# CLL-IPI (chronic lymphocytic leukaemia prognostic index)

Source: https://onco.cc/terms/cll-ipi/  
OnCo record `cll-ipi` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

CLL-IPI scores five things at diagnosis (TP53 loss or mutation, unmutated IGHV, raised beta-2 microglobulin, advanced stage and age over 65) to predict time to first treatment and survival; TP53 and IGHV are the two that still change which drug is chosen, because they decide whether chemo-immunotherapy is ever an option.

## Summary

What is measured: prognosis in chronic lymphocytic leukaemia. How: CLL-IPI (2016) gives 4 points for del(17p) or TP53 mutation, 2 for unmutated IGHV, 2 for serum beta-2 microglobulin above 3.5 mg/L, 1 for Binet B or C (Rai I to IV) and 1 for age over 65, giving low (0 to 1), intermediate (2 to 3), high (4 to 6) and very high (7 to 10) risk with five-year survival of about 93, 79, 63 and 23 percent in the derivation data. Inputs: FISH for del(17p), TP53 sequencing, IGHV sequencing (under 98 percent identity to germline means mutated), serum beta-2 microglobulin and clinical staging. What a result changes: the score does not itself start treatment (the iwCLL criteria do); early-stage high-risk patients have been offered trials (CLL12 tested ibrutinib in early stage and delayed progression without improving survival); del(17p) or TP53 mutation rules out chemo-immunotherapy such as FCR for good, favouring continuous BTK inhibitors or venetoclax with obinutuzumab; unmutated IGHV predicts shorter remissions after fixed-duration therapy and is retested rarely because it does not change. Where it matters: CLL, treatment-naive.

## Fields

- Kind: Term
- Last checked: 2026-09-17
- Also known as: CLL-IPI; CLL International Prognostic Index; CLL-IPI score; beta-2 microglobulin in CLL; B2M in CLL; very high risk CLL; high-risk CLL

## Connected records

- terms: [del(17p) / TP53 aberration in CLL](https://onco.cc/terms/del17p-tp53/), [Disease-specific staging and risk systems (FIGO, Ann Arbor, IPI, R-ISS, ELN, IMDC)](https://onco.cc/terms/staging-systems/), [FISH / ISH (in situ hybridisation)](https://onco.cc/terms/fish/), [IGHV mutational status](https://onco.cc/terms/ighv-status/), [SF3B1 mutation](https://onco.cc/terms/sf3b1-mutation/)
- drugs: [Acalabrutinib](https://onco.cc/drugs/acalabrutinib/), [Ibrutinib](https://onco.cc/drugs/ibrutinib/), [Obinutuzumab](https://onco.cc/drugs/obinutuzumab/), [Venetoclax](https://onco.cc/drugs/venetoclax/), [Zanubrutinib](https://onco.cc/drugs/zanubrutinib/)
- cancers: [Chronic lymphocytic leukaemia](https://onco.cc/cancers/cll/), [Chronic lymphocytic leukaemia, first treatment](https://onco.cc/cancers/cll-treatment-naive/)

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