WPSS — WHO Prognostic Scoring System for MDS
WHO-based prognostic scoring system for myelodysplastic syndromes. Incorporates WHO category, karyotype, and transfusion dependence.
Score interpretation
WPSS 0. Median survival 103 months (Pavia cohort; 141 months in the Düsseldorf validation cohort).
→ Watch and wait or EPO for anaemia. Annual review.
WPSS 1. Median survival 72 months (66 months in the validation cohort).
→ Supportive care, EPO, growth factors. Consider lenalidomide for del5q.
WPSS 2. Median survival 40 months (48 months in the validation cohort).
→ Hypomethylating agents (azacitidine) may be indicated. Consider allo-SCT if eligible.
WPSS 3–4. Median survival 21 months (26 months in the validation cohort).
→ Azacitidine or intensive chemotherapy. Allo-SCT for eligible patients. Clinical trial.
WPSS 5–6. Median survival 12 months (9 months in the validation cohort).
→ Best supportive care or hypomethylating agent. Allo-SCT only if fit and suitable donor available. Palliative considerations.
Interpretation bands for the WPSS. Apply clinical judgement and local guidance.
References
- Malcovati L et al. Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes. J Clin Oncol. 2007;25(23):3503-3510.
Related
Curated clinical cross-links plus same-class fallbacks.
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- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.