Stages

There is no staging system for myelodysplastic syndromes. Because myelodysplastic syndrome is a disease of the bone marrow, it cannot be staged by looking at the size of a tumor like other cancers. Other factors are used instead. These factors include the patient's blood counts, the appearance of their bone marrow, their age, and certain chromosome changes.

International Prognostic Scoring System (IPSS)

While the syndromes aren't staged, a prognostic scoring system for myelodysplastic syndromes has been established and rates three factors:

The Percentage of Blasts in the Bone Marrow (scored on a scale from 0 to 2)
Chromosome Abnormalities (scored on a scale from 0 to 2)
Blood Counts (scored as 0 or 0.5)

Each factor is then given a score, with the lowest scores having the best outlook. Then the scores for the factors are added together and categorized into four groups:

Low Risk
Intermediate - 1 risk (Int-1)
Intermediate - 2 risk (Int-2)
High Risk

WHO Prognostic Scoring System (WPSS)

In addition to the International Prognostic Scoring System, the WHO Prognostic Scoring System has been established. This system is also based on three factors:

The Type of Syndrome Based on the WHO Classification
Chromosome Abnormalities
Whether the Patient Requires Blood Transfusions

It then places patients into one of five groups:

Very Low Risk (score=0)
Low Risk (score=1)
Intermediate Risk (score=2)
High Risk (score=3)
Very High Risk (score=5 or 6)

Treatment is based on whether the disease developed after the patient was exposed to factors that cause myelodysplastic syndrome or whether the disease was previously treated.

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