# IPSS-R and IPSS-M (myelodysplastic syndrome risk scores)

Source: https://onco.cc/terms/ipss-m-ipss-r/  
OnCo record `ipss-m-ipss-r` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

IPSS-R adds up marrow blasts, blood counts and chromosome findings, and IPSS-M adds the mutations in 31 genes, to place a person with myelodysplastic syndrome in a risk group that decides between watching, growth-factor and low-intensity drugs, or moving quickly to a transplant.

## Summary

What is measured: the risk of progression to acute leukaemia and of death. How: IPSS-R (2012) scores marrow blast percentage, a five-tier cytogenetic category (very good to very poor), haemoglobin, platelets and neutrophils into five groups from very low to very high; IPSS-M (2022) keeps the clinical variables and adds mutations in 31 genes from a myeloid sequencing panel, including TP53 allelic state (multi-hit is far worse than single-hit), SF3B1 (favourable when isolated) and a count of residual mutated genes, giving six groups and moving about half of patients, most of them upwards. Inputs come from a marrow aspirate and trephine with blast count, karyotype and FISH (del(5q), monosomy 7 or del(7q), complex karyotype) and sequencing. What a result changes: lower-risk disease is managed for its cytopenias (erythropoiesis-stimulating agents, luspatercept, lenalidomide for del(5q), imetelstat, transfusion and iron chelation); higher-risk disease moves to hypomethylating agents and, when fit, allogeneic transplant, with the score deciding timing; both scores set trial eligibility. Where it matters: lower-risk and higher-risk MDS; DIPSS and MIPSS70 are the myelofibrosis equivalents and IPSSWM the Waldenström one.

## Fields

- Kind: Term
- Last checked: 2026-09-17
- Also known as: IPSS; IPSS-R; IPSS-M; Revised International Prognostic Scoring System; Molecular International Prognostic Scoring System; IPSS-R score; IPSS-M score; lower-risk MDS; higher-risk MDS; very low risk MDS; very high risk MDS; MDS risk score; MDS risk group

## Connected records

- terms: [Allogeneic stem cell transplant (allo-SCT)](https://onco.cc/terms/allogeneic-transplant/), [AML with myelodysplasia-related gene mutations (AML-MR)](https://onco.cc/terms/aml-myelodysplasia-related/), [Blasts (leukaemic blast cells)](https://onco.cc/terms/blasts/), [Cytogenetics and karyotype](https://onco.cc/terms/cytogenetics/), [del(5q) (5q- syndrome and lenalidomide response)](https://onco.cc/terms/del5q/), [Hypomethylating agents (azacitidine, decitabine)](https://onco.cc/terms/hma/), [Next-generation sequencing (NGS)](https://onco.cc/terms/ngs/), [SF3B1 mutation](https://onco.cc/terms/sf3b1-mutation/), [TP53-mutated (p53-abnormal)](https://onco.cc/terms/tp53-mutated/)
- drugs: [Azacitidine](https://onco.cc/drugs/azacitidine/), [Imetelstat](https://onco.cc/drugs/imetelstat/), [Lenalidomide](https://onco.cc/drugs/lenalidomide/), [Luspatercept](https://onco.cc/drugs/luspatercept/)
- cancers: [Higher-risk myelodysplastic syndromes](https://onco.cc/cancers/mds-higher-risk/), [Lower-risk myelodysplastic syndromes](https://onco.cc/cancers/mds-lower-risk/)

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