MARS (advanced systemic mastocytosis)

MARS

Sum the Jawhar 2019 mutation-adjusted risk score (MARS) for advanced systemic mastocytosis and return low (0–1), intermediate (2), or high (3–5).

LIVE $0.005 USDC GET /api/calc/mars

Markdown: /docs/mars.md · Canonical: https://magentlab.com/docs/mars

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Sum the Jawhar 2019 mutation-adjusted risk score (MARS) for advanced systemic mastocytosis and return low (0–1), intermediate (2), or high (3–5).

When to use

When an agent needs the published MARS point total and risk band for AdvSM and must not invent a WHO SM diagnosis, sequence S/A/R mutations, or substitute Nazha MDS machine-learning scores.

When not to use

Not a medical device and not a WHO SM diagnosis (see related who-sm). magent does not examine the patient.
This is Jawhar 2019 MARS for advanced systemic mastocytosis only. Not indolent SM. Not cutaneous mastocytosis. Not Nazha MDS machine-learning scores.
magent does not sequence. sar_mutation_count is the caller-assigned count of S/A/R mutations among SRSF2, ASXL1, and RUNX1 (0, 1, or 2 meaning two or more). Exactly one scores 1; two or more scores 2, not 1 plus 2.
magent does not assay hemoglobin or platelets. Labs are caller-supplied. Provide hemoglobin_g_dl or hemoglobin_g_l, not both.
Training-set median OS (Jawhar 2019): low not reached, intermediate 3.9 years, high 1.9 years. Validation-set OS (12.2 / 4.4 / 1.9 years) is a cohort figure, not a second band and not a patient-specific prediction.

Formula

MARS = age_gt_60 1 + hemoglobin_lt_10 1 + platelets_lt_100 1 + sar_mutations (exactly one S/A/R 1, two or more 2; SRSF2, ASXL1, RUNX1); Jawhar 2019; max 5; low 0-1 (training-set median OS not reached), intermediate 2 (3.9 years), high 3-5 (1.9 years)

Citation

Title: MARS: Mutation-Adjusted Risk Score for Advanced Systemic Mastocytosis
Authors: Jawhar M, Schwaab J, Álvarez-Twose I, Shoumariyeh K, Naumann N, Lübke J, Perkins C, Muñoz-González JI, Meggendorfer M, Kennedy V, Metzgeroth G, Fabarius A, Pfeifer D, Sotlar K, Horny HP, von Bubnoff N, Haferlach T, Cross NCP, Hofmann WK, Sperr WR, García-Montero AC, Valent P, Gotlib J, Orfao A, Reiter A
Source: J Clin Oncol. 2019;37(31):2846-2856
DOI: 10.1200/JCO.19.00640

Worked example

No adverse MARS factors

Given: age=50hemoglobin_g_dl=12platelets_10e9_l=200sar_mutation_count=0

age 50 ≤60 → 0; hemoglobin 12 ≥10 → 0; platelets 200 ≥100 → 0; sar_mutation_count 0 → 0
Score = 0 (max 5); risk_band = low (0–1); training-set median OS not reached

Age, anemia, thrombocytopenia, and two or more S/A/R mutations

Given: age=65hemoglobin_g_dl=9platelets_10e9_l=80sar_mutation_count=2

age >60 → 1; hemoglobin <10 → 1; platelets <100 → 1; two or more S/A/R → 2 (do not also add the +1)
Score = 5 (max 5); risk_band = high (3–5); training-set median OS 1.9 years

Also searched as

mutation-adjusted risk score
Jawhar MARS
advanced systemic mastocytosis MARS
AdvSM risk score
SRSF2 ASXL1 RUNX1 score
S/A/R mutation score
systemic mastocytosis prognosis
MARS AdvSM

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/mars?age=50&hemoglobin_g_dl=12&platelets_10e9_l=200&sar_mutation_count=0

Full URL: https://api.magentlab.com/api/calc/mars?age=50&hemoglobin_g_dl=12&platelets_10e9_l=200&sar_mutation_count=0

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/mars?age=50&hemoglobin_g_dl=12&platelets_10e9_l=200&sar_mutation_count=0"

Parameters

Name	Type	Required	Description
`age`	integer	required	Age in years (integer 18-120). >60 scores 1 (Jawhar 2019). Age 61 scores; age 60 is the ≤60 arm and scores 0.
`hemoglobin_g_dl`	number	optional	Hemoglobin in g/dL (3-22). Provide this or hemoglobin_g_l, not both. <10 g/dL (<100 g/L) scores 1 (Jawhar 2019). 10.0 is the ≥10 arm and scores 0. magent does not assay hemoglobin.
`hemoglobin_g_l`	number	optional	Hemoglobin in g/L (30-220). Converted as hemoglobin_g_dl = hemoglobin_g_l / 10. Provide this or hemoglobin_g_dl, not both. <100 g/L scores 1. 100 is the ≥100 arm and scores 0.
`platelets_10e9_l`	number	required	Platelet count in 10^9/L (1-2000). <100 scores 1 (Jawhar 2019). 100.0 is the ≥100 arm and scores 0. magent does not assay platelets.
`sar_mutation_count`	integer	required	Caller-assigned count of S/A/R mutations among SRSF2, ASXL1, and RUNX1 (integer 0, 1, or 2; 2 means two or more). Exactly one scores 1. Two or more scores 2 (not 1 plus 2). Count 0 scores 0. 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.

POST /api/calc/mars Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 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 (fixture)

{
  "items": [
    {
      "age": "50",
      "hemoglobin_g_dl": "12",
      "platelets_10e9_l": "200",
      "sar_mutation_count": "0"
    },
    {
      "age": "50",
      "hemoglobin_g_dl": "12",
      "platelets_10e9_l": "200",
      "sar_mutation_count": "0"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/mars",
  "items": [
    {
      "components": [
        {
          "value": 50,
          "factor": "age_gt_60",
          "points": 0,
          "present": false
        },
        {
          "value": 12.0,
          "factor": "hemoglobin_lt_10",
          "points": 0,
          "present": false
        },
        {
          "value": 200.0,
          "factor": "platelets_lt_100",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "sar_mutations",
          "points": 0,
          "present": false
        }
      ],
      "age": 50,
      "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": "Jawhar M, Schwaab J, Álvarez-Twose I, Shoumariyeh K, Naumann N, Lübke J, Perkins C, Muñoz-González JI, Meggendorfer M, Kennedy V, Metzgeroth G, Fabarius A, Pfeifer D, Sotlar K, Horny HP, von Bubnoff N, Haferlach T, Cross NCP, Hofmann WK, Sperr WR, García-Montero AC, Valent P, Gotlib J, Orfao A, Reiter A",
        "doi": "10.1200/JCO.19.00640",
        "id": "jawhar-2019",
        "pmid": "31509472",
        "source": "J Clin Oncol. 2019;37(31):2846-2856",
        "title": "MARS: Mutation-Adjusted Risk Score for Advanced Systemic Mastocytosis"
      },
      "formula": "mars",
      "formula_expression": "MARS = age_gt_60 1 + hemoglobin_lt_10 1 + platelets_lt_100 1 + sar_mutations (exactly one S/A/R 1, two or more 2; SRSF2, ASXL1, RUNX1); Jawhar 2019; max 5; low 0-1 (training-set median OS not reached), intermediate 2 (3.9 years), high 3-5 (1.9 years)",
      "max_score": 5,
      "score": 0,
      "platelets_10e9_l": 200.0,
      "risk_band": "low",
      "hemoglobin_g_dl": 12.0,
      "sar_mutation_count": 0
    },
    {
      "components": [
        {
          "value": 50,
          "factor": "age_gt_60",
          "points": 0,
          "present": false
        },
        {
          "value": 12.0,
          "factor": "hemoglobin_lt_10",
          "points": 0,
          "present": false
        },
        {
          "value": 200.0,
          "factor": "platelets_lt_100",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "sar_mutations",
          "points": 0,
          "present": false
        }
      ],
      "age": 50,
      "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": "Jawhar M, Schwaab J, Álvarez-Twose I, Shoumariyeh K, Naumann N, Lübke J, Perkins C, Muñoz-González JI, Meggendorfer M, Kennedy V, Metzgeroth G, Fabarius A, Pfeifer D, Sotlar K, Horny HP, von Bubnoff N, Haferlach T, Cross NCP, Hofmann WK, Sperr WR, García-Montero AC, Valent P, Gotlib J, Orfao A, Reiter A",
        "doi": "10.1200/JCO.19.00640",
        "id": "jawhar-2019",
        "pmid": "31509472",
        "source": "J Clin Oncol. 2019;37(31):2846-2856",
        "title": "MARS: Mutation-Adjusted Risk Score for Advanced Systemic Mastocytosis"
      },
      "formula": "mars",
      "formula_expression": "MARS = age_gt_60 1 + hemoglobin_lt_10 1 + platelets_lt_100 1 + sar_mutations (exactly one S/A/R 1, two or more 2; SRSF2, ASXL1, RUNX1); Jawhar 2019; max 5; low 0-1 (training-set median OS not reached), intermediate 2 (3.9 years), high 3-5 (1.9 years)",
      "max_score": 5,
      "score": 0,
      "platelets_10e9_l": 200.0,
      "risk_band": "low",
      "hemoglobin_g_dl": 12.0,
      "sar_mutation_count": 0
    }
  ]
}

Response

Field	Type	Description
`formula`	string	mars
`formula_expression`	string	Exact expression used
`score`	integer	MARS points 0-5 (unclamped; max published 5)
`max_score`	integer	Always 5 (1+1+1+2)
`risk_band`	string	low when score is 0-1, intermediate when 2, high when 3-5 (Jawhar 2019 training-set MARS). Not a WHO SM diagnosis. Not indolent SM. Not Nazha MDS scores.
`age`	integer	Age in years used for the >60 criterion
`hemoglobin_g_dl`	number	Hemoglobin in g/dL used for the <10 criterion (g/L inputs converted / 10)
`platelets_10e9_l`	number	Platelets in 10^9/L used for the <100 criterion
`sar_mutation_count`	integer	Caller-assigned S/A/R mutation count among SRSF2, ASXL1, RUNX1 (0, 1, or 2 meaning two or more)
`components`	array	Per-factor points
`citation`	object	Jawhar et al. J Clin Oncol 2019 MARS citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "value": 50,
      "factor": "age_gt_60",
      "points": 0,
      "present": false
    },
    {
      "value": 12.0,
      "factor": "hemoglobin_lt_10",
      "points": 0,
      "present": false
    },
    {
      "value": 200.0,
      "factor": "platelets_lt_100",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "sar_mutations",
      "points": 0,
      "present": false
    }
  ],
  "age": 50,
  "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": "Jawhar M, Schwaab J, Álvarez-Twose I, Shoumariyeh K, Naumann N, Lübke J, Perkins C, Muñoz-González JI, Meggendorfer M, Kennedy V, Metzgeroth G, Fabarius A, Pfeifer D, Sotlar K, Horny HP, von Bubnoff N, Haferlach T, Cross NCP, Hofmann WK, Sperr WR, García-Montero AC, Valent P, Gotlib J, Orfao A, Reiter A",
    "doi": "10.1200/JCO.19.00640",
    "id": "jawhar-2019",
    "pmid": "31509472",
    "source": "J Clin Oncol. 2019;37(31):2846-2856",
    "title": "MARS: Mutation-Adjusted Risk Score for Advanced Systemic Mastocytosis"
  },
  "formula": "mars",
  "formula_expression": "MARS = age_gt_60 1 + hemoglobin_lt_10 1 + platelets_lt_100 1 + sar_mutations (exactly one S/A/R 1, two or more 2; SRSF2, ASXL1, RUNX1); Jawhar 2019; max 5; low 0-1 (training-set median OS not reached), intermediate 2 (3.9 years), high 3-5 (1.9 years)",
  "max_score": 5,
  "score": 0,
  "platelets_10e9_l": 200.0,
  "risk_band": "low",
  "hemoglobin_g_dl": 12.0,
  "sar_mutation_count": 0
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_age`	age must be an integer from 18 to 120 Returned before settlement; you are not charged.
400	`invalid_hemoglobin`	hemoglobin_g_l (30-220) or hemoglobin_g_dl (3-22) is required, not both. Returned before settlement; you are not charged.
400	`invalid_platelets`	platelets_10e9_l must be a number from 1 to 2000 Returned before settlement; you are not charged.
400	`invalid_sar_count`	sar_mutation_count must be 0, 1, or 2 (Jawhar 2019 MARS: number of S/A/R mutations among SRSF2, ASXL1, and RUNX1; 2 means two or more). magent does not sequence. Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

Related tools

WHO 2016 SM criteria — Apply the Valent 2016 / WHO 2016 systemic mastocytosis diagnostic criteria (Table 1) and return whether the published combination of the major criterion plus at least one minor, or at least three minors, is met. Tryptase >20 ng/mL does not count when an unrelated myeloid neoplasm is present.
REMA — Sum the Álvarez-Twose 2012 REMA points (sex, serum baseline tryptase, pruritus/hives/angioedema, syncope or presyncope) and return whether the total is ≥2 (published clonality and systemic-mastocytosis triage threshold).

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. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /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.