Prognostic variable | Score | ||||||
0 | 0.5 | 1.0 | 1.5 | 2.0 | 3.0 | 4.0 | |
Cytogenetics* | Very good | Good | Intermediate | Poor | Very poor | ||
Bone marrow blast (%) | ≤2 | >2 to <5 | 5 to 10 | >10 | |||
Hemoglobin (g/dL) | ≥10 | 8 to <10 | <8 | ||||
Platelets (cells/microL) | ≥100 | 50 to 100 | <50 | ||||
Absolute neutrophil count (cells/microL) | ≥0.8 | <0.8 | |||||
This scoring system was applied to an initial group of 7012 patients with primary MDS by the French-American-British classification who had at least 2 months of stable blood counts, ≤30% bone marrow blasts and ≤19% peripheral blood blasts, and who were observed until progression to AML transformation or death (did not receive disease-modifying agents for MDS). Patients could be stratified into 5 groups with the following estimated overall survival and progression to AML. | |||||||
Risk group | IPSS-R score | Median overall survival (years) | Median time to 25% AML evolution (years) | ||||
Very low | ≤1.5 | 8.8 | >14.5 | ||||
Low | >1.5 to 3.0 | 5.3 | 10.8 | ||||
Intermediate | >3 to 4.5 | 3.0 | 3.2 | ||||
High | >4.5 to 6 | 1.6 | 1.4 | ||||
Very high | >6 | 0.8 | 0.7 | ||||
The prognostic value of the IPSS-R was validated in an external cohort of 200 patients with MDS. |
AML: acute myeloid leukemia; MDS: myelodysplastic syndromes.
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