What Is the DIPSS Scoring System and How Is It Used to Monitor MPNs?

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From our latest Ask the Expert segment with Dr. Bart Scott from Seattle Cancer Care Alliance (SCCA), he answers viewer Vern’s question, “What is the DIPSS scoring system, and how is it used in the monitoring of MPNs?”  Dr. Scott explains risk scores associated with survival and how that affects choices for treatment. 

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:

Hello.  Andrew Schorr from Patient Power and welcome to our Ask the Expert series discussing MPNs.  With me is Dr. Bart Scott from the Fred Hutchinson Cancer Research Center and the Seattle Cancer Care Alliance.  We have questions that have been sent in to us, Dr. Scott, so I'm going to fire it to you. 

Dr. Scott:

Okay. 

Andrew Schorr:

So this one comes from Vern from Staten Island, New York, and he says, “What is the DIPSS scoring system, and how is it used in the monitoring of MPNs?” 

Dr. Scott:

All right.  So that stands for DIPSS.  It's the Dynamic International Prognostic Scoring System, and it's our current prognostic model for myelofibrosis. 

We have different prognostic models for polycythemia vera and a different prognostic model for essential thrombocytosis, so they each have their own prognostic model.  But for myelofibrosis it's the DIPSS, and that is age greater than 65, the presence of peripheral blast, constitutional symptoms, a white count greater than 20,000, and the constitutional systems are weight loss, night sweats and fever.  So if you have those types of problems then—oh, and a hemoglobin less than 10, that's the other one. 

But if you have any of those, that increases your risk score. And so for example I mentioned in the earlier session about how we decide whether or not someone should go to transplant, we use that DIPSS score to determine if someone should go to transplant.  So if they have intermediate 2 or high-risk disease and they're a good transplant candidate, then we would refer them for allogeneic transplant, because the DIPSS score's associated with survival. 

I'll just mention also that ruxolitinib (Jakafi) technically is only FDA approved for intermediate 1, intermediate 2 and high-risk disease. So if someone has low?risk disease, that might be someone that you would just follow and not necessarily institute therapy.  

Andrew Schorr: 

Thank you, Dr. Scott.  If you have a question for us, just send it to mpn@patientpower.info, and perhaps it will be part of one of our other Ask the Expert sessions. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on November 23, 2015