Clinical calculator summary
Original 2009 Morel IPSSWM
Clinical calculator summary
Original 2009 Morel IPSSWM
A five-factor baseline prognostic classification for symptomatic Waldenström macroglobulinemia.
Evidence-based context for fast calculator use
- Purpose:
- Reproduce the original adverse-factor total and low, intermediate, or high prognostic group.
- Population:
- Patients with proven symptomatic Waldenström macroglobulinemia at initiation of first-line treatment.
- Factors:
- Age, Hemoglobin, Platelets, Beta-2 microglobulin, Serum monoclonal IgM
- Reference:
- Morel et al. Blood. 2009;113(18):4163-4170. doi:10.1182/blood-2008-08-174961.
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IPSSWM (Waldenström)
years
mg/L
g/dL
x 10^9/L
g/dL
Clinical Context & Background
This calculator reproduces the original 2009 International Prognostic Scoring System for Waldenström Macroglobulinemia (IPSSWM). It assigns one adverse factor each for age >65 years, hemoglobin <=11.5 g/dL, platelets <=100 x 10^9/L, beta-2 microglobulin >3 mg/L, and serum monoclonal IgM >7 g/dL. Values are assessed without rounding.
Low risk requires age <=65 years and zero or one total adverse factor. Intermediate risk includes exactly two total adverse factors or age >65 years as the only adverse factor. Three or more total adverse factors are high risk. The original cohort's 5-year overall survival observations were 87%, 68%, and 36% for low-, intermediate-, and high-risk groups.
Use IPSSWM for proven symptomatic Waldenström macroglobulinemia at initiation of first-line treatment. It is not for asymptomatic disease, IgM MGUS, deciding when to start treatment, response assessment, relapse, or individualized survival prediction. Ages outside 28-95 years are outside the derivation range and receive an applicability warning.
Formula Logic
Original 2009 IPSSWM: one adverse factor each for age >65 years, hemoglobin <=11.5 g/dL, platelets <=100 x 10^9/L, beta-2 microglobulin >3 mg/L, and serum monoclonal IgM >7 g/dL. Low risk requires age <=65 and 0-1 total factors; intermediate risk is exactly 2 factors or age >65 alone; high risk is >=3 total factors.Reference Data
| Risk Group | Original rule | Historical 5-Year Survival |
|---|---|---|
| Low | Age <=65 and 0-1 total adverse factors | 87% |
| Intermediate | Exactly 2 total factors, or age >65 alone | 68% |
| High | At least 3 total adverse factors | 36% |
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 initiation of first-line treatment for proven symptomatic Waldenström macroglobulinemia.
- Enter unrounded baseline age and laboratory values.
How To Interpret
- Count all five adverse factors, including age.
- Low risk requires age <=65 and no more than one total factor; exactly two or age >65 alone is intermediate; at least three is high.
- Historical survival values describe the source cohort and are not individualized predictions.
What To Do Next
- Interpret alongside disease features, comorbidity, current guidelines, and specialist judgment.
Limitations
- Not for asymptomatic WM, IgM MGUS, treatment-initiation decisions, response assessment, or relapse.
- Ages outside the original 28-95 year derivation range have uncertain applicability.
- Does not prescribe treatment or predict an individual patient’s survival.
Validated Population
Symptomatic Waldenström macroglobulinemia patients starting first-line treatment in the original international cohort; derivation ages 28-95 years.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed cases passed through visible production controls at IPSSWM scores 0, 2, and 5.
- The former valid-submission crash and first-profile missing-field defects were absent.
- 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/ipsswm-Prognostic-Waldenström-2026-08-03.json.
: Local browser remediation verified; production retest pending
- Corrected the visible result trace method from unsupported `points-based` to registered `additive`; the Morel score and risk grouping were unchanged.
- Ten local visible-browser cases passed across scores 0-5, every threshold and classification branch, derivation-range boundaries, required-field feedback, and reset/repeat behavior.
- The original production crash remains open until deployment and public revalidation.
Local diagnostic evidence is retained in validation/browser-production/ipsswm-Prognostic-Waldenström.local-remediation.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 1/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
- Overall browser status: failed-calculation-ui-and-console. critical: All eight complete valid profiles and the repeated valid profile failed to render a result. A supplemental all-adverse reproduction showed all five number controls holding the intended values immediately before Calculate; submission then raised a TypeError reading `map` from undefined and replaced the calculator with the production `This page couldn’t load` screen. | high: The first complete no-adverse profile produced no result and four required-field messages despite all five visible number controls having been filled. | 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/ipsswm-Prognostic-Waldenström.json.
: Browser input adapter corrected and reverified
- Accepted finite number values already normalized by the shared calculator form while retaining strict malformed-input rejection.
- No equation, cutoff, unit, classification, or applicability rule changed; calculator-specific verification and the calculator-wide browser-input audit passed.
: Full validation test
- 512/512 exhaustive factor, equality-boundary, derivation-range, strict-input, UI, trace, wording, immutability, registry, and no-panel checks passed with zero score or classification mismatches.
- Scope is the original 2009 model for symptomatic Waldenstrom macroglobulinemia at first-line treatment initiation; no panel calculates IPSSWM or inherits this status.
: Calculation and input-contract correction
- Replaced favorable pre-scored defaults with raw age, hemoglobin, platelets, beta-2 microglobulin, and monoclonal IgM values using exact source thresholds without rounding.
- Corrected age >65 plus two other adverse factors to high risk because the total is three; removed coercion and missing/extra/nonfinite acceptance.
- Added the 28-95 year derivation-range warning, five-factor trace, matched source row, historical 87%/68%/36% cohort outcomes, and non-directive scope wording.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Frequently Asked Questions
When should IPSSWM (Waldenström) be used?
Use it for patients with the specific hematologic diagnosis and disease phase described by the model when all required inputs and the intended clinical setting are confirmed.
Can IPSSWM (Waldenström) determine treatment by itself?
No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.
Evidence-based oncology decision support. Verify with clinical guidelines.