# WPSS (myelodysplastic syndromes)

WPSS

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

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

## What it computes

Sum the Malcovati 2007 WPSS (WHO classification-based prognostic scoring system) for myelodysplastic syndromes and return very_low (0), low (1), intermediate (2), high (3–4), or very_high (5–6).

## When to use

When an agent needs the published WPSS point total and risk group and must not invent an MDS diagnosis, transplant listing, or survival estimate, and must not substitute IPSS-R, IPSS 1997, IPSS-M, or DIPSS.

## When not to use

- Not a medical device and not an MDS diagnosis, treatment choice, or transplant listing. magent does not examine the patient.
- This is Malcovati 2007 WPSS (WHO 2001 Table 2) only, not Greenberg 2012 IPSS-R, not Greenberg 1997 IPSS, not IPSS-M, and not DIPSS (myelofibrosis).
- magent does not karyotype. cytogenetics is the caller-assigned IPSS three-group class (good, intermediate, poor), not the IPSS-R five-group scale (very_good and very_poor are invalid).
- magent does not assign WHO category. who_mds is the caller-mapped 2001 WHO group (RA/RARS/5q-, RCMD/RCMD-RS, RAEB-1, RAEB-2). Later WHO/ICC entities are not mapped.
- Regular transfusion is a caller-assigned boolean (at least one RBC transfusion every 8 weeks over 4 months). magent does not count units.
- Does not report median overall survival or AML evolution times from the 2007 figures.

## Formula

```
WPSS = WHO (ra_rars_5q 0, rcmd 1, raeb1 2, raeb2 3) + karyotype (good 0, intermediate 1, poor 2) + regular_transfusion 1; Malcovati 2007 Table 2; max 6; very_low 0, low 1, intermediate 2, high 3-4, very_high 5-6
```

## Citation

[Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes](https://doi.org/10.1200/JCO.2006.08.5696)
Malcovati L, Germing U, Kuendgen A, et al.
J Clin Oncol. 2007;25(23):3503-3510
DOI: [10.1200/JCO.2006.08.5696](https://doi.org/10.1200/JCO.2006.08.5696)

## Worked example

### RA/RARS/5q-, good karyotype, no regular transfusion

Given: `cytogenetics=good, regular_transfusion=false, who_mds=ra_rars_5q`

1. who_mds ra_rars_5q → 0; cytogenetics good → 0; regular_transfusion false → 0
2. Score = 0 (max 6); risk_group = very_low


### Maximum published score

Given: `cytogenetics=poor, regular_transfusion=true, who_mds=raeb2`

1. who_mds raeb2 → 3; cytogenetics poor → 2; regular_transfusion → 1
2. Score = 6 (max 6); risk_group = very_high (5–6)


## Also searched as

- WPSS
- WHO classification-based prognostic scoring system
- Malcovati WPSS
- WPSS MDS
- WHO-based prognostic scoring system
- Malcovati 2007 MDS
- WPSS myelodysplastic syndrome
- WHO WPSS 2007

## Parameters

- `who_mds` (string, required): Malcovati 2007 Table 2 WHO 2001 group as assigned by the caller. ra_rars_5q is RA, RARS, or MDS with isolated del(5q) and scores 0. rcmd is RCMD or RCMD-RS and scores 1. raeb1 is RAEB-1 and scores 2. raeb2 is RAEB-2 and scores 3. magent does not assign WHO category.
- `cytogenetics` (string, required): IPSS (Greenberg 1997) cytogenetic group as assigned by the caller (good 0, intermediate 1, poor 2). Not the IPSS-R five-group scale (very_good and very_poor are invalid). magent does not karyotype.
- `regular_transfusion` (boolean, required): Regular RBC transfusion requirement as assigned by the caller (Malcovati 2007: at least one RBC transfusion every 8 weeks over 4 months). true scores 1. magent does not count units.

## 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/wpss`
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": [
    {
      "cytogenetics": "good",
      "regular_transfusion": "false",
      "who_mds": "ra_rars_5q"
    },
    {
      "cytogenetics": "good",
      "regular_transfusion": "false",
      "who_mds": "ra_rars_5q"
    }
  ]
}
```

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

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/wpss",
  "items": [
    {
      "components": [
        {
          "value": "ra_rars_5q",
          "factor": "who_mds",
          "points": 0,
          "present": false
        },
        {
          "value": "good",
          "factor": "cytogenetics",
          "points": 0,
          "present": false
        },
        {
          "factor": "regular_transfusion",
          "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": "Malcovati L, Germing U, Kuendgen A, et al.",
        "doi": "10.1200/JCO.2006.08.5696",
        "id": "malcovati-2007",
        "pmid": "17687155",
        "source": "J Clin Oncol. 2007;25(23):3503-3510",
        "title": "Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes"
      },
      "formula": "wpss",
      "formula_expression": "WPSS = WHO (ra_rars_5q 0, rcmd 1, raeb1 2, raeb2 3) + karyotype (good 0, intermediate 1, poor 2) + regular_transfusion 1; Malcovati 2007 Table 2; max 6; very_low 0, low 1, intermediate 2, high 3-4, very_high 5-6",
      "max_score": 6,
      "score": 0,
      "risk_group": "very_low",
      "cytogenetics": "good",
      "regular_transfusion": false,
      "who_mds": "ra_rars_5q"
    },
    {
      "components": [
        {
          "value": "ra_rars_5q",
          "factor": "who_mds",
          "points": 0,
          "present": false
        },
        {
          "value": "good",
          "factor": "cytogenetics",
          "points": 0,
          "present": false
        },
        {
          "factor": "regular_transfusion",
          "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": "Malcovati L, Germing U, Kuendgen A, et al.",
        "doi": "10.1200/JCO.2006.08.5696",
        "id": "malcovati-2007",
        "pmid": "17687155",
        "source": "J Clin Oncol. 2007;25(23):3503-3510",
        "title": "Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes"
      },
      "formula": "wpss",
      "formula_expression": "WPSS = WHO (ra_rars_5q 0, rcmd 1, raeb1 2, raeb2 3) + karyotype (good 0, intermediate 1, poor 2) + regular_transfusion 1; Malcovati 2007 Table 2; max 6; very_low 0, low 1, intermediate 2, high 3-4, very_high 5-6",
      "max_score": 6,
      "score": 0,
      "risk_group": "very_low",
      "cytogenetics": "good",
      "regular_transfusion": false,
      "who_mds": "ra_rars_5q"
    }
  ]
}
```

## Response fields

- `formula` (string): wpss
- `formula_expression` (string): Exact expression used
- `score` (integer): WPSS points 0-6
- `max_score` (integer): Always 6 (3+2+1)
- `risk_group` (string): very_low when score is 0, low when 1, intermediate when 2, high when 3-4, very_high when 5-6 (Malcovati 2007 Table 2). Not an MDS diagnosis. Not IPSS-R. Not IPSS 1997. Not DIPSS.
- `who_mds` (string): Caller-assigned WHO 2001 Table 2 group used
- `cytogenetics` (string): Caller-assigned IPSS three-group karyotype used
- `regular_transfusion` (boolean): Caller-assigned regular-transfusion flag used
- `components` (array): Per-factor points
- `citation` (object): Malcovati et al. J Clin Oncol 2007 WPSS citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "components": [
    {
      "value": "ra_rars_5q",
      "factor": "who_mds",
      "points": 0,
      "present": false
    },
    {
      "value": "good",
      "factor": "cytogenetics",
      "points": 0,
      "present": false
    },
    {
      "factor": "regular_transfusion",
      "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": "Malcovati L, Germing U, Kuendgen A, et al.",
    "doi": "10.1200/JCO.2006.08.5696",
    "id": "malcovati-2007",
    "pmid": "17687155",
    "source": "J Clin Oncol. 2007;25(23):3503-3510",
    "title": "Time-dependent prognostic scoring system for predicting survival and leukemic evolution in myelodysplastic syndromes"
  },
  "formula": "wpss",
  "formula_expression": "WPSS = WHO (ra_rars_5q 0, rcmd 1, raeb1 2, raeb2 3) + karyotype (good 0, intermediate 1, poor 2) + regular_transfusion 1; Malcovati 2007 Table 2; max 6; very_low 0, low 1, intermediate 2, high 3-4, very_high 5-6",
  "max_score": 6,
  "score": 0,
  "risk_group": "very_low",
  "cytogenetics": "good",
  "regular_transfusion": false,
  "who_mds": "ra_rars_5q"
}
```

## Errors

- HTTP 400 `invalid_wpss`: each WPSS 2007 item must be a published WHO, karyotype, or transfusion category. Returned before settlement; you are not charged.
- HTTP 400 `invalid_who_mds`: who_mds must be ra_rars_5q, rcmd, raeb1, or raeb2 (Malcovati 2007 WHO groups). 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

- [IPSS-R](https://magentlab.com/docs/ipss-r) — Sum the Greenberg 2012 IPSS-R (revised international prognostic scoring system) for myelodysplastic syndromes and return very_low (≤1.5), low (>1.5–3), intermediate (>3–4.5), high (>4.5–6), or very_high (>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.