IPSS-R Scoring System

IPSS-R Scoring System

The prognosis and disease course may vary widely among patients with MDS based on the type of MDS and the risk category (estimate of severity). The system most widely used to estimate the severity of MDS is the International Prognostic Scoring System (IPSS). This system has recently been revised and is now known as the Revised International Prognostic Scoring System (IPSS-R). The IPSS-R may be used to estimate life expectancy (survival) for a patient newly diagnosed with MDS without treatment and estimate the risk of developing acute myelogenous leukemia (AML).

The bone marrow biopsy and aspirate, the cytogenetics and the peripheral blood (CBC, differential and platelet count) are used to determine the risk category. The impact of molecular features is not yet included in this system. It is important to know that these criteria are used to guide treatment selection and to guide patient and caregiver counseling. They do not represent patients who are receiving treatment where survival may be extended.

There are five overall risk scores in the IPSS-R with estimated survival and median risk of AML:

Score <1.5
Very Low
Very High
Overall Survival (Mean)8.8 years5.3 years3.0 years1.6 years0.8 years
Risk of AML in 25% of patients (median) Not reached10.8 years3.2 years1.4 years.73 years

Prognostic Values for Determining IPSS-R Score

A bone marrow biopsy and aspirate, cytogenetics and peripheral blood counts are used to determine your risk category (Very Low, Low, Intermediate, High, Very High).