Myelofibrosis DIPSS Plus Risk calculator

The Dynamic International Prognostic Scoring System (DIPSS) was developed by the IWG-MRT and it takes into account progression of disease over time and hence it can be used to evaluate prognosis as a patient’s condition in any time point of disease course.

DIPSS Plus is based on DIPSS and includes additional risk factors, specifically karyotype, transfusion dependency, and platelet count less than 100 × 10⁹/L.

1. Tell about patients clinical and laboratory profile. Select all those factors which are present in your patient ?

Age 65 or above

Constitutional symptoms (see below for definition)

Hemoglobin level <10 g/dL

Leukocyte count >25 × 109/L

Circulating blast cells ≥1%

Platelets <100 × 109/L

Unfavorable karyotype (see below for list)

Red cell transfusion dependent

None of these are applicable in my patient

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The 8 adverse prognostic factors included in DIPSS Plus risk model are

1. Age >65 years -1 POINT
2. Constitutional symptoms -Constitutional symptoms are defined as: Weight loss >10% of baseline in the year preceding diagnosis and/or unexplained fever or excessive sweats persisting for more than 1 month – 1 POINT
3. Hemoglobin <10 g/dL – 1 POINT
4. WBC count >25 × 109/L – 1 POINT
5. Blood blasts ≥1% – 1 POINT
6. Unfavourable karyotype (complex karyotype or abnormalities that include +8, -7/7q-, i(17q), inv(3), 5/5q-, 12p-, or 11q23 rearrangement) – 1 POINT
7. Platelets <100 × 10⁹/L
8. Red cell transfusion dependent

Prognostic groups

Reference:

Gangat N, Caramazza D, Vaidya R, George G, Begna K, Schwager S, Van Dyke D, Hanson C, Wu W, Pardanani A, Cervantes F, Passamonti F, Tefferi A (February 2011). “DIPSS plus: a refined Dynamic International Prognostic Scoring System for primary myelofibrosis that incorporates prognostic information from karyotype, platelet count, and transfusion status”. J. Clin. Oncol. 29 (4): 392–7. doi:10.1200/JCO.2010.32.2446.