# GIPSS (primary myelofibrosis) GIPSS Status: LIVE Price: $0.005 USDC `GET /api/calc/gipss` HTML: https://magentlab.com/docs/gipss Markdown: https://magentlab.com/docs/gipss.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Sum the Tefferi 2018 GIPSS (genetically inspired prognostic scoring system) for primary myelofibrosis and return low (0), intermediate_1 (1), intermediate_2 (2), or high (≥3). ## When to use When an agent needs the published GIPSS point total and risk group and must not invent a PMF diagnosis or transplant listing, and must not substitute DIPSS, DIPSS Plus, or MIPSS70-plus. ## When not to use - Not a medical device and not a PMF diagnosis or transplant listing. magent does not examine the patient. - This is Tefferi 2018 GIPSS only, not DIPSS, not DIPSS Plus, not MIPSS70, and not MIPSS70-plus. - magent does not karyotype. karyotype is the caller-assigned three-tier class (favorable, unfavorable, vhr) from Tefferi 2018 revised cytogenetics. - magent does not sequence. calr_type1_like, asxl1_mutated, srsf2_mutated, and u2af1_q157_mutated are caller-assigned flags. U2AF1 scores only Q157, not S34. - Published median and 5-year survivals are Tefferi 2018 cohort figures for the four GIPSS bands, not a patient-specific prediction. ## Formula ``` GIPSS = karyotype (favorable 0, unfavorable 1, vhr 2) + absence of type 1/like CALR 1 + asxl1_mutated 1 + srsf2_mutated 1 + u2af1_q157_mutated 1; Tefferi 2018; max 6; low 0, intermediate_1 1, intermediate_2 2, high ≥3 ``` ## Citation [GIPSS: genetically inspired prognostic scoring system for primary myelofibrosis](https://doi.org/10.1038/s41375-018-0107-z) Tefferi A, Guglielmelli P, Nicolosi M, Mannelli F, Mudireddy M, Bartalucci N, Finke CM, Lasho TL, Hanson CA, Ketterling RP, Begna KH, Gangat N, Pardanani A, Vannucchi AM Leukemia. 2018;32(7):1631-1642 DOI: [10.1038/s41375-018-0107-z](https://doi.org/10.1038/s41375-018-0107-z) ## Worked example ### Favorable karyotype, type 1/like CALR, no high-risk mutations Given: `asxl1_mutated=false, calr_type1_like=true, karyotype=favorable, srsf2_mutated=false, u2af1_q157_mutated=false` 1. karyotype favorable → 0; calr_type1_like true → 0; asxl1_mutated false → 0; srsf2_mutated false → 0; u2af1_q157_mutated false → 0 2. Score = 0 (max 6); risk_group = low ### VHR karyotype, no type 1/like CALR, ASXL1 and SRSF2 Given: `asxl1_mutated=true, calr_type1_like=false, karyotype=vhr, srsf2_mutated=true, u2af1_q157_mutated=false` 1. karyotype vhr → 2; absence of type 1/like CALR → 1; asxl1_mutated → 1; srsf2_mutated → 1; u2af1_q157_mutated false → 0 2. Score = 5 (max 6); risk_group = high (≥3) ## Also searched as - GIPSS - genetically inspired prognostic scoring system - Tefferi GIPSS - GIPSS myelofibrosis - primary myelofibrosis GIPSS - PMF GIPSS - Tefferi 2018 GIPSS - genetically inspired PMF score ## Parameters - `karyotype` (string, required): Tefferi 2018 revised three-tier karyotype as assigned by the caller (mutually exclusive). favorable is a normal karyotype or sole 13q−, +9, 20q−, chromosome 1 translocation/duplication, or sex chromosome abnormality including −Y and scores 0. unfavorable is all other abnormalities and scores 1. vhr is very high risk: single/multiple −7, i(17q), inv(3)/3q21, 12p−/12p11.2, 11q−/11q23, +21, or other autosomal trisomies not including +8/+9 and scores 2. magent does not karyotype. - `calr_type1_like` (boolean, required): Presence of a type 1/like CALR mutation as assigned by the caller (Tefferi 2018). false (absence) scores 1. true scores 0. Type 2/like CALR, JAK2, MPL, and triple-negative are absence of type 1/like CALR. magent does not sequence. - `asxl1_mutated` (boolean, required): ASXL1 mutation as assigned by the caller (Tefferi 2018). true scores 1. magent does not sequence. - `srsf2_mutated` (boolean, required): SRSF2 mutation as assigned by the caller (Tefferi 2018). true scores 1. magent does not sequence. - `u2af1_q157_mutated` (boolean, required): U2AF1 Q157 mutation (Q157P or Q157R) as assigned by the caller (Tefferi 2018). true scores 1. U2AF1 S34 does not score. magent does not sequence. ## Bulk (POST) POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/gipss` Max items: 25 Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "asxl1_mutated": "false", "calr_type1_like": "true", "karyotype": "favorable", "srsf2_mutated": "false", "u2af1_q157_mutated": "false" }, { "asxl1_mutated": "false", "calr_type1_like": "true", "karyotype": "favorable", "srsf2_mutated": "false", "u2af1_q157_mutated": "false" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/gipss Example 200: ```json { "count": 2, "path": "/api/calc/gipss", "items": [ { "components": [ { "value": "favorable", "factor": "karyotype", "points": 0, "present": false }, { "factor": "absence_of_calr_type1_like", "points": 0, "present": false }, { "factor": "asxl1_mutated", "points": 0, "present": false }, { "factor": "srsf2_mutated", "points": 0, "present": false }, { "factor": "u2af1_q157_mutated", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Tefferi A, Guglielmelli P, Nicolosi M, Mannelli F, Mudireddy M, Bartalucci N, Finke CM, Lasho TL, Hanson CA, Ketterling RP, Begna KH, Gangat N, Pardanani A, Vannucchi AM", "doi": "10.1038/s41375-018-0107-z", "id": "tefferi-2018", "pmid": "29654267", "source": "Leukemia. 2018;32(7):1631-1642", "title": "GIPSS: genetically inspired prognostic scoring system for primary myelofibrosis" }, "formula": "gipss", "formula_expression": "GIPSS = karyotype (favorable 0, unfavorable 1, vhr 2) + absence of type 1/like CALR 1 + asxl1_mutated 1 + srsf2_mutated 1 + u2af1_q157_mutated 1; Tefferi 2018; max 6; low 0, intermediate_1 1, intermediate_2 2, high ≥3", "max_score": 6, "score": 0, "risk_group": "low", "asxl1_mutated": false, "calr_type1_like": true, "five_year_survival_percent": 94, "karyotype": "favorable", "median_survival_years": 26.4, "srsf2_mutated": false, "u2af1_q157_mutated": false }, { "components": [ { "value": "favorable", "factor": "karyotype", "points": 0, "present": false }, { "factor": "absence_of_calr_type1_like", "points": 0, "present": false }, { "factor": "asxl1_mutated", "points": 0, "present": false }, { "factor": "srsf2_mutated", "points": 0, "present": false }, { "factor": "u2af1_q157_mutated", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Tefferi A, Guglielmelli P, Nicolosi M, Mannelli F, Mudireddy M, Bartalucci N, Finke CM, Lasho TL, Hanson CA, Ketterling RP, Begna KH, Gangat N, Pardanani A, Vannucchi AM", "doi": "10.1038/s41375-018-0107-z", "id": "tefferi-2018", "pmid": "29654267", "source": "Leukemia. 2018;32(7):1631-1642", "title": "GIPSS: genetically inspired prognostic scoring system for primary myelofibrosis" }, "formula": "gipss", "formula_expression": "GIPSS = karyotype (favorable 0, unfavorable 1, vhr 2) + absence of type 1/like CALR 1 + asxl1_mutated 1 + srsf2_mutated 1 + u2af1_q157_mutated 1; Tefferi 2018; max 6; low 0, intermediate_1 1, intermediate_2 2, high ≥3", "max_score": 6, "score": 0, "risk_group": "low", "asxl1_mutated": false, "calr_type1_like": true, "five_year_survival_percent": 94, "karyotype": "favorable", "median_survival_years": 26.4, "srsf2_mutated": false, "u2af1_q157_mutated": false } ] } ``` ## Response fields - `formula` (string): gipss - `formula_expression` (string): Exact expression used - `score` (integer): GIPSS points 0-6 - `max_score` (integer): Always 6 (2+1+1+1+1) - `risk_group` (string): low when score is 0, intermediate_1 when 1, intermediate_2 when 2, high when ≥3 (Tefferi 2018). Not a PMF diagnosis. Not DIPSS. Not MIPSS70-plus. - `karyotype` (string): Caller-assigned three-tier karyotype used (favorable, unfavorable, or vhr) - `calr_type1_like` (boolean): Caller-assigned type 1/like CALR flag used - `asxl1_mutated` (boolean): Caller-assigned ASXL1 mutation flag used - `srsf2_mutated` (boolean): Caller-assigned SRSF2 mutation flag used - `u2af1_q157_mutated` (boolean): Caller-assigned U2AF1 Q157 mutation flag used (not S34) - `median_survival_years` (number): Tefferi 2018 published median overall survival in years for this GIPSS band (low 26.4, intermediate_1 8.0, intermediate_2 4.2, high 2). Cohort figure, not a patient-specific prediction. - `five_year_survival_percent` (integer): Tefferi 2018 published 5-year survival percent for this GIPSS band (low 94, intermediate_1 73, intermediate_2 40, high 14). Cohort figure, not a patient-specific prediction. - `components` (array): Per-factor points - `citation` (object): Tefferi et al. Leukemia 2018 GIPSS citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": "favorable", "factor": "karyotype", "points": 0, "present": false }, { "factor": "absence_of_calr_type1_like", "points": 0, "present": false }, { "factor": "asxl1_mutated", "points": 0, "present": false }, { "factor": "srsf2_mutated", "points": 0, "present": false }, { "factor": "u2af1_q157_mutated", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Tefferi A, Guglielmelli P, Nicolosi M, Mannelli F, Mudireddy M, Bartalucci N, Finke CM, Lasho TL, Hanson CA, Ketterling RP, Begna KH, Gangat N, Pardanani A, Vannucchi AM", "doi": "10.1038/s41375-018-0107-z", "id": "tefferi-2018", "pmid": "29654267", "source": "Leukemia. 2018;32(7):1631-1642", "title": "GIPSS: genetically inspired prognostic scoring system for primary myelofibrosis" }, "formula": "gipss", "formula_expression": "GIPSS = karyotype (favorable 0, unfavorable 1, vhr 2) + absence of type 1/like CALR 1 + asxl1_mutated 1 + srsf2_mutated 1 + u2af1_q157_mutated 1; Tefferi 2018; max 6; low 0, intermediate_1 1, intermediate_2 2, high ≥3", "max_score": 6, "score": 0, "risk_group": "low", "asxl1_mutated": false, "calr_type1_like": true, "five_year_survival_percent": 94, "karyotype": "favorable", "median_survival_years": 26.4, "srsf2_mutated": false, "u2af1_q157_mutated": false } ``` ## Errors - HTTP 400 `invalid_gipss_karyotype`: karyotype must be favorable, unfavorable, or vhr (Tefferi 2018 GIPSS revised cytogenetic tiers). Returned before settlement; you are not charged. - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. Shared HTTP 402 and 503: https://magentlab.com/docs/payments ## Related tools - [DIPSS](https://magentlab.com/docs/dipss) — Sum the Passamonti 2010 DIPSS (dynamic international prognostic scoring system) for primary myelofibrosis and return low (0), intermediate_1 (1–2), intermediate_2 (3–4), or high (5–6). ## Payment Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional. - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers). Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments Stdio MCP (one process per host): https://magentlab.com/docs/mcp ## Guarantees - HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON. - exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.