MDS Risk Assessment-IPSS-R

IPSS-R Calculator

Be ready with bone marrow blast %, karyotype results and Hb/ANC/PLT counts. Kindly select only one entry from each group to get correct results.

1. Cytogenetic prognostic subgroups (see list below)

2. BM Blast %

3. Hemoglobin

4. Platelets

5. ANC (Absolute Neutrophil count)


 

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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)