Myelofibrosis prognosis

DIPSS, IWG-MRT and Lille prognostic scores for myelofibrosis

DIPSS prognostic score

The Dynamic International Prognostic Scoring System (DIPSS) can be applied at any time in disease course.

1. Sum the points for each prognostic factor

Prognostic variable0 points1 point2 points
Age (y)≤ 65> 65-
White blood cell count (x109/L)≤ 25> 25-
Hemoglobin (g/dL)≥ 10-< 10
Peripheral blood blasts (%)< 1≥ 1-
Constitutional symptoms?NoYes-

2. Determine DIPSS risk category and prognosis

DIPSS scoreDIPSS risk categoryMedian OS (y)
0LowNot reached
1 - 2Intermediate-114.2
3 - 4Intermediate-24
5 - 6High1.5

IWG-MRT prognostic score for myelofibrosis

Applies at the time of diagnosis.

1. Sum the number of adverse prognostic factors

  • Age > 65 y
  • Constitutional symptoms
  • Hemoglobin <10 g/dL
  • WBC count > 25 × 109/L
  • Circulating blasts >1%

2. Determine IWG-MRT risk group and prognosis

Number of factorsRisk groupPro­portion of patientsMedian OS (m)
0Low22135
1Inter­mediate-12995
2Inter­mediate-22848
≥ 3High2127

Lille prognostic score for myelofibrosis

Applies at the time of diagnosis.

1. Sum the number of adverse prognostic factors

  • Hemoglobin <10 g/dL
  • White cell count < 4 or > 30 x 109/L

2. Determine risk category and prognosis

Number of factorsRisk groupPro­portion of patientsMedian OS (m)
0Low4793
1Inter­mediate4526
2High813

The Dynamic International Prognostic Scoring System (DIPSS) was derived from multivariate analysis of survival of 525 patients with primary myelofibrosis diagnosed between 1980 and 2008, and can be applied at any stage during disease course.1

The International Working Group for Myelofibrosis Research and Treatment (IWG-MRT) prognostic score is applied at diagnosis, and derives from a retrospective analysis of survival of 1131 patients diagnosed with primary myelofibrosis between 1980 and 2007.2

The Lille prognostic score was developed from a multivariate analysis of survival of 195 patients diagnosed with primary myelofibrosis between 1962 and 1992,3 and is applied at the time of diagnosis.