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Blood, 1 March 2007, Vol. 109, No. 5, pp. 1857-1861. Prepublished online as a Blood First Edition Paper on November 14, 2006; DOI 10.1182/blood-2006-08-038257. This Article Full Text (PDF) All Versions of this Article: blood-2006-08-038257v1 109/5/1857    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Sehn, L. H Articles by Connors, J. M Search for Related Content PubMed PubMed Citation Articles by Sehn, L. H Articles by Connors, J. M Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted August 10, 2006 Accepted October 13, 2006 Revised International Prognostic Index (R-IPI) is a better predictor of outcome than the Standard IPI for patients with DLBCL treated with R-CHOP Laurie H Sehn*, Brian Berry, Mukesh Chhanabhai, Catherine Fitzgerald, Karamjit Gill, Paul Hoskins, Richard Klasa, Kerry J Savage, Tamara Shenkier, Judy Sutherland, Randy D Gascoyne, and Joseph M Connors Division of Medical Oncology & the Dept of Pathology, BC Cancer Agency, Vancouver, Canada * Corresponding author; email: lsehn{at}bccancer.bc.ca. Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous entity with patients exhibiting a wide range of outcomes. The addition of rituximab to CHOP chemotherapy (R-CHOP) has led to a marked improvement in survival and has called into question the significance of previously recognized prognostic markers. Since randomized controlled trials of R-CHOP in DLBCL have included select groups of patients, the utility of the International Prognostic Index (IPI) has not been reassessed. We performed a retrospective analysis of patients with DLBCL treated with R-CHOP in the province of British Columbia to assess the value of the IPI in the era of immuno-chemotherapy. While the IPI remains predictive, it only identifies two risk groups. Redistribution of the IPI factors into a Revised IPI (R-IPI) provides a more clinically useful prediction of outcome. The R-IPI identifies three distinct prognostic groups with a very good (4-year PFS 94%, OS 94%), good (4-year PFS 80%, OS 79%) and poor (4-year PFS 53%, OS 55%) outcome, respectively (p<0.0001). The IPI (or R-IPI) no longer identifies a risk group with less than a 50% chance of survival. In the era of R-CHOP treatment, the R-IPI is a clinically useful prognostic index that may help guide treatment planning and interpretation of clinical trials. 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