Relevance of the International Prognostic Index in the Rituximab Era

TO THEEDITOR:Wereadwithinterestthismeta-anaylsisbyZiepert etal 1 involving1,062patientswithdiffuselargeB-celllymphomaaccrued fromthreeprospectivephaseII/IIItrials:MinT(Mab-TheraInternational Trial), RICOVER-60 (cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab [R-CHOP] for patients older than age 60 years),andMegaCHOEP(dose-escalatedregimenofcyclophosphamide, doxorubicin,vincristine,etoposide,andprednisone)trials. 2-4 Theauthors affirms the prognostic relevance of the International Prognostic Index (IPI)scoreforallthreeendpointsofprogression-freesurvival,event-free survival,andoverallsurvival.Thus,theyconcludedthatIPIshouldremain the major tool for risk stratification for patients with diffuse large B-cell lymphoma in the era of rituximab. WhileweagreewithZiepertetal 1 thattheIPIwillremainanimpor