How is the International Prognostic Scoring System (IPSS) used to stage myelodysplastic syndrome (MDS)?

Updated: Jul 24, 2018
  • Author: Emmanuel C Besa, MD; Chief Editor: Koyamangalath Krishnan, MD, FRCP, FACP  more...
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Answer

In 1997, an international group of experts, the MDS Risk Analysis Workshop, developed the International Prognostic Scoring System (IPSS) for staging MDS. [17] The IPSS was revised in 2012 to accommodate advances in defining cytogenetic abnormalities. [18] The revised IPSS (IPSS-R) also includes a more detailed consideration of cytopenias. (See Tables 2-4, below.) An online calculator for determining an individual patient's R-IPSS score is available on the MDS Foundation Web site.

Table 2 Cytogenetic abnormalities assigned an IPSS-R value for scoring (Open Table in a new window)

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, t(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

 

Table 3.Calculation of IPSS-R score (Open Table in a new window)

 

Points Assigned

0

0.5

1

1.5

2

3

4

 

 

 

Variable

Cytogenetic subgroup

Very Good

 

Good

 

Intermediate

Poor

Very Poor

Bone marrow blasts (%)

≤2

 

>2-

< 5

 

5-10

>10

 

Hemoglobin (g/dL)

≥10

 

8-9.9

< 8

     

Platelet count (x 109/L)

≥100

50-99.9

< 50

       

Absolute neutrophil count (x 109/L)

≥0.8

< 0.8

         

Table 4. IPSS-R prognostic risk scores and categories (Open Table in a new window)

Risk Score

Risk Category

≤1.5

Very Low

>1.5-3

Low

>3-4.5

Intermediate

>4.5-6

 High

>6

Very High


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