R-IPSS-Score (MDS)

Additional Information

Score Description

The R-IPSS -Score is a prognostic scoring system for myelodysplastic syndrome at diagnosis and without treatment. In comparison to the original IPSS, the IPSS-R has one additional risk category, two cytogenetic risk categories, splits the lower marrow blast percentages and incorporates the severity of each individual cytopenia.  The revised IPSS is based on a much larger cohort than the IPSS (7012 patients) and provides more precise estimates of prognosis than the original IPSS. The model has been validated in separate cohorts.

Definition

  Points
Prognostic variables 0 0.5 1 1.5 2 3 4
Cytogenetic group Very good Good Intermediate Poor Very poor
Medullary blasts (%) ≤ 2 > 2 – < 5 5–10 > 10
Hemoglobin (g/l) ≥ 10 8 – < 10 < 8
Platelets (G/l) ≥ 100 50–99.99 < 50        
Absolute neutrophil count (G/l) ≥ 0.8 < 0.8
Score
Very low risk 0–1.5 points
Low risk 2–3 points
Intermediate risk 3.5–4.5 points
High risk 5–6 points
Very high risk > 6 points
Cytogenetics
Very good -Y, del(11q)
Good Normal, del(5q), del(12p), del(20q), double including del(5q)
Intermediate del(7q), +8, +19, i(17q), any other single or double independent clones
Poor -7, inv(3)/t(3q)/del(3q), double including -7/del(7q), complex with 3 abnormalities
Very poor Complex with > 3 abnormalities

Further Reading

Greenberg P et al. Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012 Sep 20;120(12):2454-65.