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Mutation-Enhanced International Prognostic Score System (MIPSS70)

Risk-stratifies transplant-age patients with overt primary myelofibrosis using clinical, mutation, and marrow data.

Mutation-Enhanced International Prognostic Score System (MIPSS70)
Hemoglobin
Leukocyte count
x10⁹/L
Platelet count
x10⁹/L
Circulating blasts
%
Bone marrow fibrosis grade 2-3
Constitutional symptoms (fever, night sweats, weight loss >10%)
Absence of CALR type-1/type-1-like mutation
High-molecular-risk mutations present (ASXL1, EZH2, SRSF2, IDH1/2)
Complete the fields above to see the result.

When to use

  • Risk-stratifying transplant-eligible (≤70 years) patients with overt primary myelofibrosis to guide timing of allogeneic transplant referral.

Formula

Points: Hb<10 g/dL (1), leukocytes>25x10⁹/L (2), platelets<100x10⁹/L (1), circulating blasts≥2% (1), marrow fibrosis grade≥2 (1), constitutional symptoms (1), absence of CALR type-1 mutation (1), 1 high-molecular-risk mutation (1) or ≥2 (2). Low 0-1, intermediate 2-4, high ≥5.

Pearls and pitfalls

  • MIPSS70-plus additionally incorporates karyotype and yields four risk categories (adds a very-high-risk group).
  • Requires next-generation sequencing for CALR and high-molecular-risk mutation status; not usable without molecular data.

References

  1. Guglielmelli P, et al. J Clin Oncol. 2018;36(4):310-318.