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
- Use recent laboratory values
- Ensure accurate documentation of constitutional symptoms
- Double-check input numbers
- 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!
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