out of date in that they are based on data prior to the widespread use of Rituximab. When added to CHOP chemotherapy, Rituximab has dramatically improved the outcomes for B-cell lymphoma patients. It is so effective that some oncologists feel it is tantamount to malpractice not to use it.


My IPI is 1, which means I have a low risk of return and a high chance of staying in remission, but there are no guarantees. If the cancer does come back, the next course of action is a bone marrow transplant and I don’t want to contemplate that possibility right now. I’m in the clinic today for my sixth and final round of chemo. I want to bake bask in the victory of that for now.



6 thoughts on “International Prognosis Index

  1. Mike,
    That is fantastic news with the low score we are so happy for you. I looked at your climbing photos and couldn’t see a belay rope for you. That’s pretty awesome to climb cliffs like that. I hang on too tight when I’m more than 10 ft up.

  2. Mike,
    Thrilled to know you are on your last round of Chemo and that your IPI is so low! Much to be thankful for!
    Have a wonderful Thanksgiving. Pass on special hugs to the two very special kids the four of us feel blessed to call our own … Dave

  3. And what perfect timing for the last round. . .just in time for a big Thanks-giving. 🙂 Nate & I give thanks a lot for you, for your healing, but also that we’ve had the blessing of being in CO with you guys during the process. Love you! See you Thursday. 🙂

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