WPSS Calculator

World Health Organisation (WHO) Classification-Based Prognosis Scoring System1,2


Classification1
WPSS Score
RESULT
WPSS risk classification
RESULT
Prognosis1
Median overall survival (months)
RESULT
Probability of 2-year AML progression (%)
RESULT
*The shown prognosis is based on the learning cohort.1

How to use the WPSS calculator

1

Select the WHO 2002 classification as defined below2

WHO 2002 Classification
Refractory anaemia (RA)
Refractory anaemia with ringed sideroblasts (RARS)
Refractory cytopenia with multilineage dysplasia (RCMD)
Refractory cytopenia with multilineage dysplasia and ringed sideroblasts (RCMD-RS)
Refractory anaemia with excess blasts-1 (RAEB-1)
Refractory anaemia with excess blasts-2 (RAEB-2)
Myelodysplastic syndrome (MDS) with isolated del(5q)
Blood findings
Anaemia
No or rare blasts
Anemia
No blasts
Cytopenias (bicytopenia or pancytopenia)
No or rare blasts
No Auer rods
<1x109/L monocytes
Cytopenias (bicytopenia or pancytopenia)
No or rare blasts
No Auer rods
<1x109/L monocytes
Cytopenias
<5% blasts
No Auer rods
<1x109/L monocytes
Cytopenias (RAEB-2)
5–19% blasts
No Auer rods
Auer rods ± <1x109/L monocytes
Anemia
<5% blasts
Platelets normal or increased
Bone marrow findings
Erythroid dysplasia only
<5% blasts
<15% ringed sideroblasts
Erythroid dysplasia only
≥15% ringed sideroblasts
<5% blasts
Dysplasia in ≥10% of cells in 2 or more myeloid cell lines
≥15% ringed sideroblasts
<5% blasts
No Auer rods
Dysplasia in ≥10% of cells in 2 or more myeloid cell lines
<5% blasts
No Auer rods
<15% ringed sideroblasts
Unilineage or multilineage dysplasia
10–19% blasts
No Auer rods
Unilineage or multilineage dysplasia
10–19% blasts
Auer rods ±
Normal to increased megakaryocytes with hypolobated nuclei
<5% blasts
No Auer rods
Isolated del(5q)

Note: Patients with MDS unclassified, patients with chronic myelomonocytic leukemia, and patients with 20% marrow blasts, who were considered as having AML, were excluded.1

Used with permission of Blood: journal of the American Society of Hematology, from The World Health Organization (WHO) classification of the myeloid neoplasms, Vardiman JW et al., 100(7), 2002; permission conveyed through Copyright Clearance Center, Inc.

2

Select the karyotype risk according to the International Prognostic Scoring System (IPSS)3

Definition of karyotype risk

Good: normal; –Y; del(5q); del(20q)

Intermediate: other abnormalities not specified as good- or poor-risk

Poor: complex (≥3 abnormalities); chromosome 7 anomalies

3

Select the transfusion requirement1

Definition of red blood cell transfusion dependency

No: <1 red blood cell transfusion every 8 weeks over a period of 4 months

Regular: ≥1 red blood cell transfusion every 8 weeks over a period of 4 months

4

Click ‘CALCULATE’

5

In the classification field, the WPSS score and risk group will be shown

6

In the prognosis field, the estimated median overall survival (months) and probability of acute myeloid leukaemia (AML) progression within 2 years (%) according to the WPSS risk group will also be shown

7

If necessary, the WPSS score can be recalculated by amending the WHO classification, karyotype risk and/or transfusion requirement in the drop down boxes and clicking ‘RECALCULATE’

Additional Information

Risk classification of MDS patients using the WPSS1

The WPSS is a time-dependent risk classification for patients with MDS. Three parameters are included in the evaluation:

Depending on these parameters, a score is calculated that leads to the classification into one of five risk groups (very low, low, intermediate, high, very high). Unlike the IPSS, the WPSS considers patients' red blood cell transfusion requirements and allows for repeat assessments during treatment.

The WPSS was developed using a cohort of 426 patients with de novo MDS from an Italian registry and was validated using a cohort of 739 patients with de novo MDS from the German Düsseldorf MDS registry.1 The WPSS is able to predict estimated survival and AML progression rates in patients with MDS. From this, the median overall survival and 2-year AML progression rate were estimated for each risk group.

Prognosis of MDS patients using the WPSS1

MDS patients with a lower WPSS classification score have longer survival and a longer time to AML progression than patients with a higher WPSS classification score.1

Time-dependent overall survival and AML progression in patients with de novo MDS according to WPSS classification are shown below.

Malcovati L, et al. Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes: J Clin Oncol 25, 2007: 3505–10. Reprinted with permission. © (2007) American Society of Clinical Oncology. All rights reserved.

  1. Malcovati L, et al. J Clin Oncol 2007;25:3503–10
  2. Vardiman JW, et al. Blood 2002;100:2292–302
  3. Greenberg P, et al. Blood 1997;89:2079–88