Risk Stratification

The IPSS-R stratifies patients into 5 risk groups (very low, low, intermediate, high, and very high), based on the sum of the individual scores for each parameterGreenberg PL et al. Blood. 2012;120:2454-2465.
A cutoff point of ≤ 3.5 has generally been used to classify patients as low-risk myelodysplastic syndrome (LR-MDS; median survival, 5.9 years) and > 3.5 for high-risk myelodysplastic syndrome (HR-MDS; median survival, 1.5 years)Cazzola M. N Engl J Med. 2020;383:1358-1374.

Revised International Prognostic Scoring System (IPSS-R)Greenberg PL et al. Blood. 2012;120:2454-2465.

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The result of the IPSS-M is a continuous patient-specific risk score that may be classified into 1 of 6 groups: very low, low, moderate low, moderate high, high, and very highBernard E et al. NEJM Evid. 2022;1:EVIDoa2200008.
Compared with the IPSS-R, the IPSS-M improved prognostic discrimination and re-stratified 46% of patients to a different risk category (74% of whom were upstaged and 26% of whom were downstaged)Bernard E et al. NEJM Evid. 2022;1:EVIDoa2200008.

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