# MIPSS70 (primary myelofibrosis)

MIPSS70

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/mipss70`
HTML: https://magentlab.com/docs/mipss70
Markdown: https://magentlab.com/docs/mipss70.md

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

## What it computes

Sum the Guglielmelli 2018 MIPSS70 (mutation-enhanced international prognostic score system) for transplantation-age primary myelofibrosis and return low (0–1), intermediate (2–4), or high (≥5).

## When to use

When an agent needs the published MIPSS70 point total and risk band and must not invent a PMF diagnosis or transplant listing, and must not substitute MIPSS70-plus, MIPSS70+ version 2.0, DIPSS, or GIPSS.

## When not to use

- Not a medical device and not a PMF diagnosis or transplant listing. magent does not examine the patient.
- This is Guglielmelli 2018 MIPSS70 only, not MIPSS70-plus, not MIPSS70+ version 2.0, and not DIPSS or GIPSS.
- magent does not sequence. calr_type1_like and hmr_mutation_count (ASXL1, EZH2, SRSF2, IDH1, IDH2) are caller-assigned.
- magent does not grade marrow. fibrosis_grade is the caller-assigned WHO marrow fibrosis grade 0–3.
- magent does not assay hemoglobin, leukocytes, platelets, or circulating blasts. Labs are caller-supplied. Provide hemoglobin_g_dl or hemoglobin_g_l, not both.
- Published Italian-cohort median and 5-year survivals are Guglielmelli 2018 cohort figures for the three MIPSS70 bands, not a patient-specific prediction.

## Formula

```
MIPSS70 = hemoglobin_lt_10 1 + leukocytes_gt_25 2 + platelets_lt_100 2 + blasts_ge_2 1 + fibrosis_ge_2 1 + constitutional_symptoms 1 + absence_of_calr_type1_like 1 + hmr_category 1 + hmr_two_or_more 2; Guglielmelli 2018; max 12; low 0-1, intermediate 2-4, high ≥5
```

## Citation

[MIPSS70: Mutation-Enhanced International Prognostic Score System for Transplantation-Age Patients With Primary Myelofibrosis](https://doi.org/10.1200/JCO.2017.76.4886)
Guglielmelli P, Lasho TL, Rotunno G, Mudireddy M, Mannarelli C, Nicolosi M, Pacilli A, Pardanani A, Rumi E, Rosti V, Hanson CA, Mannelli F, Ketterling RP, Gangat N, Rambaldi A, Passamonti F, Barosi G, Barbui T, Cazzola M, Vannucchi AM, Tefferi A
J Clin Oncol. 2018;36(4):310-318
DOI: [10.1200/JCO.2017.76.4886](https://doi.org/10.1200/JCO.2017.76.4886)

## Worked example

### No adverse MIPSS70 factors

Given: `blasts_percent=0, calr_type1_like=true, constitutional_symptoms=false, fibrosis_grade=1, hemoglobin_g_dl=12, hmr_mutation_count=0, leukocytes_10e9_l=10, platelets_10e9_l=200`

1. hemoglobin 12 ≥10 → 0; leukocytes 10 ≤25 → 0; platelets 200 ≥100 → 0; blasts 0% <2 → 0; fibrosis 1 <2 → 0; constitutional_symptoms false → 0; calr_type1_like true → 0; hmr_mutation_count 0 → 0
2. Score = 0 (max 12); risk_band = low (0–1)


### All nine MIPSS70 adverse factors

Given: `blasts_percent=2, calr_type1_like=false, constitutional_symptoms=true, fibrosis_grade=2, hemoglobin_g_dl=9.9, hmr_mutation_count=2, leukocytes_10e9_l=26, platelets_10e9_l=80`

1. hemoglobin <10 → 1; leukocytes >25 → 2; platelets <100 → 2; blasts ≥2 → 1; fibrosis ≥2 → 1; constitutional_symptoms → 1; absence of type 1/like CALR → 1; HMR category → 1; two or more HMR → 2
2. Score = 12 (max 12); risk_band = high (≥5)


## Also searched as

- MIPSS70
- mutation-enhanced international prognostic score
- Guglielmelli MIPSS70
- primary myelofibrosis MIPSS70
- PMF MIPSS70
- MIPSS-70
- HMR myelofibrosis score
- transplant-age myelofibrosis score

## Parameters

- `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 (Guglielmelli 2018). 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.
- `leukocytes_10e9_l` (number, required): Leukocyte count in 10^9/L (0.5-200). >25 scores 2 (Guglielmelli 2018). 25.0 is the ≤25 arm and scores 0. magent does not assay leukocytes.
- `platelets_10e9_l` (number, required): Platelet count in 10^9/L (1-2000). <100 scores 2 (Guglielmelli 2018). 100.0 is the ≥100 arm and scores 0. magent does not assay platelets.
- `blasts_percent` (number, required): Circulating blasts as a percent (0-30). ≥2 scores 1 (Guglielmelli 2018). 2.0 scores; 1.9 is the <2 arm and scores 0. magent does not read a smear.
- `fibrosis_grade` (integer, required): WHO bone-marrow fibrosis grade as an integer 0-3, assigned by the caller (Guglielmelli 2018). ≥2 scores 1. Grade 2 scores; grade 1 scores 0. magent does not grade marrow.
- `constitutional_symptoms` (boolean, required): Constitutional symptoms as assigned by the caller (Guglielmelli 2018). true scores 1. magent does not take a history.
- `calr_type1_like` (boolean, required): Presence of a type 1/like CALR mutation as assigned by the caller (Guglielmelli 2018). false (absence) scores 1. true scores 0. magent does not sequence.
- `hmr_mutation_count` (integer, required): Count of high-molecular-risk mutations among ASXL1, EZH2, SRSF2, IDH1, and IDH2 as assigned by the caller (integer 0-5). ≥1 scores 1 (HMR category). ≥2 scores an additional 2 (two or more HMR mutations), so a count of 2 or more contributes 3. 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.

Method: `POST /api/calc/mipss70`
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": [
    {
      "blasts_percent": "0",
      "calr_type1_like": "true",
      "constitutional_symptoms": "false",
      "fibrosis_grade": "1",
      "hemoglobin_g_dl": "12",
      "hmr_mutation_count": "0",
      "leukocytes_10e9_l": "10",
      "platelets_10e9_l": "200"
    },
    {
      "blasts_percent": "0",
      "calr_type1_like": "true",
      "constitutional_symptoms": "false",
      "fibrosis_grade": "1",
      "hemoglobin_g_dl": "12",
      "hmr_mutation_count": "0",
      "leukocytes_10e9_l": "10",
      "platelets_10e9_l": "200"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/mipss70

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/mipss70",
  "items": [
    {
      "components": [
        {
          "value": 12.0,
          "factor": "hemoglobin_lt_10",
          "points": 0,
          "present": false
        },
        {
          "value": 10.0,
          "factor": "leukocytes_gt_25",
          "points": 0,
          "present": false
        },
        {
          "value": 200.0,
          "factor": "platelets_lt_100",
          "points": 0,
          "present": false
        },
        {
          "value": 0.0,
          "factor": "blasts_ge_2",
          "points": 0,
          "present": false
        },
        {
          "value": 1,
          "factor": "fibrosis_ge_2",
          "points": 0,
          "present": false
        },
        {
          "factor": "constitutional_symptoms",
          "points": 0,
          "present": false
        },
        {
          "factor": "absence_of_calr_type1_like",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "hmr_category",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "hmr_two_or_more",
          "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": "Guglielmelli P, Lasho TL, Rotunno G, Mudireddy M, Mannarelli C, Nicolosi M, Pacilli A, Pardanani A, Rumi E, Rosti V, Hanson CA, Mannelli F, Ketterling RP, Gangat N, Rambaldi A, Passamonti F, Barosi G, Barbui T, Cazzola M, Vannucchi AM, Tefferi A",
        "doi": "10.1200/JCO.2017.76.4886",
        "id": "guglielmelli-2018",
        "pmid": "29226763",
        "source": "J Clin Oncol. 2018;36(4):310-318",
        "title": "MIPSS70: Mutation-Enhanced International Prognostic Score System for Transplantation-Age Patients With Primary Myelofibrosis"
      },
      "formula": "mipss70",
      "formula_expression": "MIPSS70 = hemoglobin_lt_10 1 + leukocytes_gt_25 2 + platelets_lt_100 2 + blasts_ge_2 1 + fibrosis_ge_2 1 + constitutional_symptoms 1 + absence_of_calr_type1_like 1 + hmr_category 1 + hmr_two_or_more 2; Guglielmelli 2018; max 12; low 0-1, intermediate 2-4, high ≥5",
      "max_score": 12,
      "score": 0,
      "platelets_10e9_l": 200.0,
      "risk_band": "low",
      "hemoglobin_g_dl": 12.0,
      "blasts_percent": 0.0,
      "constitutional_symptoms": false,
      "calr_type1_like": true,
      "five_year_survival_percent": 95,
      "median_survival_years": 27.7,
      "fibrosis_grade": 1,
      "hmr_mutation_count": 0,
      "leukocytes_10e9_l": 10.0
    },
    {
      "components": [
        {
          "value": 12.0,
          "factor": "hemoglobin_lt_10",
          "points": 0,
          "present": false
        },
        {
          "value": 10.0,
          "factor": "leukocytes_gt_25",
          "points": 0,
          "present": false
        },
        {
          "value": 200.0,
          "factor": "platelets_lt_100",
          "points": 0,
          "present": false
        },
        {
          "value": 0.0,
          "factor": "blasts_ge_2",
          "points": 0,
          "present": false
        },
        {
          "value": 1,
          "factor": "fibrosis_ge_2",
          "points": 0,
          "present": false
        },
        {
          "factor": "constitutional_symptoms",
          "points": 0,
          "present": false
        },
        {
          "factor": "absence_of_calr_type1_like",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "hmr_category",
          "points": 0,
          "present": false
        },
        {
          "value": 0,
          "factor": "hmr_two_or_more",
          "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": "Guglielmelli P, Lasho TL, Rotunno G, Mudireddy M, Mannarelli C, Nicolosi M, Pacilli A, Pardanani A, Rumi E, Rosti V, Hanson CA, Mannelli F, Ketterling RP, Gangat N, Rambaldi A, Passamonti F, Barosi G, Barbui T, Cazzola M, Vannucchi AM, Tefferi A",
        "doi": "10.1200/JCO.2017.76.4886",
        "id": "guglielmelli-2018",
        "pmid": "29226763",
        "source": "J Clin Oncol. 2018;36(4):310-318",
        "title": "MIPSS70: Mutation-Enhanced International Prognostic Score System for Transplantation-Age Patients With Primary Myelofibrosis"
      },
      "formula": "mipss70",
      "formula_expression": "MIPSS70 = hemoglobin_lt_10 1 + leukocytes_gt_25 2 + platelets_lt_100 2 + blasts_ge_2 1 + fibrosis_ge_2 1 + constitutional_symptoms 1 + absence_of_calr_type1_like 1 + hmr_category 1 + hmr_two_or_more 2; Guglielmelli 2018; max 12; low 0-1, intermediate 2-4, high ≥5",
      "max_score": 12,
      "score": 0,
      "platelets_10e9_l": 200.0,
      "risk_band": "low",
      "hemoglobin_g_dl": 12.0,
      "blasts_percent": 0.0,
      "constitutional_symptoms": false,
      "calr_type1_like": true,
      "five_year_survival_percent": 95,
      "median_survival_years": 27.7,
      "fibrosis_grade": 1,
      "hmr_mutation_count": 0,
      "leukocytes_10e9_l": 10.0
    }
  ]
}
```

## Response fields

- `formula` (string): mipss70
- `formula_expression` (string): Exact expression used
- `score` (integer): MIPSS70 points 0-12
- `max_score` (integer): Always 12 (1+2+2+1+1+1+1+1+2)
- `risk_band` (string): low when score is 0-1, intermediate when 2-4, high when ≥5 (Guglielmelli 2018 MIPSS70). Not a PMF diagnosis. Not MIPSS70-plus. Not MIPSS70+ version 2.0.
- `hemoglobin_g_dl` (number): Hemoglobin in g/dL used for the <10 criterion (g/L inputs converted / 10)
- `leukocytes_10e9_l` (number): Leukocytes in 10^9/L used for the >25 criterion
- `platelets_10e9_l` (number): Platelets in 10^9/L used for the <100 criterion
- `blasts_percent` (number): Circulating blast percent used for the ≥2 criterion
- `fibrosis_grade` (integer): Caller-assigned WHO marrow fibrosis grade 0-3 used for the ≥2 criterion
- `constitutional_symptoms` (boolean): Caller-assigned constitutional-symptoms flag used
- `calr_type1_like` (boolean): Caller-assigned type 1/like CALR flag used
- `hmr_mutation_count` (integer): Caller-assigned HMR mutation count among ASXL1, EZH2, SRSF2, IDH1, IDH2 (0-5)
- `median_survival_years` (number): Guglielmelli 2018 Italian-cohort median overall survival in years for this MIPSS70 band (low 27.7, intermediate 7.1, high 2.3). Cohort figure, not a patient-specific prediction.
- `five_year_survival_percent` (integer): Guglielmelli 2018 Italian-cohort 5-year survival percent for this MIPSS70 band (low 95, intermediate 70, high 29). Cohort figure, not a patient-specific prediction.
- `components` (array): Per-factor points
- `citation` (object): Guglielmelli et al. J Clin Oncol 2018 MIPSS70 citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": 12.0,
      "factor": "hemoglobin_lt_10",
      "points": 0,
      "present": false
    },
    {
      "value": 10.0,
      "factor": "leukocytes_gt_25",
      "points": 0,
      "present": false
    },
    {
      "value": 200.0,
      "factor": "platelets_lt_100",
      "points": 0,
      "present": false
    },
    {
      "value": 0.0,
      "factor": "blasts_ge_2",
      "points": 0,
      "present": false
    },
    {
      "value": 1,
      "factor": "fibrosis_ge_2",
      "points": 0,
      "present": false
    },
    {
      "factor": "constitutional_symptoms",
      "points": 0,
      "present": false
    },
    {
      "factor": "absence_of_calr_type1_like",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "hmr_category",
      "points": 0,
      "present": false
    },
    {
      "value": 0,
      "factor": "hmr_two_or_more",
      "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": "Guglielmelli P, Lasho TL, Rotunno G, Mudireddy M, Mannarelli C, Nicolosi M, Pacilli A, Pardanani A, Rumi E, Rosti V, Hanson CA, Mannelli F, Ketterling RP, Gangat N, Rambaldi A, Passamonti F, Barosi G, Barbui T, Cazzola M, Vannucchi AM, Tefferi A",
    "doi": "10.1200/JCO.2017.76.4886",
    "id": "guglielmelli-2018",
    "pmid": "29226763",
    "source": "J Clin Oncol. 2018;36(4):310-318",
    "title": "MIPSS70: Mutation-Enhanced International Prognostic Score System for Transplantation-Age Patients With Primary Myelofibrosis"
  },
  "formula": "mipss70",
  "formula_expression": "MIPSS70 = hemoglobin_lt_10 1 + leukocytes_gt_25 2 + platelets_lt_100 2 + blasts_ge_2 1 + fibrosis_ge_2 1 + constitutional_symptoms 1 + absence_of_calr_type1_like 1 + hmr_category 1 + hmr_two_or_more 2; Guglielmelli 2018; max 12; low 0-1, intermediate 2-4, high ≥5",
  "max_score": 12,
  "score": 0,
  "platelets_10e9_l": 200.0,
  "risk_band": "low",
  "hemoglobin_g_dl": 12.0,
  "blasts_percent": 0.0,
  "constitutional_symptoms": false,
  "calr_type1_like": true,
  "five_year_survival_percent": 95,
  "median_survival_years": 27.7,
  "fibrosis_grade": 1,
  "hmr_mutation_count": 0,
  "leukocytes_10e9_l": 10.0
}
```

## Errors

- HTTP 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.
- HTTP 400 `invalid_leukocytes`: leukocytes_10e9_l must be a number from 0.5 to 200 (Guglielmelli 2018 MIPSS70). Returned before settlement; you are not charged.
- HTTP 400 `invalid_platelets`: platelets_10e9_l must be a number from 1 to 2000 Returned before settlement; you are not charged.
- HTTP 400 `invalid_mipss_blasts`: blasts_percent must be a number from 0 to 30 (Guglielmelli 2018 MIPSS70 circulating blasts; magent clamp). Returned before settlement; you are not charged.
- HTTP 400 `invalid_fibrosis_grade`: fibrosis_grade must be an integer 0-3 (Guglielmelli 2018 MIPSS70 WHO marrow fibrosis). 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).
- [GIPSS](https://magentlab.com/docs/gipss) — 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).

## 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.