MDS Risk Assessment-IPSS-R

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