DIPSS-Plus-Score (PMF)

* Constitutional symptoms constitute weight loss > 10 % of baseline value in the year preceding diagnosis, unexplained fever or excessive sweats persisting for > 1 month.

** RBC transfusion need: Please note that a transfusion-dependent patient automatically has 2 risk factors because of transfusion need (1 risk point) and hemoglobin level < 10 g/dl (1 risk point).

*** Unfavorable karyotype constitutes complex karyotype or sole or 2 abnormalities that include +8, -7/7q-, i(17q), inv(3), -5/5q-, 12p- or 11q23 rearrangement.

Additional Information

Score Description

The DIPSS-Plus Score is a refined dynamic international prognostic scoring system for primary myelofibrosis. In comparison to the original DIPSS-Score it incorporates three additional independent risk factors, including red cell transfusion need, platelet count < 100 G/L and unfavorable karyotype.

Definition

Points per true condition
Age > 65 years 1
Presence of constitutional symptoms* 1
Hemoglobin < 100 g/l 1
White blood cells > 25 G/l 1
Peripheral blood blasts ≥ 1% 1
Platelet count < 100 G/l 1
RBC transfusion need** 1
Unfavorable karyotype*** 1
Score
Low risk 0 points
Intermediate-1 risk 1 points
Intermediate-2 risk 2–3 points
High risk ≥ 4 points
* Constitutional symptoms constitute weight loss > 10% of baseline value in the year preceding diagnosis, unexplained fever or excessive sweats persisting for > 1 month.
** RBC transfusion need = Please note that a transfusion-dependent patient automatically has 2 risk factors because of transfusion need (1 risk point) and hemoglobin level < 10 g/dl (1 risk point).
*** Unfavorable karyotype constitutes complex karyotype or sole or 2 abnormalities that include +8, -7/7q-, i(17q), inv(3), -5/5q-, 12p- or 11q23 rearrangement.

Further Reading

Gangat N et al. 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 29:392-397.