Glotz and colleagues have recommended adding a prognostic index, such as the International Prognostic Index (IPI). The IPI is composed of five factors that may segregate rapidly growing lymphomas into different survival outcomes on the number of negative prognostic factors. These factors include age older than 60, stage of tumor (grade Ill/IV disease), performance status, extranodal serum lactate dehydrogenase. Thus, a low- or intermediate-risk group would be younger than age 60, have stage l or Il disease, lymphoma located within the lymph nodes, intact functionality, and normal serum lactate.