IPSS-R Calculator
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Revised International Prognostic Scoring System (IPSS-R) for Myelodysplastic Syndromes Risk Assessment.
It was developed by the International Working Group for the Prognosis of MDS (IWG-PM) under the aegis of the MDS Foundation. It was created by examining 7012 MDS cases from the United States and Europe.
- Note: Earlier IPSS was used based on BM blasts, cytopenias and karyotype “Greenberg P, Cox C, LeBeau MM et. al. International Scoring System for Evaluating Prognosis in Myelodysplastic Syndromes. Blood. 1997; 89;6: 2079 – 2088. Erratum in Blood 1998; 91:1100.”
- Compared with the IPSS, the IPSS-R includes additional cytogenetic risk groups and describes more chromosomal abnormalities. It decreases the relative weight of elevated BM blast percentage and it considers cytopenias individually, with additional weight given to more severe cytopenias.
Greenberg, Tuechler, Schanz et al, Revised International Prognostic Scoring System (IPSS-R) for Myelodysplastic Syndrome, Blood 120: 2454, 2012.
IPSS-R Prognostic Score Values
Prognostic variable | 0 | 0.5 | 1 | 1.5 | 2 | 3 | 4 |
Cytogenetics | Very Good | Good | Intermediate | Poor | Very Poor | ||
BM Blast % | <=2 | >2-<5% | 5-10% | >10% | |||
Hemoglobin | =>10 | 8-<10 | <8 | ||||
Platelets | =>100 | 50-<100 | <50 | ||||
ANC | =>0.8 | <0.8 |
IPSS-R Cytogenetic risk groups
Cytogenetic prognostic subgroups | Cytogenetic abnormalities |
Very good | -Y, del(11q) |
Good | Normal, del(5q), del(12p), del(20q), double including del(5q) |
Intermediate | del(7q), +8, +19, i(17q), any other single or double independent clones |
Poor | -7, inv(3)/t(3q)/del(3q), double including -7/del(7q), Complex: 3 abnormalities |
Very poor | Complex: >3 abnormalities |
IPSS-R Prognostic Risk Categories
RISK CATEGORY | RISK SCORE |
Very Low | <=1.5 |
Low | >1.5 – 3 |
Intermediate | >3 – 4.5 |
High | >4.5 – 6 |
Very High | >6 |
IPSS-R: Prognostic Risk Category Clinical Outcomes
No. pts | Very Low | Low | Intermediate | High | Very High | |
Patients (%) | 7012 | 19% | 38% | 20% | 13% | 10% |
Median Survival (years) | 8.8 | 5.3 | 3.0 | 1.6 | 0.8 | |
Median time to 25% AML evolution | NR | 10.8 | 3.2 | 1.4 | 0.7 |
OTHER RISK GROUP -PROGNOSTIC SCORING
- [1] WHO-based Prognostic Scoring System (WPSS)
- [2] Lower-Risk MDS Prognostic Scoring System (LR-PSS)
- [3] MD Anderson Comprehensive Scoring System (MDA-CSS)
Read following Review article on MDS prognostic score (click here)