# MYSEC-PM (post-PV/ET myelofibrosis)

MYSEC-PM

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

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

## What it computes

Sum the Passamonti 2017 MYSEC-PM (myelofibrosis secondary to PV/ET prognostic model) and return low (<11), intermediate_1 (≥11 and <14), intermediate_2 (≥14 and <16), or high (≥16).

## When to use

When an agent needs the published MYSEC-PM point total and risk group for post-polycythemia vera or post-essential thrombocythemia myelofibrosis and must not invent a PMF/DIPSS result, a GIPSS genetics score, or a transplant listing.

## When not to use

- Not a medical device and not a myelofibrosis diagnosis or treatment choice. magent does not examine the patient.
- This is Passamonti 2017 MYSEC-PM for post-PV and post-ET myelofibrosis only. Not DIPSS or DIPSS Plus for primary myelofibrosis. Not GIPSS. Not a transplant listing.
- magent does not sequence CALR. calr_unmutated is a caller-assigned genotype flag (JAK2, MPL, or triple-negative).
- magent does not assay hemoglobin, platelets, or circulating blasts. Labs are caller-supplied. Provide hemoglobin_g_dl or hemoglobin_g_l, not both.
- Median OS years (low NR; intermediate_1 9.3; intermediate_2 4.4; high 2) are Passamonti 2017 cohort medians, not an individual survival prediction.

## Formula

```
MYSEC-PM = 0.15*age_years + hemoglobin_lt_11 2 + blasts_ge_3 2 + calr_unmutated 2 + platelets_lt_150 1 + constitutional_symptoms 1; Passamonti 2017; low <11, intermediate_1 ≥11 and <14, intermediate_2 ≥14 and <16, high ≥16
```

## Citation

[A clinical-molecular prognostic model to predict survival in patients with post polycythemia vera and post essential thrombocythemia myelofibrosis](https://doi.org/10.1038/leu.2017.169)
Passamonti F, Giorgino T, Mora B, Guglielmelli P, Rumi E, Maffioli M, Rambaldi A, Caramella M, Komrokji R, Gotlib J, Kiladjian JJ, Cervantes F, Devos T, Palandri F, De Stefano V, Ruggeri M, Silver RT, Benevolo G, Albano F, Caramazza D, Merli M, Pietra D, Casalone R, Rotunno G, Barbui T, Cazzola M, Vannucchi AM
Leukemia. 2017;31(12):2726-2731
DOI: [10.1038/leu.2017.169](https://doi.org/10.1038/leu.2017.169)

## Worked example

### Paper illustration, age 40

Given: `age=40, blasts_percent=6, calr_unmutated=false, constitutional_symptoms=false, hemoglobin_g_dl=10, platelets_10e9_l=200`

1. hemoglobin 10 g/dL <11 → 2; circulating blasts 6% ≥3 → 2; platelets 200 ≥150 → 0; calr_unmutated false → 0; constitutional_symptoms false → 0 (4 non-age points)
2. age 40 → 0.15*40 = 6.0; score = 4+6.0 = 10.0; risk_group = low (<11); median OS NR


### Paper illustration, age 70

Given: `age=70, blasts_percent=6, calr_unmutated=false, constitutional_symptoms=false, hemoglobin_g_dl=10, platelets_10e9_l=200`

1. Same non-age points as the age-40 illustration (Hb <11 and blasts ≥3 → 4)
2. age 70 → 0.15*70 = 10.5; score = 4+10.5 = 14.5; risk_group = intermediate_2 (≥14 and <16); median OS 4.4 years


## Also searched as

- MYSEC-PM
- MYSEC PM
- post-PV myelofibrosis prognostic model
- post-ET myelofibrosis score
- Passamonti 2017 myelofibrosis
- secondary myelofibrosis prognostic model
- CALR-unmutated myelofibrosis score
- myelofibrosis after polycythemia vera

## Parameters

- `age` (integer, required): Age in years (18-120). Adds 0.15 points per year as published (Passamonti 2017). Age stays continuous; the total score is rounded to 2 decimal places.
- `hemoglobin_g_dl` (number, optional): Hemoglobin in g/dL (3-22). Provide this or hemoglobin_g_l, not both. <11 scores 2 (Passamonti 2017). 11.0 is the ≥11 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.
- `platelets_10e9_l` (number, required): Platelet count in 10^9/L (1-2000). <150 scores 1 (Passamonti 2017). 150.0 is the ≥150 arm and scores 0. magent does not assay platelets.
- `blasts_percent` (number, required): Circulating blasts as a percent (0-30). ≥3 scores 2 (Passamonti 2017). 2.9 is the <3 arm and scores 0. magent does not read a smear.
- `calr_unmutated` (boolean, required): CALR-unmutated genotype (JAK2, MPL, or triple-negative) as assigned by the caller (Passamonti 2017). true scores 2. magent does not sequence CALR.
- `constitutional_symptoms` (boolean, required): Constitutional symptoms as assigned by the caller (Passamonti 2017). true scores 1. magent does not take a history.

## 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/mysec_pm`
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": [
    {
      "age": "40",
      "blasts_percent": "6",
      "calr_unmutated": "false",
      "constitutional_symptoms": "false",
      "hemoglobin_g_dl": "10",
      "platelets_10e9_l": "200"
    },
    {
      "age": "40",
      "blasts_percent": "6",
      "calr_unmutated": "false",
      "constitutional_symptoms": "false",
      "hemoglobin_g_dl": "10",
      "platelets_10e9_l": "200"
    }
  ]
}
```

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

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/mysec_pm",
  "items": [
    {
      "components": [
        {
          "value": 40,
          "factor": "age",
          "points": 6.0,
          "present": true
        },
        {
          "value": 10.0,
          "factor": "hemoglobin_lt_11",
          "points": 2,
          "present": true
        },
        {
          "value": 6.0,
          "factor": "blasts_ge_3",
          "points": 2,
          "present": true
        },
        {
          "factor": "calr_unmutated",
          "points": 0,
          "present": false
        },
        {
          "value": 200.0,
          "factor": "platelets_lt_150",
          "points": 0,
          "present": false
        },
        {
          "factor": "constitutional_symptoms",
          "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": "Passamonti F, Giorgino T, Mora B, Guglielmelli P, Rumi E, Maffioli M, Rambaldi A, Caramella M, Komrokji R, Gotlib J, Kiladjian JJ, Cervantes F, Devos T, Palandri F, De Stefano V, Ruggeri M, Silver RT, Benevolo G, Albano F, Caramazza D, Merli M, Pietra D, Casalone R, Rotunno G, Barbui T, Cazzola M, Vannucchi AM",
        "doi": "10.1038/leu.2017.169",
        "id": "passamonti-2017",
        "pmid": "28561069",
        "source": "Leukemia. 2017;31(12):2726-2731",
        "title": "A clinical-molecular prognostic model to predict survival in patients with post polycythemia vera and post essential thrombocythemia myelofibrosis"
      },
      "formula": "mysec_pm",
      "formula_expression": "MYSEC-PM = 0.15*age_years + hemoglobin_lt_11 2 + blasts_ge_3 2 + calr_unmutated 2 + platelets_lt_150 1 + constitutional_symptoms 1; Passamonti 2017; low <11, intermediate_1 ≥11 and <14, intermediate_2 ≥14 and <16, high ≥16",
      "age_years": 40,
      "score": 10.0,
      "platelets_10e9_l": 200.0,
      "hemoglobin_g_dl": 10.0,
      "risk_group": "low",
      "blasts_percent": 6.0,
      "constitutional_symptoms": false,
      "calr_unmutated": false,
      "median_os_years": null
    },
    {
      "components": [
        {
          "value": 40,
          "factor": "age",
          "points": 6.0,
          "present": true
        },
        {
          "value": 10.0,
          "factor": "hemoglobin_lt_11",
          "points": 2,
          "present": true
        },
        {
          "value": 6.0,
          "factor": "blasts_ge_3",
          "points": 2,
          "present": true
        },
        {
          "factor": "calr_unmutated",
          "points": 0,
          "present": false
        },
        {
          "value": 200.0,
          "factor": "platelets_lt_150",
          "points": 0,
          "present": false
        },
        {
          "factor": "constitutional_symptoms",
          "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": "Passamonti F, Giorgino T, Mora B, Guglielmelli P, Rumi E, Maffioli M, Rambaldi A, Caramella M, Komrokji R, Gotlib J, Kiladjian JJ, Cervantes F, Devos T, Palandri F, De Stefano V, Ruggeri M, Silver RT, Benevolo G, Albano F, Caramazza D, Merli M, Pietra D, Casalone R, Rotunno G, Barbui T, Cazzola M, Vannucchi AM",
        "doi": "10.1038/leu.2017.169",
        "id": "passamonti-2017",
        "pmid": "28561069",
        "source": "Leukemia. 2017;31(12):2726-2731",
        "title": "A clinical-molecular prognostic model to predict survival in patients with post polycythemia vera and post essential thrombocythemia myelofibrosis"
      },
      "formula": "mysec_pm",
      "formula_expression": "MYSEC-PM = 0.15*age_years + hemoglobin_lt_11 2 + blasts_ge_3 2 + calr_unmutated 2 + platelets_lt_150 1 + constitutional_symptoms 1; Passamonti 2017; low <11, intermediate_1 ≥11 and <14, intermediate_2 ≥14 and <16, high ≥16",
      "age_years": 40,
      "score": 10.0,
      "platelets_10e9_l": 200.0,
      "hemoglobin_g_dl": 10.0,
      "risk_group": "low",
      "blasts_percent": 6.0,
      "constitutional_symptoms": false,
      "calr_unmutated": false,
      "median_os_years": null
    }
  ]
}
```

## Response fields

- `formula` (string): mysec_pm
- `formula_expression` (string): Exact expression used
- `score` (number): MYSEC-PM total rounded to 2 decimal places (0.15*age plus discrete points)
- `risk_group` (string): low when score is <11, intermediate_1 when ≥11 and <14, intermediate_2 when ≥14 and <16, high when ≥16 (Passamonti 2017). Not a PMF/DIPSS result. Not GIPSS. Not a transplant listing.
- `median_os_years` (number): Passamonti 2017 cohort median OS in years: null (NR) if low, 9.3 if intermediate_1, 4.4 if intermediate_2, 2.0 if high. Not an individual prediction.
- `age_years` (integer): Age used for the 0.15-per-year term
- `hemoglobin_g_dl` (number): Hemoglobin in g/dL used for the <11 criterion (g/L inputs converted / 10)
- `platelets_10e9_l` (number): Platelets in 10^9/L used for the <150 criterion
- `blasts_percent` (number): Circulating blast percent used for the ≥3 criterion
- `calr_unmutated` (boolean): Caller-assigned CALR-unmutated genotype flag used
- `constitutional_symptoms` (boolean): Caller-assigned constitutional-symptoms flag used
- `components` (array): Per-factor points
- `citation` (object): Passamonti et al. Leukemia 2017 MYSEC-PM citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": 40,
      "factor": "age",
      "points": 6.0,
      "present": true
    },
    {
      "value": 10.0,
      "factor": "hemoglobin_lt_11",
      "points": 2,
      "present": true
    },
    {
      "value": 6.0,
      "factor": "blasts_ge_3",
      "points": 2,
      "present": true
    },
    {
      "factor": "calr_unmutated",
      "points": 0,
      "present": false
    },
    {
      "value": 200.0,
      "factor": "platelets_lt_150",
      "points": 0,
      "present": false
    },
    {
      "factor": "constitutional_symptoms",
      "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": "Passamonti F, Giorgino T, Mora B, Guglielmelli P, Rumi E, Maffioli M, Rambaldi A, Caramella M, Komrokji R, Gotlib J, Kiladjian JJ, Cervantes F, Devos T, Palandri F, De Stefano V, Ruggeri M, Silver RT, Benevolo G, Albano F, Caramazza D, Merli M, Pietra D, Casalone R, Rotunno G, Barbui T, Cazzola M, Vannucchi AM",
    "doi": "10.1038/leu.2017.169",
    "id": "passamonti-2017",
    "pmid": "28561069",
    "source": "Leukemia. 2017;31(12):2726-2731",
    "title": "A clinical-molecular prognostic model to predict survival in patients with post polycythemia vera and post essential thrombocythemia myelofibrosis"
  },
  "formula": "mysec_pm",
  "formula_expression": "MYSEC-PM = 0.15*age_years + hemoglobin_lt_11 2 + blasts_ge_3 2 + calr_unmutated 2 + platelets_lt_150 1 + constitutional_symptoms 1; Passamonti 2017; low <11, intermediate_1 ≥11 and <14, intermediate_2 ≥14 and <16, high ≥16",
  "age_years": 40,
  "score": 10.0,
  "platelets_10e9_l": 200.0,
  "hemoglobin_g_dl": 10.0,
  "risk_group": "low",
  "blasts_percent": 6.0,
  "constitutional_symptoms": false,
  "calr_unmutated": false,
  "median_os_years": null
}
```

## Errors

- HTTP 400 `invalid_age`: age must be an integer from 18 to 120 Returned before settlement; you are not charged.
- 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_platelets`: platelets_10e9_l must be a number from 1 to 2000 Returned before settlement; you are not charged.
- HTTP 400 `invalid_mysec_blasts`: blasts_percent must be a number from 0 to 30 (Passamonti 2017 MYSEC-PM circulating blasts; magent clamp). 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.