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Modified WPSS (WHO Classification-Based Prognostic Scoring System) of Cermak et al

Description

Transfusion dependency in myelodysplasia may not be known for some time. Cermak et al substituted hemoglobin at presentation in order to allow earlier evaluation of the patient. The authors are from the Institute of Hematology and Blood Transfusions in Prague.


Parameters:

(1) WHO classification of myelodysplasia

(2) karyotype on bone marrow cytogenetics

(3) hemoglobin at presentation in g/L

 

Parameter

Finding

Points

type of myelodysplasia (WHO)

refractory anemia

0

 

refractory anemia with ringed sideroblasts

0

 

5q(-)

0

 

refractory cytopenia with multilineage dysplasia

1

 

refractory cytopenia with multilineage dysplasia and ringed sideroblasts

1

 

refractory anemia with excess blasts, type 1

2

 

refractory anemia with excess blasts, type 2

3

karyotype

normal, (-)Y, 5q(-), 20q(-)

0

 

not in either of other groups

1

 

>= 3 abnormalities (complex), chromosome 7 abnormalities

2

hemoglobin at presentation

>= 80 g/L

0

 

< 80 g/L

1

 

total score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 6

• The higher the score the worse the prognosis.

 

Total Score

Risk Group

Leukemia Transformation

0

very low

22%

1

low

39%

2

intermediate

47%

3 or 4

high

89%

5 or 6

very high

NA

 


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