cliot (version 1.0.0)

nccn_ipi_score: NCCN-IPI for Diffuse Large B-Cell Lymphoma

Description

Calculates the NCCN-IPI score to predict 5-year overall survival in patients with Diffuse Large B-Cell Lymphoma (DLBCL) treated with rituximab-based chemotherapy. This enhanced index refines the original IPI by better stratifying age and LDH levels and identifying specific high-risk extranodal sites.

Usage

nccn_ipi_score(age, ldh_ratio, extranodal_sites_disease, stage,
               performance_status)

Value

A list containing:

NCCN_IPI_Score

The calculated total score (Range 0-8).

Risk_Group

Classification (Low, Low-Intermediate, High-Intermediate, High).

Est_5_Year_Overall_Survival

Estimated 5-year overall survival percentage.

Arguments

age

Numeric. Patient age in years. <= 40: 0 pts. 41-60: 1 pt. 61-75: 2 pts. > 75: 3 pts.

ldh_ratio

Numeric. Ratio of patient's LDH to the Upper Limit of Normal (ULN). <= 1: 0 pts. > 1-3: 1 pt. > 3: 2 pts.

extranodal_sites_disease

String. Presence of disease in specific high-risk extranodal sites (Bone Marrow, CNS, Liver, GI Tract, or Lung). "bone_marrow", "cns", "liver", "gi_tract", "lung": 1 pt. "none_or_other": 0 pts.

stage

Numeric. Ann Arbor Stage (1-4). Stage III or IV: 1 pt. Stage I or II: 0 pts.

performance_status

Numeric. ECOG Performance Status (0-4). >= 2: 1 pt. < 2: 0 pts.

References

Zhou Z, Sehn LH, Rademaker AW, et al. An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood. 2014;123(6):837-842. doi:10.1182/blood-2013-09-524108

Examples

# Example 1: High Risk
# Age 80 (+3), LDH 4x (+2), Bone Marrow (+1), Stage IV (+1), ECOG 2 (+1)
# Score = 8
nccn_ipi_score(80, 4.0, "bone_marrow", 4, 2)

# Example 2: Low Risk
# Age 35 (0), Normal LDH (0), No high-risk sites, Stage I (0), ECOG 0 (0)
# Score = 0
nccn_ipi_score(35, 0.8, "none_or_other", 1, 0)