IPSS, IPSS-R und WPSS Rechner

IPSS (International Prognostic Scoring System, Greenberg et al. 2002)

Table 1: Definition of the IPSSS)

Score 0 0,5 1 1,5 2,0
Medullary blasts (%) 0 – 4 5 – 10 11 – 20 21 – 29
Number of Cytopenias 1) 0 – 1 2 – 3
Cytogenetic risk group 2) Low Intermed. High

 

1) Platelets < 100.000/µl, Hemoglobin < 10 g/dl, ANC < 1.800/µl
2) Low risk = normal karyotype, 5q-, 20q-, -Y
High risk =complex karyotype (≥ 3 anomalien), chromosom 7-anomalies
Interm. risk = all other aberrations

 

Table 2: IPSS-prognostic risk categories

Score Risk groups
0 Low risk
0,5 – 1 Intermed. risk I
1,5 – 2 Intermed. risk II
≥ 2,5 High risk

 

IPSS-R (Revised _International Prognostic Scoring System, Greenberg et al, 2012)

Table 3: Definition of the IPSS-R

Score 0 0,5 1 1,5 2 3 4
Cytogenetic group3) very good good Intermed. poor very poor
Medullary blasts (%) < 2 >2–<5 5–10 >10
Hemoglobin >10 8–<10 <8
Platelets >100 50–<100 <50
ANC >0,8 <0.8

 

3) Very good = del(11q), -Y
Good = normal karyotype, del(20q), del(5q), del(12p), double including del(5q)
Intermediate = +8, del(7q), i(17q), +19, any other single or double independent clone
Poor = -7, inv(3)/t(3q)/del(3q), double including -7/del(7q), complex: 3 abnormalities
Very poor = Complex >3 abnormalities

 

Table 4: IPSS-R prognostic risk categories and clinical outcomes

Score Risk groups Survival in years (Medians) Time to 25% AML evolution (Medians)
0–1,5 Very low risk 8,8 Not reached
1,5–3 Low 5,3 10,8
>3–4,5 Intermed. 3,0 3,2
4,5–6 High 1,6 1,4
>6 Very high 0,8 0,73

 

WPSS (WHO adapted Prognostic Scoring System, Malcovati et al. 2007)

Table 5: Definition of the WPSS

Score 0 1 2 3
WHO Type RA/RARS/5q- RCMD/RSCMD RAEB I RAEB II
Karoytype risk4) Low Intermed. High
Transfusion requirements5) No one Regularly

 

4) Low risk = normal karyotype,del (5q),del( 20q), -Y
High risk = complex karyotype (≥ 3 anomalien), chromosom 7-anomalies
Intermediate risk = all other aberrations
5) at least 1 transfusion every 8 weeks over a period of 3 months

 

Table 6: WPSS-prognostic risk categories

Score Risk groups
0 Very low risk
1 Low risk
2 Intermed. risk
3 – 4 High risk
5 – 6 Very high risk