# IPSS-M: the molecular international prognostic scoring system for myelodysplastic syndromes

Source: https://onco.cc/key-papers/paper-ipss-m-bernard-nejm-evidence-2022/  
OnCo record `paper-ipss-m-bernard-nejm-evidence-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

By adding mutations in 31 genes to blood counts and chromosomes, the IPSS-M sorts myelodysplastic syndromes into six risk groups and reclassifies about half of patients compared with the older score.

## Summary

Development and validation of a prognostic model in 2,957 patients with MDS, combining clinical variables, cytogenetics and mutations in 31 genes into a continuous score with six risk categories; validated in an independent cohort of 754 patients.

TP53 multi-hit, FLT3 and MLL partial tandem duplications carried the most adverse weight; SF3B1 was favourable. Compared with IPSS-R, 46 percent of patients were reclassified, most often upwards.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: NEJM Evidence
- Year: 2022
- DOI: 10.1056/EVIDoa2200008
- Authors: Bernard E, Tuechler H, Greenberg PL, et al.
- Findings: Six risk categories with median survival from over 10 years to about one year.; 46 percent of patients reclassified compared with IPSS-R, 74 percent of those to a higher risk group.
- What it means: Sequencing at diagnosis now changes the risk group, and therefore the transplant discussion, for a large fraction of patients. Trials and guidelines are adopting the IPSS-M in place of the IPSS-R.
- Caveats: Requires a broad myeloid sequencing panel that is not universally available.; Derived mostly from untreated patients at diagnosis.

## Sources

- NEJM Evid 2022: https://doi.org/10.1056/EVIDoa2200008
- PubMed: https://pubmed.ncbi.nlm.nih.gov/38319256/

## Connected records

- cancers: [Higher-risk myelodysplastic syndromes](https://onco.cc/cancers/mds-higher-risk/)
- journals: [NEJM Evidence](https://onco.cc/journals/nejm-evidence/)

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