Table 2.

Prognostic scoring systems in myelodysplastic syndrome.

System	Risk factors evaluated	Validated application
IPSS (IWG-PM) Blood. 1997;89: 2079.	4 risk groups Factors: blasts, cytogenetics, and number of cytopenias	At diagnosis Patients not on therapy de novo MDS (not to be used for therapy-related or secondary MDS or CMML) Lower risk group is highly variable
WPSS (WHO) J Clin Oncol. 2005;23:7594.	5 risk groups Factors: WHO category, cytogenetics, and red cell transfusion dependence ≥q8weeks for ≥4 months	Applied at any time Patients not on therapy de novo MDS (not to be used for therapy-related or secondary MDS or CMML)
MDACC (MD Anderson) Cancer. 2008;113:1351.	4 risk groups Factors: cytogenetics, performance status, age, hemoglobin, platelet count, white blood count, marrow blasts, prior transfusion	At diagnosis only Patients not on therapy de novo MDS, therapy-related and secondary MDS, and CMML Delineation of the low to intermediate-1 IPSS groups better
IPSS-R (IWG-PM) Blood. 2012;120:2454.	5 risk groups In addition to IPSS risk factors, increased delineation of the cytogeneWc subgroups†	At diagnosis Patients not on therapy de novo MDS (not to be used for therapy-related or secondary MDS or CMML) Lower risk group is highly variable

^†

Cytogene:c subgroups:

• Very good: -Y, del(11q).
• Good: Normal, del(5q), del(12p), del(20q), double including del(5q).
• Intermediate: del(7q), +8, +19, i(17q), any other single or double independent clones.
• Poor: -7, inv(3)/t(3q)/del(3q), double including -7/del(7q), complex: 3 abnormalities.
• Very poor: Complex: >3 abnormalities.