Hana Safah, MD explains how the risk stratification for MDS has evolved over time and provides an in-depth of the current risk stratification tools, IPSS, IPSS-R and IPSS-M.
This is a video synopsis/summary of a Precision Medicine series featuring Hana Safah, MD, and Jamie Koprivnikar, MD. Safah and Koprivnikar discuss the evolution of risk stratification for patients with myelodysplastic syndromes (MDS). Initially, the International Prognostic Scoring System (IPSS) categorized patients into 4 risk groups based on cytopenia, blast percentage, and karyotype. This enabled treatment decisions and clinical trial eligibility.
The revised IPSS (IPSS-R) refined this into 5 groups using the same parameters plus depth of individual cytopenia. It defines low-risk MDS as having very low–, low-, and intermediate-risk categories, comprising 77% of patients. Despite 5- to 6-year median overall survival, low-risk patients still suffer meaningful cytopenia impacting quality of life.
More recently, the molecular IPSS (IPSS-M) better captures prognosis by integrating genetic data. Some patients classified as low risk by IPSS-R are upstaged to higher-risk disease by IPSS-M. With 6 risk strata, IPSS-M provides more precise classification.
However, clinical trials and treatment selections still rely on traditional IPSS/IPSS-R. With time, IPSS-M will be incorporated into research and practice to guide management. Ongoing refinements should continue to provide individualized assessments optimizing patient outcomes.
Video synopsis is AI generated and reviewed by Targeted Oncology™ editorial staff.
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