Revised international prognostic scoring system (IPSS-R)

While IPSS-R has been fully accepted as risk model for newly diagnosed patients, its role in therapeutic decision-making is weakened by the fact that most EMA approved treatments have been evaluated according to IPSS, not IPSS-R.

The MDS Right guidelines therefore do not offer an IPSS-R based therapeutic decision model. However, information about IPSS-R status is included under each specific treatment alternative.

• Generally, IPSS-R very low and low risk can be treated as IPSS low and intermediate-1 risk.
• Generally, IPSS-R high and very high risk can be treated as IPSS intermediate-2 and high risk.

Patients with IPSS-R Intermediate risk need special consideration. The Guideline group foresee that large ongoing clinical trials and sequencing projects will add to the knowledge about these patients. We recommend that patients with intermediate IPSS-R, who are considered potential SCT candidates, are discussed with specialized centers.