The International Prognostic Scoring System (IPSS), published in 1997, is used by many doctors to help assess the severity of a patient's
myelodysplastic syndrome
A myelodysplastic syndrome (MDS) is one of a group of cancers in which immature blood cells in the bone marrow do not mature, and as a result, do not develop into healthy blood cells. Early on, no symptoms typically are seen. Later, symptoms may ...
(MDS). Based on the IPSS score, the patient's history, and his/her personal observations, the physician will design a treatment plan to address the MDS.
Process
The IPSS uses three "prognostic indicators" to develop a "score" which may be useful in understanding how the MDS may progress:
:* the proportion of
blast cells
In cell biology, a precursor cell, also called a blast cell or simply blast, is a partially differentiated cell, usually referred to as a unipotent cell that has lost most of its stem cell properties. A precursor cell is also known as a pro ...
in the bonemarrow
:* the type of
chromosomal changes, if any, in the
marrow cells
:* the presence of one or more low blood cell counts (
cytopenias
Cytopenia is a reduction in the number of mature blood cells. It is common in cancer patients being treated with radiation and/or chemotherapy.
Types
Anemia – a reduction of the red blood cells in the body.
Leukopenia – a deficiency of whit ...
)
Each indicator is rated according to its severity and the ratings are combined into a "score."
Scores are sorted into one of four risk categories:
:* low
:* intermediate-1
:* intermediate-2
:* high
The two lower categories can be further described as the lower risk group while the two upper categories can be further described as the higher risk group.
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A revised IPSS, IPSS-R was published in 2012. IPSS-R is more refined in its prognostic precision and includes five instead of four prognostic groups.
References
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Myeloid neoplasia