MIPI Calculator

Mantle Cell Lymphoma International Prognostic Index for risk assessment

Calculate MIPI Score

years

Patient's age at diagnosis

Fully active, no restrictions

U/L

Lactic acid dehydrogenase level

U/L

Laboratory's upper normal limit (typically 160 U/L)

×1000/µL

Normal range: 4.3-10.8 ×1000/µL

Ki-67 is used to calculate MIPI-b (biologic MIPI) for more accurate prognosis

MIPI Results

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MIPI Score

Formula used: MIPI = 0.03535 × age + [1.367 × log₁₀(LDH/ULN) + 0.9393 × log₁₀(WBC)]

Medical Disclaimer: This calculator is for educational purposes only and provides statistical estimates based on historical data. Individual outcomes may vary significantly. Always consult with an oncologist for proper diagnosis and treatment planning.

Risk Group Classifications

Low Risk
MIPI < 5.7
5-year survival: >60%
Intermediate Risk
MIPI 5.7 - 6.2
Median: 51 months
High Risk
MIPI ≥ 6.2
Median: 29 months

Example Case

Patient Steven (65 years old)

Age: 65 years

ECOG: 1 (symptoms present, can do light work)

LDH: 2500 U/L

ULN LDH: 160 U/L

WBC: 20 ×1000/µL

Calculation Result

MIPI = 0.03535 × 65 + 0.6978 + [1.367 × log₁₀(2500/160) + 0.9393 × log₁₀(20)]

MIPI = 7.97

Risk Group: High Risk

Median Survival: 29 months

ECOG Performance Status

0

Fully active, no restrictions

1

Restricted in strenuous activity, ambulatory and able to light work

2

Ambulatory >50% of waking hours, unable to work, can care for self

3

Limited self-care, confined to bed/chair >50% of waking hours

4

Completely disabled, confined to bed/chair, cannot care for self

Normal Laboratory Values

LDH (Lactic Acid Dehydrogenase)

Normal: 140-280 U/L

Common ULN: 160 U/L

White Blood Cells (WBC)

Normal: 4.3-10.8 ×1000/µL

Ki-67 Proliferation Index

Low: <30%

High: ≥30%

Treatment Considerations

Low risk: Standard immunochemotherapy may be sufficient

Intermediate risk: Consider intensified treatment approaches

High risk: Aggressive treatment and targeted therapies indicated

Consider clinical trials for novel treatments

Understanding MIPI and Mantle Cell Lymphoma

What is MIPI?

The Mantle Cell Lymphoma International Prognostic Index (MIPI) is a validated scoring system used to assess prognosis and guide treatment decisions in patients with mantle cell lymphoma (MCL). It was developed based on analysis of 455 patients with advanced-stage MCL.

Clinical Applications

  • Risk stratification at diagnosis
  • Treatment planning and intensity selection
  • Patient counseling and prognosis discussion
  • Clinical trial stratification

MIPI Components

MIPI = 0.03535 × age + ECOG component + LDH component + WBC component

Where ECOG component = 0.6978 if ECOG > 1, otherwise 0

  • Age: Patient age at diagnosis (continuous variable)
  • ECOG PS: Performance status (0-4 scale)
  • LDH: Serum lactate dehydrogenase level
  • WBC: White blood cell count
  • Ki-67: Optional proliferation marker for MIPI-b

About Mantle Cell Lymphoma

Mantle cell lymphoma is a rare and aggressive B-cell non-Hodgkin lymphoma that typically affects older adults. It accounts for approximately 6% of all non-Hodgkin lymphomas and is characterized by the translocation t(11;14) involving the cyclin D1 gene.

  • Median age: 65-70 years
  • Male predominance: 3-4:1 ratio
  • Common sites: Lymph nodes, spleen, GI tract
  • Prognosis: Variable, improved with modern therapies

MIPI vs MIPI-b

MIPI-b (biologic MIPI) incorporates the Ki-67 proliferation index in addition to the four standard MIPI variables, providing enhanced prognostic accuracy.

  • MIPI: Age, ECOG, LDH, WBC
  • MIPI-b: MIPI + Ki-67 proliferation index
  • Ki-67 <30%: Lower proliferation, better prognosis
  • Ki-67 ≥30%: Higher proliferation, worse prognosis

Important Limitations

  • • MIPI was developed in the era of conventional chemotherapy; modern targeted therapies may improve outcomes
  • • Individual patient outcomes may vary significantly from population-based estimates
  • • MIPI does not incorporate molecular markers beyond Ki-67
  • • Should be used in conjunction with other clinical factors and judgment