{"entity":{"id":"ipss-m-ipss-r","kind":"term","name":"IPSS-R and IPSS-M (myelodysplastic syndrome risk scores)","aka":["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"],"tldr":"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.","asOf":"2026-09-17","links":[],"tags":[],"related":["cytogenetics","tp53-mutated","del5q","sf3b1-mutation","ngs","blasts","hma","azacitidine","luspatercept","lenalidomide","imetelstat","allogeneic-transplant"],"cancers":["mds-lower-risk","mds-higher-risk"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Biomarkers"},"route":"/terms/ipss-m-ipss-r/","neighbours":{"term":[{"id":"allogeneic-transplant","kind":"term","name":"Allogeneic stem cell transplant (allo-SCT)","route":"/terms/allogeneic-transplant/"},{"id":"aml-myelodysplasia-related","kind":"term","name":"AML with myelodysplasia-related gene mutations (AML-MR)","route":"/terms/aml-myelodysplasia-related/"},{"id":"blasts","kind":"term","name":"Blasts (leukaemic blast cells)","route":"/terms/blasts/"},{"id":"cytogenetics","kind":"term","name":"Cytogenetics and karyotype","route":"/terms/cytogenetics/"},{"id":"del5q","kind":"term","name":"del(5q) (5q- syndrome and lenalidomide response)","route":"/terms/del5q/"},{"id":"hma","kind":"term","name":"Hypomethylating agents (azacitidine, decitabine)","route":"/terms/hma/"},{"id":"ngs","kind":"term","name":"Next-generation sequencing (NGS)","route":"/terms/ngs/"},{"id":"sf3b1-mutation","kind":"term","name":"SF3B1 mutation","route":"/terms/sf3b1-mutation/"},{"id":"tp53-mutated","kind":"term","name":"TP53-mutated (p53-abnormal)","route":"/terms/tp53-mutated/"}],"drug":[{"id":"azacitidine","kind":"drug","name":"Azacitidine","route":"/drugs/azacitidine/"},{"id":"imetelstat","kind":"drug","name":"Imetelstat","route":"/drugs/imetelstat/"},{"id":"lenalidomide","kind":"drug","name":"Lenalidomide","route":"/drugs/lenalidomide/"},{"id":"luspatercept","kind":"drug","name":"Luspatercept","route":"/drugs/luspatercept/"}],"cancer":[{"id":"mds-higher-risk","kind":"cancer","name":"Higher-risk myelodysplastic syndromes","route":"/cancers/mds-higher-risk/"},{"id":"mds-lower-risk","kind":"cancer","name":"Lower-risk myelodysplastic syndromes","route":"/cancers/mds-lower-risk/"}]}}