Clinical calculator summary
Original basic IPSS-R (2012) for MDS
Clinical calculator summary
Original basic IPSS-R (2012) for MDS
Five-variable prognostic score for primary untreated MDS at diagnosis.
Evidence-based context for fast calculator use
- Purpose:
- Assign the original IPSS-R group and reproduce its historical cohort outcomes.
- Population:
- Primary untreated MDS at diagnosis with stable counts, as represented in the original 2012 cohort.
- Factors:
- Reviewed cytogenetic category, Bone marrow blasts, Hemoglobin, Platelet count, Absolute neutrophil count
- Reference:
- Greenberg PL, et al. Blood. 2012;120(12):2454-2465.
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IPSS-R for MDS
%
g/dL
x10^9/L
x10^9/L
Clinical Context & Background
This calculator implements the original basic five-variable Revised International Prognostic Scoring System (IPSS-R) published in 2012 for primary, untreated myelodysplastic syndromes at diagnosis. It combines a reviewed cytogenetic risk category, bone marrow blast percentage, hemoglobin, platelet count, and absolute neutrophil count. AML is an MDS-evolution endpoint in this model; this is not an AML prognostic calculator.
The original cohort required stable blood counts for at least two months and excluded secondary or therapy-related MDS and prior disease-altering MDS therapy. The published cohort included patients aged 16 years or older, marrow blasts up to 30%, peripheral blood blasts up to 19%, WBC up to 12 x10^9/L, and ANC up to 8 x10^9/L. Because age, peripheral blood blasts, and WBC are not calculator inputs, confirm those scope conditions separately. The official calculator accepts ANC up to 15 x10^9/L; results above 8 carry an applicability warning. Marrow blasts of 20-30% are retained for historical-model fidelity but require confirmation against the current disease classification.
Select a cytogenetic category only after expert review. Isolated del(7q) is Intermediate, monosomy 7 is Poor, a double abnormality including -7/del(7q) is Poor, a complex karyotype with exactly 3 abnormalities is Poor, and a complex karyotype with at least 4 abnormalities is Very poor. This calculator does not parse raw karyotypes.
Displayed overall-survival and AML-evolution values are historical observations from the original untreated primary-MDS cohort, not individualized contemporary predictions or treatment directives. This model is distinct from the original IPSS, age-adjusted IPSS-RA, the 2022 molecular IPSS-M, and prognostic models for established AML.
Formula Logic
Cytogenetics (0-4) + marrow blasts (0-3) + hemoglobin (0-1.5) + platelets (0-1) + ANC (0-0.5); exact total 0-10.Reference Data
| Risk Group | Total Score | Historical median OS | Historical time to 25% AML evolution |
|---|---|---|---|
| Very Low Risk | <= 1.5 | 8.8 years | Not reached |
| Low Risk | > 1.5 - 3.0 | 5.3 years | 10.8 years |
| Intermediate Risk | > 3.0 - 4.5 | 3.0 years | 3.2 years |
| High Risk | > 4.5 - 6.0 | 1.6 years | 1.4 years |
| Very High Risk | > 6.0 | 0.8 years | 0.73 years |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use at diagnosis for primary MDS before disease-altering therapy, after blood counts have been stable for at least two months.
- Select one of the five cytogenetic categories after expert cytogenetic review; this calculator does not interpret raw karyotype text.
How To Interpret
- Add the five published component scores and map the exact half-point total to one of five IPSS-R groups.
- Interpret median overall survival and time to 25% AML evolution only as historical original-cohort observations.
What To Do Next
- Document all five inputs, the cytogenetic category rationale, exact total, group, warnings, and assessment date.
- Determine diagnosis and management separately from the complete clinical, morphologic, molecular, cytogenetic, comorbidity, and patient-preference context.
Limitations
- Do not apply this source-locked model to secondary or therapy-related MDS, previously disease-modifying-treated disease, or established AML.
- This is not original IPSS, IPSS-RA, IPSS-M, or an AML prognostic calculator. Historical outcomes are not individualized contemporary predictions.
Validated Population
Original 2012 primary untreated MDS cohort at diagnosis; counts were stable for at least two months.
Keep AML evolution in context
AML in the output means the historical time for 25% of the original MDS cohort to evolve to AML; it is not an outcome model for a patient who already has AML.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed cases passed through visible production controls at IPSS-R totals 0, 3.5, and 10.
- Very Low, Intermediate, and Very High groups rendered as expected.
- No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/ipss-r-AML-Prognostic-MDS-2026-08-03.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 12 visible submissions.
- Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/ipss-r-AML-Prognostic-MDS.json.
: Full validation test
- Verified all 360 component-category combinations in numeric and canonical UI serialization, all point thresholds and operational limits, all five group boundaries and historical outcomes, applicability warnings, strict invalid-input rejection, exact five-row trace, determinism, immutability, and public evidence wiring.
: Correction history
- Removed the assumed Good cytogenetic default; corrected the marrow-blast maximum from 100% to 30%; enforced official operational limits; completed cytogenetic definitions; added exact component tracing, historical AML-evolution outcomes, and scope warnings. Published arithmetic for complete canonical valid inputs was unchanged.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Related Tools
Frequently Asked Questions
Is this an AML prognosis calculator?
No. AML evolution is an endpoint observed after MDS diagnosis in the original IPSS-R cohort.
How should chromosome 7 findings be categorized?
Isolated del(7q) is Intermediate; monosomy 7 and a double abnormality including -7/del(7q) are Poor.
Is a complex karyotype with three abnormalities Very poor?
No. Exactly three abnormalities is Poor; at least four is Very poor.
Evidence-based oncology decision support. Verify with clinical guidelines.