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Myelodysplastic Syndromes: IPSS Risk Stratification

The International Prognostic Scoring System (IPSS) is based on the:1

  • Percentage of bone marrow blasts
  • Cytogenetic profile
  • Number of blood cell lineages affected

Based on these factors, patients are stratified into 1 of 4 risk groups (Low, Int-1, Int-2, and High) that have distinct survival rates (Table).1

Table. The International Prognostic Scoring System (IPSS) for myelodysplastic syndromes (MDS)1

Prognostic variable 0 0.5 1.0 1.5 2.0
Bone marrow blasts (%) < 5 5-10 11-20 21-30
Cytogenetics* Good Intermediate Poor
Cytopenias, n 0 or 1 2 or 3

Score IPSS subgroup Median survival (years)
0 Low 5.7
0.5-1.0 Int-1 3.5
1.5-2.0 Int-2 1.2
> 2.5 High 0.4

*Good: normal, -Y, del(5q), del(20q); intermediate: other abnormalities; poor: complex (≥ 3 abnormalities) or chromosome 7 anomalies.
†Platelets < 100,000/μL; hemoglobin < 10 g/dL; neutrophils < 1,800/μL.

Reproduced from Greenberg P, et al. Blood. 1997;89:2079-88 © 1997 by The American Society of Hematology.

The IPSS scoring system is used only at the time of MDS diagnosis as it does not take into account the impact of transfusions on the prognosis of MDS patients.

Learn about a dynamic risk stratification system >


  1. Greenberg P, et al. Blood. 1997;89:2079-88.

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