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Calculator: Revised International Prognostic Scoring System (IPSS-R) in primary myelodysplastic syndrome in adults


Calculator: Revised International Prognostic Scoring System (IPSS-R) in primary myelodysplastic syndrome in adults

 
Cytogenetics

Very good: -Y, del(11q) (0 points)

Good: normal, del(5q), del(12p), del(20q), double including del(5q) (1 point)

Intermediate: del(7q), +8, +19, i(17q), any other single or double independent clones (2 points)

Poor: -7, inv(3)/t(3q)/del(3q), double including -7/del(7q), complex: 3 abnormalities (3 points)

Very poor: complex: >3 abnormalities (4 points)
Percentage of bone marrow blasts

≤2% (0 points)

>2 to <5% (1 point)

5 to 10% (2 points)

>10% (3 points)
Hemoglobin

≥10 g/dL [≥100 g/L] (0 points)

≥8 g/dL [≥80 g/L] to <10 g/dL [<100 g/L] (1 point)

<8 g/dL [<80 g/L] (1.5 points)
Platelets

≥100,000/microL (0 points)

50,000 to 100,000/microL (0.5 points)

<50,000/microL (1 point)
Absolute neutrophil count

≥800/microL (0 points)

<800/microL (0.5 points)

 
Important: Inputs must be complete to perform calculation.

 
Total criteria point count:
 

 

IPSS-R interpretation

 
Score ≤1.5: Very low risk: median overall survival 8.8 years with >14.5 years to 25% AML evolution
Score >1.5 and ≤3: Low risk: median overall survival 5.3 years with 10.8 years to 25% AML evolution
Score >3 and ≤4.5: Intermediate risk: median overall survival 3 years with 3.2 years to 25% AML evolution
Score >4.5 and ≤6: High risk: median overall survival 1.6 years with 1.4 years to 25% AML evolution
Score >6: Very high risk: median overall survival 0.8 years with 0.7 years to 25% AML evolution

 
Notes
  • This scoring system was applied to an initial group of 7012 patients with primary MDS by the French-American-British classification who had at least two months of stable blood counts, ≤30 percent bone marrow blasts, and ≤19 percent peripheral blood blasts, and who were observed until progression to AML transformation or death (did not receive disease-modifying agents for MDS). Patients could be stratified into five groups with estimated overall survival and progression to AML as described above.
  • AML: acute myeloid leukemia; MDS: myelodysplastic syndrome.

 
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