DIPSS

DIPSS stands for Dynamic International Prognostic Scoring System, a prognostic tool used to estimate survival and disease trajectory in primary myelofibrosis, a rare bone marrow disorder. Developed to provide a dynamic, time-updated assessment, DIPSS allows clinicians to re-evaluate prognosis as a patient’s clinical and laboratory features change.

The original DIPSS assigns one point for each of five adverse factors: age over 65 years, hemoglobin less than 10 g/dL, white blood cell count greater than 25 x 10^9/L, circulating blasts of 1% or more, and the presence of constitutional symptoms such as fever, night sweats, or weight loss. Based on the total score, patients are categorized into four risk groups: low (0 points), intermediate-1 (1-2 points), intermediate-2 (3-4 points), and high risk (5 points). Each category corresponds to an estimated survival prognosis, aiding clinical decisions.

DIPSS Plus extends the original model by adding three additional adverse factors: unfavorable cytogenetics, red blood cell transfusion dependence, and thrombocytopenia (low platelet count). These additions aim to refine risk stratification further and improve prognostic accuracy for individual patients.

In clinical practice, DIPSS and DIPSS Plus are used to guide treatment decisions, including timing of disease-modifying therapy and consideration of clinical trials. They are applicable at diagnosis and can be reapplied as a patient’s condition evolves, reflecting the dynamic nature of myelofibrosis prognosis. Limitations include variability in data collection and evolving understanding of molecular drivers, which has led to newer scoring systems that incorporate genetic mutations alongside clinical features.