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IPSSWM Calculator

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:

  1. Age > 65 years
  2. Hemoglobin ≤ 11.5 g/dL
  3. Platelet count ≤ 100 × 10^9/L
  4. β2-microglobulin > 3 mg/L
  5. 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

Important Considerations

  • Results should be interpreted by a healthcare professional
  • The score should be considered alongside other clinical factors
  • Regular monitoring may be necessary
  • Treatment decisions should not be based solely on IPSSWM

When to Calculate IPSSWM

Calculate IPSSWM:

  • At initial diagnosis
  • Before starting treatment
  • When evaluating prognosis
  • For clinical trial eligibility

Limitations

This calculator:

  • Is based on pre-treatment characteristics
  • May not reflect changes after therapy
  • Should be interpreted within clinical context
  • May not account for all prognostic factors

Tips for Accurate Results

  1. Use recent laboratory values
  2. Ensure correct units are selected
  3. Verify all measurements
  4. Consider repeat testing if results are unexpected

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:

  1. Morel P, Duhamel A, Gobbi P, et al. International prognostic scoring system for Waldenstrom macroglobulinemia. Blood. 2009;113(18):4163-4170. doi:10.1182/blood-2008-08-174961