Jelicic, Jelena (56180044800)Jelena (56180044800)JelicicJuul-Jensen, Karen (57218352166)Karen (57218352166)Juul-JensenBukumiric, Zoran (36600111200)Zoran (36600111200)BukumiricRunason Simonsen, Mikkel (59177988400)Mikkel (59177988400)Runason SimonsenKragh Jørgensen, Rasmus Rask (58838186100)Rasmus Rask (58838186100)Kragh JørgensenRoost Clausen, Michael (58039350000)Michael (58039350000)Roost ClausenLudvigsen Al-Mashhadi, Ahmed (57189056494)Ahmed (57189056494)Ludvigsen Al-MashhadiSchou Pedersen, Robert (59178141900)Robert (59178141900)Schou PedersenBjørn Poulsen, Christian (59177988500)Christian (59177988500)Bjørn PoulsenOrtved Gang, Anne (58039201900)Anne (58039201900)Ortved GangBrown, Peter (56437846200)Peter (56437846200)BrownEl-Galaly, Tarec Christoffer (22634515900)Tarec Christoffer (22634515900)El-GalalyStauffer Larsen, Thomas (35405235400)Thomas (35405235400)Stauffer Larsen2025-06-122025-06-122025https://doi.org/10.1007/s00277-024-06155-3https://www.scopus.com/inward/record.uri?eid=2-s2.0-85213712245&doi=10.1007%2fs00277-024-06155-3&partnerID=40&md5=d67662da0f147720cc75ec7f0202aadfhttps://remedy.med.bg.ac.rs/handle/123456789/673The International Prognostic Index (IPI) is the most frequently used tool for prognostication in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) of all ages. This study validated and compared six models developed for patients above 60 with International Prognostic Indices (IPI, R-IPI, NCCN-IPI). Moreover, we created a clinical nomogram with an online tool for individualized predictions. A total of 2,835 patients aged over 60 with newly diagnosed DLBCL treated with potentially curative immunochemotherapy were identified in the Danish Lymphoma Registry. A nomogram was developed by combining NCCN-IPI variables (excluding extranodal localization), albumin, and platelet levels in 1,970 patients and verified the results in the remaining 956 patients. Compared to other models, the elderly IPI (E-IPI) and age-adjusted IPI (aaIPI) showed better accuracy and discriminatory ability. However, the models failed to identify a high-risk group with a 3-year overall survival rate below 40%. Our nomogram-based model demonstrated superior discriminatory ability and provided more precise individual predictions than all other models based on a risk stratification system. Most clinical prognostic models fail to accurately predict patient outcomes in patients over 60 years old. Therefore, nomogram-based models should be considered in this population to prevent information loss due to variable dichotomization. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.ElderlyNomogramPrognostic modelsTo index the content: diffuse large B cell lymphomaValidation