The International Prognostic Index in aggressive B-cell lymphoma
Matthew J. Maurer
Abstract
Prognostication and risk assessment are standard components of a clinical workup for a patient with a newly diagnosed hematologic malignancy.The information given by a prognostic tool provides guidance for treatment selection, helps to define clinical trial eligibility, and is useful for patient counseling.The development of an accurate measure of prognosis that can be broadly applied in a disease setting is a deceptively difficult endeavor.It requires assembly of a dataset that has a sufficiently large number of entries for statistical modeling, is representative of patients with the disease, and has adequate follow-up to assess clinically relevant outcomes.Furthermore, information in models may become clinically obsolete as new therapies are developed and/or the natural history of the disease evolves.The International Prognostic Index (IPI) 1 was published in 1993 and has been a clinically relevant prognostic tool in aggressive B-cell lymphoma for 30 years.The fact that we are still using the model to define patient populations in this disease in 2023 is frankly remarkable.