IPSS-M risk score, risk categories, and clinical outcomes
| Risk category . | IPSS-M score . | Median leukemia-free survival (y) . | Median OS (y) . | AML transformation by 1 y (%) . |
|---|---|---|---|---|
| Six-category risk schema | ||||
| Very low (14% of all patients) | Less than or equal to −1.5 | 9.7 | 10.6 | 0 |
| Low (33%) | More than −1.5 to −0.5 | 5.9 | 6.0 | 1.7 |
| Moderate low (11%) | More than −0.5 to 0 | 4.5 | 4.6 | 4.9 |
| Moderate high (11%) | >0 to 0.5 | 2.3 | 2.8 | 9.5 |
| High (14%) | >0.5 to 1.5 | 1.5 | 1.7 | 14.3 |
| Very high (17%) | >1.5 | 0.7 | 1.0 | 28.2 |
| Lower-risk vs higher-risk MDS | ||||
| Lower-risk MDS (58%) | ≤0 (negative value) | 6.0 (95% CI, 5.7-6.7) | 6.3 (95% CI, 5.8-7.2) | 2.0 |
| Higher-risk MDS (42%) | >0 (positive value) | 1.2 (95% CI, 1.1-1.3) | 1.5 (95% CI, 1.4-1.6) | 18.9 |
| Risk category . | IPSS-M score . | Median leukemia-free survival (y) . | Median OS (y) . | AML transformation by 1 y (%) . |
|---|---|---|---|---|
| Six-category risk schema | ||||
| Very low (14% of all patients) | Less than or equal to −1.5 | 9.7 | 10.6 | 0 |
| Low (33%) | More than −1.5 to −0.5 | 5.9 | 6.0 | 1.7 |
| Moderate low (11%) | More than −0.5 to 0 | 4.5 | 4.6 | 4.9 |
| Moderate high (11%) | >0 to 0.5 | 2.3 | 2.8 | 9.5 |
| High (14%) | >0.5 to 1.5 | 1.5 | 1.7 | 14.3 |
| Very high (17%) | >1.5 | 0.7 | 1.0 | 28.2 |
| Lower-risk vs higher-risk MDS | ||||
| Lower-risk MDS (58%) | ≤0 (negative value) | 6.0 (95% CI, 5.7-6.7) | 6.3 (95% CI, 5.8-7.2) | 2.0 |
| Higher-risk MDS (42%) | >0 (positive value) | 1.2 (95% CI, 1.1-1.3) | 1.5 (95% CI, 1.4-1.6) | 18.9 |
Original information is from Bernard et al,16 as displayed by Cazzola and Malcovati (reproduced under a CC BY-NC license).25
The IPSS-M calculation uses information about the mutation status of the following genes in addition to del(5q): ASXL1, BCOR, BCORL1, CBL, CEBPA, DNMT3A, ETNK1, ETV6, EZH2, FLT3, GATA2, GNB1, IDH1, IDH2, KRAS, MLL (KMT2A), NF1, NPM1, NRAS, PHF6, PPM1D, PRPF8, PTPN11, RUNX1, SETBP1, SF3B1, SRSF2, STAG2, TP53, U2AF1, and WT1.
The International Working Group for Prognosis in MDS has developed the IPSS-M web-based calculator, which is freely available online.16 In addition to providing the individual IPSS-R and IPSS-M scores, the calculator also returns the expected leukemia-free survival (median value, y), (OS median value, y), and risk of AML transformation (% by 1 y). Notably, the calculator is capable of accounting for missing values, whereby the IPSS-M is calculated under three distinct scenarios: best, average, and worst.
CI, confidence interval.