Greenberg et al reported a revision of the International Prognostic Scoring System (IPSS). This provdes an additional category and better prediction of outcome for a patient with myelodysplasia. The authors are from multiple institutions in North America, Europe and Japan.
Parameters:
(1) cytogenetics
(2) percent bone marrow blasts
(3) hemoglobin
(4) platelet count
(5) absolute neutrophil count
|
Parameter |
Finding |
Points |
|
cytogenetic abnormality |
very good |
0 |
|
|
good |
1 |
|
|
intermediate |
2 |
|
|
poor |
3 |
|
|
very poor |
4 |
|
percent blasts in bone marrow |
<= 2% |
0 |
|
|
2.01 to 4.99 percent |
1 |
|
|
5 to 10% |
2 |
|
|
> 10% |
3 |
|
hemoglobin |
>= 10 g/dL |
0 |
|
|
8 to 9.99 g/dL |
1 |
|
|
< 8 g/dL |
1.5 |
|
platelet count |
>= 100,000 per µL |
0 |
|
|
50,000 to 99,999 per µL |
0.5 |
|
|
< 50,000 per µL |
1 |
|
absolute neutrophil count |
>= 800 per µL |
0 |
|
|
< 800 per µL |
0.5 |
|
Cytogenetic Risk |
Finding |
|
very good |
(-)Y; del(11q) |
|
good |
normal; del(12p); del(20q); double including del(5q) |
|
intermediate |
del(7q); +8; +19; I(17q); any other single or double independent clones |
|
poor |
complex with 3 abnormalities; double including –7/del(7q); -7; inv(3)/t(3q)/del(3q) |
|
very poor |
complex with >= 4 abnormalities |
total IPSS-R =
= SUM(points for all 5 parameters)
This score was developed for patients 70 years of age. To adjust the score for age:
age factor =
= ((age) – 70) * (0.05 – (0.005 * (IPSS-R)))
age-adjusted IPSS-R = IPSS-RA =
= (IPSS-R) + (age factor)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the IPSS-R the greater the risk.
|
IPSS-RA |
Risk Category |
|
0 to 1.5 |
very low |
|
2.0 to 3.0 |
low |
|
3.5 to 4.5 |
intermediate |
|
5 to 6 |
high |
|
6.5 to 10 |
very high |
Specialty: Hematology Oncology, Clinical Laboratory
ICD-10: ,
