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DIPSS Calculator for Myelofibrosis

Dynamic International Prognostic Scoring System (DIPSS)

Understanding DIPSS for Myelofibrosis

The Dynamic International Prognostic Scoring System (DIPSS) is a valuable prognostic tool used to assess risk and predict survival in patients with primary myelofibrosis. Unlike its predecessor IPSS, DIPSS can be applied at any time during the disease course, making it a more versatile tool for ongoing patient assessment.

What is DIPSS?

DIPSS evaluates five key risk factors:

  • Age > 65 years
  • Hemoglobin < 10 g/dL
  • White Blood Cell count > 25 × 10^9/L
  • Peripheral blood blasts ≥ 1%
  • Constitutional symptoms (night sweats, weight loss > 10%, unexplained fever)

Risk Groups and Scoring

DIPSS assigns points as follows:

  • Age > 65 years: 1 point
  • Hemoglobin < 10 g/dL: 2 points
  • WBC > 25 × 10^9/L: 1 point
  • Peripheral blood blasts ≥ 1%: 1 point
  • Constitutional symptoms: 1 point

Risk groups are determined by total score:

  • Low risk: 0 points
  • Intermediate-1: 1-2 points
  • Intermediate-2: 3-4 points
  • High risk: 5-6 points

Clinical Significance

Median Survival by Risk Group

  • Low risk: Not reached
  • Intermediate-1: 14.2 years
  • Intermediate-2: 4 years
  • High risk: 1.5 years

Important Considerations

  • Results should be interpreted by a healthcare professional
  • DIPSS should be considered alongside other clinical findings
  • Regular reassessment may be necessary as disease progresses
  • Treatment decisions should not be based solely on DIPSS score

When to Use DIPSS

DIPSS is particularly useful for:

  • Initial risk assessment
  • Disease monitoring
  • Treatment planning
  • Clinical trial stratification
  • Prognosis discussion

Limitations

This calculator:

  • Provides estimates based on input values
  • Should not replace clinical judgment
  • Must be interpreted within clinical context
  • May not account for all prognostic factors

Tips for Accurate Results

  1. Use recent laboratory values
  2. Ensure accurate documentation of constitutional symptoms
  3. Double-check input numbers
  4. Consider repeat testing if results unexpected

Clinical Applications

DIPSS is valuable for:

  • Risk stratification
  • Treatment selection
  • Monitoring disease progression
  • Timing of allogeneic stem cell transplantation
  • Clinical research

Start calculating now to better understand your patient's prognosis!

References:

  1. Passamonti F, et al. A dynamic prognostic model to predict survival in primary myelofibrosis: a study by the IWG-MRT. Blood. 2010;115(9):1703-1708.