Diffuse large B cell lymphoma prognosis is contingent upon several factors, and can be determined by using a well-established and reliably predictive model known as the Revised International Non-Hodgkin's Lymphoma Prognostic Index (IPI or R-IPI). In order for this to be applicable, the patient must have been diagnosed with DLBCL and be treated with Rituximab-based combination chemotherapy, namely R-CHOP.
The Index uses five factors for a prognosis, assigns a single point to each factor if true, then takes the sum total and uses it to determine a survival rate percentage.
So a patient can have between 0 and 5 points. Here's what those totals mean for a prognosis:
- AGE: Patients over the age of 60 add one point.
- SERUM LDH: If LDH (lactate dehydrogenase) levels are elevated, add one point.
- PERFORMANCE STATUS: If the patient's performance status is determined to be between 2 and 4 add one point.
- DISEASE STAGE: If the patient is diagnosed at stage III or stage IV, add one point.
- EXTRANODAL INVOLVEMENT: If the patient's lymphoma involves more than one extranodal site (such as bone, liver, spleen, or bone marrow), add one point.
- Prognosis: Very good
- Predicted 4-year progression-free survival: 94 percent
- Overall survival: 94 percent
- Prognosis: Good.
- Predicted 4-year progression-free survival: 80 percent
- Overall survival: 79 percent
- Prognosis: Poor
- Predicted 4-year progression-free survival:53 percent
- Overall survival: 55 percent
This index has shown to be a reasonably predictive model in determining a prognosis; however, it will not hold true for every single diagnosed and treated patient.