# FLIPI, FLIPI2 and POD24 (follicular lymphoma risk)

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

## TL;DR

FLIPI counts five simple things (age over 60, stage III or IV, more than four node areas, raised LDH, low haemoglobin) to predict how a follicular lymphoma will behave; POD24, relapse within two years of starting chemo-immunotherapy, is the single strongest sign of a dangerous one.

## Summary

What is measured: prognosis in follicular lymphoma. How: FLIPI (2004) gives a point each for age over 60, Ann Arbor stage III or IV, more than four nodal areas, LDH above normal and haemoglobin under 120 g/L, with 0 to 1 low, 2 intermediate and 3 or more high risk (ten-year survival of about 70, 50 and 35 percent in the pre-rituximab series). FLIPI2 (2009) uses beta-2 microglobulin, a node over 6 cm, marrow involvement, haemoglobin and age. m7-FLIPI adds the mutation status of seven genes (EZH2, ARID1A, MEF2B, EP300, FOXO1, CREBBP, CARD11) from a targeted panel. POD24 is not a score but an event: progression within 24 months of first-line chemo-immunotherapy, seen in about a fifth of patients, whose five-year survival falls to about 50 percent against 90 percent for the rest. Inputs come from examination, PET-CT staged by Lugano, blood tests and marrow. What a result changes: FLIPI does not itself trigger treatment (the GELF criteria for tumour burden do) but stratifies trials; POD24 identifies patients for bispecific antibodies (mosunetuzumab, epcoritamab), CAR-T, lenalidomide with rituximab, tazemetostat in EZH2-mutant disease, and a biopsy to exclude transformation. Where it matters: follicular lymphoma.

## Fields

- Kind: Term
- Last checked: 2026-09-17
- Also known as: FLIPI; FLIPI2; FLIPI-2; m7-FLIPI; Follicular Lymphoma International Prognostic Index; POD24; progression of disease within 24 months; early progression follicular lymphoma; GELF criteria; high tumour burden follicular lymphoma

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Follicular_Lymphoma_International_Prognostic_Index
- Wikipedia: https://en.wikipedia.org/wiki/Follicular_Lymphoma_International_Prognostic_Index

## Connected records

- terms: [Deauville score and PET-adapted therapy](https://onco.cc/terms/deauville/), [International Prognostic Index (IPI)](https://onco.cc/terms/ipi-score/), [Lugano classification / Ann Arbor staging](https://onco.cc/terms/lugano-classification/), [Tumour markers (CEA, LDH, chromogranin, thyroglobulin)](https://onco.cc/terms/tumour-markers/)
- drugs: [Lenalidomide](https://onco.cc/drugs/lenalidomide/), [Obinutuzumab](https://onco.cc/drugs/obinutuzumab/), [Rituximab](https://onco.cc/drugs/rituximab/), [Tazemetostat](https://onco.cc/drugs/tazemetostat/)
- targets: [EZH2](https://onco.cc/targets/ezh2/)
- cancers: [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/)

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