International Prognostic Scoring System for Waldenström Macroglobulinemia (IPSSWM)
Understanding IPSSWM
The International Prognostic Scoring System for Waldenström Macroglobulinemia (IPSSWM) is a validated tool used to assess prognosis in patients with Waldenström Macroglobulinemia (WM). It considers five key factors that have been shown to independently affect survival: age, hemoglobin level, platelet count, β2-microglobulin, and serum monoclonal IgM concentration.
Risk Factors
Each of these factors contributes one point to the score when beyond the threshold:
- Age > 65 years
- Hemoglobin ≤ 11.5 g/dL
- Platelet count ≤ 100 × 10^9/L
- β2-microglobulin > 3 mg/L
- Serum monoclonal IgM > 70 g/L
Risk Groups
Based on the total score and age, patients are classified into three risk groups:
-
Low Risk:
- Score ≤ 1 and age ≤ 65 years
- 5-year survival rate: 87%
-
Intermediate Risk:
- Score = 2 and age ≤ 65 years, or
- Score ≤ 2 and age > 65 years
- 5-year survival rate: 68%
-
High Risk:
- Score ≥ 3
- 5-year survival rate: 36%
Clinical Applications
IPSSWM is used to:
- Stratify patients for clinical trials
- Guide treatment decisions
- Provide prognostic information
- Compare outcomes across different studies
When to Calculate IPSSWM
Calculate IPSSWM:
- At initial diagnosis
- Before starting treatment
- When evaluating prognosis
- For clinical trial eligibility
Factors Affecting Components
Age
- Fixed factor
- Reflects overall health status
- Associated with comorbidities
Hemoglobin
- Affected by bone marrow involvement
- May indicate disease severity
- Can be influenced by other conditions
Platelet Count
- Reflects bone marrow function
- May be affected by other conditions
- Can indicate disease progression
β2-microglobulin
- Marker of tumor burden
- Affected by kidney function
- Indicates disease activity
Serum Monoclonal IgM
- Direct measure of disease burden
- May cause hyperviscosity
- Reflects tumor cell activity
Start calculating now to better understand your patient's prognosis!
References: