Clinical calculator summary
Original all-age DIPSS for primary myelofibrosis
Clinical calculator summary
Original all-age DIPSS for primary myelofibrosis
Five-factor dynamic prognostic score for confirmed primary myelofibrosis.
Evidence-based context for fast calculator use
- Purpose:
- Assign the original DIPSS risk group at diagnosis or reassessment from a complete source-defined assessment.
- Population:
- Patients with confirmed primary myelofibrosis represented in the original 2010 IWG-MRT cohort.
- Factors:
- Age >65 years, Persistent non-treatment-related hemoglobin <10 g/dL, WBC >25 x 10^9/L, Peripheral blood blasts >=1%, Source-defined constitutional symptoms
- Reference:
- Passamonti F, et al. Blood. 2010;115(9):1703-1708.
Pin your most used calculators here by clicking the star in the dropdown.
DIPSS (Myelofibrosis)
Clinical Context & Background
The original all-age Dynamic International Prognostic Scoring System (DIPSS) is a five-factor prognostic model for confirmed primary myelofibrosis (PMF). It may be reassessed during the disease course and assigns two points for persistent hemoglobin below 10 g/dL (100 g/L) that is not caused by treatment toxicity, plus one point each for age older than 65 years, white blood cell count above 25 x 10^9/L, peripheral blood blasts at least 1%, and at least one source-defined constitutional symptom: weight loss greater than 10% in 6 months, night sweats, or unexplained fever above 37.5 C. Other newly acquired factors should be disease-related.
The displayed median overall survival values are historical original-cohort observations interpreted using elapsed time since diagnosis and valid only until the risk category changes. They are not individualized contemporary survival estimates or treatment or transplant directives. The model excluded post-polycythemia-vera MF, post-essential-thrombocythemia MF, prefibrotic MF, and treatment-toxicity-induced anemia. It is distinct from baseline IPSS, age-adjusted DIPSS, DIPSS-Plus, MIPSS70 variants, and MYSEC-PM.
Formula Logic
Age >65 (+1) + source-defined constitutional symptoms (+1) + persistent non-treatment-related hemoglobin <10 g/dL (+2) + WBC >25 x 10^9/L (+1) + peripheral blood blasts >=1% (+1).Reference Data
| Risk Group | Score | Historical median overall survival |
|---|---|---|
| Low Risk | 0 | Not reached |
| Intermediate-1 Risk | 1 - 2 | 14.2 years |
| Intermediate-2 Risk | 3 - 4 | 4.0 years |
| High Risk | 5 - 6 | 1.5 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 for confirmed primary myelofibrosis at diagnosis or reassessment when all five source-defined factors are known.
- For longitudinal scoring, mark hemoglobin adverse only when the value is persistently below 10 g/dL and is not caused by treatment toxicity; newly acquired factors should be disease-related.
How To Interpret
- Sum the exact 0-6 score and map it to the source-defined low, intermediate-1, intermediate-2, or high group.
- Interpret historical median overall survival using elapsed time since diagnosis and only until the patient changes risk category.
What To Do Next
- Document the five responses, assessment date, total, and category so the result can be reproduced and reassessed.
- Make treatment and transplant decisions separately using the complete clinical, molecular, cytogenetic, comorbidity, and patient-preference context.
Limitations
- Do not apply this original PMF model to post-PV MF, post-ET MF, prefibrotic MF, or treatment-toxicity-induced anemia.
- This is not baseline IPSS, age-adjusted DIPSS, DIPSS-Plus, a MIPSS70 variant, or MYSEC-PM; historical cohort outcomes are not individualized contemporary predictions.
Validated Population
Original IWG-MRT primary-myelofibrosis cohort; secondary and prefibrotic myelofibrosis were excluded.
Reassess when the category changes
A score of 3 maps to Intermediate-2 Risk and historical median overall survival of 4.0 years in the original cohort; the observation applies only until a subsequent category change.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed cases passed through visible production controls at DIPSS scores 0, 3, and 6.
- The former numeric-radio rejection and invalid-result gauge 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/myelofibrosis-dipss-score-2026-08-03.json.
: Local browser remediation verified; production retest pending
- Updated the DIPSS form adapter to accept the exact numeric 0/1/2 radio values emitted by the browser while preserving the strict engine.
- Ten local visible-browser cases passed across scores 0-6, all four source groups, the two-point anemia branch, required-field feedback, and reset/repeat behavior.
- The production finding remains open until deployment and public revalidation.
Local diagnostic evidence is retained in validation/browser-production/myelofibrosis-dipss-score.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: Every complete DIPSS profile failed. The initial all-zero profile was treated as missing, while nonzero profiles and the repeated all-zero profile rendered N/A / Invalid Input with the exact-five-factor error. A supplemental score-6 reproduction showed all five radio groups checked immediately before Calculate. | medium: Invalid DIPSS result cards displayed a generic Low Risk / Intermediate / High Risk gauge despite the unavailable result and the source model's four groups. | 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/myelofibrosis-dipss-score.json.
: Full validation test
- Verified all 32 feasible predictor combinations, scores 0-6, all group transitions, 15 source-boundary and applicability cases, exact historical outcome mapping, additive trace, strict invalid-input rejection, no-default behavior, determinism, immutability, and exact UI serialization.
: Correction history
- Corrected low-risk survival wording from an unsupported 15-plus-year estimate to median not reached; removed favorable defaults and permissive value summation; required all five canonical inputs; and added the source-defined symptom, persistent non-treatment-related anemia, PMF population, exclusions, and historical-outcome context. No valid-input point-formula mismatch was found.
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
Does age 65 count as an adverse factor?
No. The original DIPSS threshold is older than 65 years, so age 65 scores zero and age 66 scores one.
What counts as constitutional symptoms?
At least one of weight loss greater than 10% in 6 months, night sweats, or unexplained fever above 37.5 C.
Can DIPSS be used for post-PV or post-ET myelofibrosis?
Not as this source-locked implementation. Those conditions were excluded from the original DIPSS cohort; use an appropriate secondary-MF model such as MYSEC-PM when applicable.
Evidence-based oncology decision support. Verify with clinical guidelines.