International prognosis scoring system (IPSS) in myelodysplastic syndrome

Variable	Score
Variable	0	0.5	1	1.5	2
Bone marrow blasts (percent)	<5	5 to 10	-	11 to 20	21 to 30
Karyotype*	Good	Intermediate	Poor	-	-
Cytopenias^¶	0/1	2/3	-	-	-
Risk group	IPSS score
Low	0
Intermediate-1	0.5 to 1
Intermediate-2	1.5 to 2
High	2.5 to 3.5

Scoring system: A score from zero to two is determined for each of the three variables; the three values are added obtain the IPSS score. Thus, a patient with 12 percent bone marrow blasts (score 1.5), complex chromosomal changes (poor karyotype score 1), neutrophil count of 1000/microL, and platelet count of 50,000/microL (two cytopenias, score 0.5) would have an IPSS score of 3 (ie, high risk).

* Karyotype definitions:
Good: Normal;-Y; del (5q); del (20q).
Poor: Complex (≥3 abnormalities); abnormal chromosome 7.
Intermediate: All others.
¶ Cytopenia definitions:
Red blood cells: Hemoglobin <10 g/dL (100 g/L).
White blood cells: Absolute neutrophil count <1800/microL.
Platelets: Platelet count <100,000/microL.

Adapted from: Greenberg P, Cox C, LeBeau MM, et al. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood 1997; 89:2079. Erratum in Blood 1998; 91:1100.

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International prognosis scoring system (IPSS) in myelodysplastic syndrome