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Prognostic Score of Malcovati et al for the Myelodysplastic Syndrome Using the WHO Classification (WHO Classification-Based Prognostic Scoring System, WPSS)

Purpose: To evaluate a patient with myelodysplasia using the prognostic score of Malcovati et al (WPSS).

Description

Malcovati et al developed a prognostic score for patients with myelodysplasia. This can help identify a patient who may benefit from more aggressive management. The authors are from the University of Pavia, Fondazione Instituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Heinrich-Heine Univerisity, and St. Johannes Hospital (Duisburg, Germany).


Parameters:

(1) WHO classification of myelodysplasia

(2) karyotype on bone marrow cytogenetics

(3) requirement for red blood cell transfusion

 

Parameter

Finding

Points

type of myelodysplasia (WHO)

refractory anemia

0

 

refractory anemia with ringed sideroblasts

0

 

5q(-)

0

 

refractory cytopenia with multilineage dysplasia

1

 

refractory cytopenia with multilineage dysplasia and ringed sideroblasts

1

 

refractory anemia with excess blasts, type 1

2

 

refractory anemia with excess blasts, type 2

3

karyotype

normal, (-)Y, 5q(-), 20q(-)

0

 

not in either of other groups

1

 

>= 3 abnormalities (complex), chromosome 7 abnormalities

2

blood transfusion requirements

not dependent

0

 

dependent (>= 1 transfusion every 8 weeks over 4 months)

1

 

where:

• The level for transfusion dependency seems to be set fairly low.

 

total score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 6

• The higher the score the worse the prognosis.

 

Total Score

Risk Group

0

very low

1

low

2

intermediate

3 or 4

high

5 or 6

very high

 


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Specialty

Objective

ICD-10