对于患有骨髓增生异常综合征或骨髓增生异常肿瘤（MDS）的患者来说，风险分层和预后评估对于适当的治疗管理至关重要，预期存活时间可以从几个月到超过10年不等。在过去的五十年里，通过顺序发展的临床预后评分系统，将MDS患者分类为高风险和低风险疾病表型。这些预后评分系统捕捉到了形态学畸形、临床血液学参数、细胞遗传学，以及最近的突变信息等因素，这些因素改进了风险分层，并指导了MDS患者的治疗管理。本文将描述这些系统逐步演化和改进至目前的分子国际预后评分系统（IPSS-M）。版权所有 © 2023 美国血液学会。

Risk stratification and prognostication are crucial for the appropriate management of patients with myelodysplastic syndromes or myelodysplastic neoplasms (MDS), for whom expected survival can vary from a few months to more than 10 years. For the past five decades, patients with MDS have been classified into higher-risk versus lower-risk disease phenotypes using sequentially developed clinical prognostic scoring systems. Factors such as morphologic dysplasia, clinical hematologic parameters, cytogenetics, and more recently, mutational information, have been captured in prognostic scoring systems which refine risk stratification and guide therapeutic management in MDS patients. This review will describe the progressive evolution and improvement of these systems to the current Molecular International Prognostic Scoring System (IPSS-M).Copyright © 2023 American Society of Hematology.