NCCN Guidelines for Patients® | Myelodysplastic Syndromes

24 NCCN Guidelines for Patients ® : Myelodysplastic Syndromes, 2018 3 Prognostic scoring Prognostic factors | Prognostic scoring Guide 2. Prognostic scoring systems and risk groups System Prognostic factors that are scored Risk groups based on total risk score IPSS ª • Percent of blast cells in bone marrow ◦◦ Score of 0, 0.5, 1.5, or 2 points • Chromosome changes ◦◦ Score of 0, 0.5, or 1 point • Number of low blood counts ◦◦ Score of 0 or 0.5 point Low IPSS Risk score = 0 Intermediate-1 IPSS Risk score = 0.5 to 1.0 Intermediate-2 IPSS Risk score = 1.5 to 2 High IPSS Risk score = 2.5 or higher IPSS-R ª • Percent of blasts in the bone marrow ◦◦ Score of 0, 1, 2, or 3 points • Chromosome changes ◦◦ Score of 0, 1, 2, 3, or 4 points • Hemoglobin level ◦◦ Score of 0, 1, or 1.5 points • Platelet count ◦◦ Score of 0, 0.5, or 1 point • Neutrophil count ◦◦ Score of 0 or 0.5 points Very low IPSS-R Risk Score = 1.5 or lower Low IPSS-R Risk Score = 2 to 3 Intermediate IPSS-R Risk Score = 3.5 to 4.5 High IPSS-R Risk Score = 5 to 6 Very High IPSS-R Risk Score = 6.5 or higher WPSS ª • MDS subtype ◦◦ Score of 0, 1, 2, or 3 points • Chromosome changes ◦◦ Score of 0, 1, or 2 points • Presence of severe anemia ◦◦ Score of 0 or 1 point Very Low WPSS Risk Score = 0 Low WPSS Risk Score = 1 Intermediate WPSS Risk Score = 2 High WPSS Risk Score = 3 to 4 Very High WPSS Risk Score = 5 to 6 The IPSS scores three main factors to classify MDS into four risk groups. See Guide 2. The scores for all of the factors are added together to make the overall risk score. This is called the IPSS score and it is used to assign the IPSS risk group. IPSS-R The IPSS-R was developed in 2012. It is an updated (revised) version of the original IPSS. A key way the IPSS-R differs is that it scores the types and severity of low blood cell counts. It also scores a wider range of chromosome changes. It classifies MDS into five risk groups instead of four.

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