Myelodysplastic Syndrome International Prognostic Scoring System
Info
Cytogenic abnormalities/Karyotype Normal, Y-, 5q-, 20q- Abnormal chromosome 7 or 3 or more abnormalities All other cytogenic abnormalities
Percentage of Bone Marrow Blasts <5% 5-10% 11-20% 21-30%
of Cytopenias (Select which are present)
Hemoglobin <10 g/dL
Absolute neutrophil count<1500/mm(3)
Platelets < 100,000/mm(3)
R e s u l t s
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Score
 
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Myelodysplastic Syndrome International Prognostic Scoring System

The international scoring system for evaluating prognosis in myelodysplastic syndromes (MDS) evaluated 7 large studies and developed the following scoring system during an international MDS risk analysis workshop.

MDS are clonal hematologic disorders that result in ineffective hematopoiesis. The natural history of these illnesses ranges from a chronic low grade condition to one that rapidly has leukemic progression.

These prognostic outcomes focus upon:

  • Cytogenic abnormalities
  • % of Bone Marrow Myeloblasts
  • Number of cytopenias

Each of these items is scored and the scores added together to generate a total score, which is then used to predict median survival.

Cytogenic abnormalities/Karyotype

  • Normal, Y-, 5q-, 20q- (0 points)
  • Abnormal chromosome 7 or 3 or more abnormalities (1.0 points)
  • All other cytogenic abnormalities (0.5 points)

Percentage of Bone Marrow Blasts

  • 5% (0 points)
  • 5-10% (0.5 points)
  • 11-20% (1.5 points)
  • 21-30% (2.0 points)

Number of Cytopenias (Select which are present)>

  • Hemoglobin 10 g/dL
  • Absolute neutrophil count1500/mm3
  • Platelets100,000/mm3

Scoring (0 or 1 present = 0 points, 2 or 3 present = 0.5 points)

Interpretation

Points Risk Category Median Survival (Years)
0 Low 5.7
0.5-1 Intermediate 1 3.5
1.5-2.0 Intermediate 2 1.2
2.5-3.5 High 0.4

References:

  • Greenberg P, Cox C, Lebeau MM, et al. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood. 1997;89(6):2079-88.
  • Heaney ML, Golde DW. Myelodysplasia. N Engl J Med. 1999;340(21):1649-60.