Myelodysplastic Syndromes — Lower-Risk (IPSS-R very low / low / intermediate)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DIS-MDS-LR |
|---|---|
| Type | Disease |
| Aliases | LR-MDSLower-risk MDSMDS-LRMyelodysplastic Syndromes — Lower RiskМДС низького ризикуМієлодиспластичні синдроми, низький ризик (IPSS-R дуже низький / низький / проміжний) |
| Status | reviewed 2026-04-25 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-ESMO-MDS-2021 SRC-IPSS-M-BERNARD-2022 SRC-NCCN-AML-2025 |
Informational support. All recommendations must be verified by a qualified oncologist. Engineering checks are not clinical validation or treatment approval.
| icd_o_3_morphology | 9989/3 |
|---|---|
| icd_o_3_topography | ["C42.1"] |
| icd_10 | D46.9 |
| who_classification | Myelodysplastic neoplasms (per WHO 5th ed.) — lower-risk subgroup by IPSS-R / IPSS-M |
Notes
Risk-stratified archetype split into TWO entities (DIS-MDS-LR and DIS-MDS-HR) because therapeutic intent is fundamentally different: cytopenia management vs disease modification + transplant. IPSS-R remains most widely used; IPSS-M (2022) integrates molecular features and reclassifies ~46%. del(5q) carries unique lenalidomide indication. RS-MDS (SF3B1+) is the luspatercept population. STUB — requires clinical co-lead signoff before publication. Myeloid expansion (heme).
Used By
Actionability
BMA-IDH1-R132H-MDS-LR- IDH1 R132 in MDS — ivosidenib monotherapy active (DiNardo et al. JCO 2021 — ORR 75% MDS,...BMA-IDH2-R140Q-MDS-LR- IDH2 R140Q in MDS — enasidenib monotherapy active in MDS (NCT01915498, DiNardo et al. Blo...BMA-IDH2-R172K-MDS-LR- IDH2 R172K in MDS — same enasidenib rationale as R140Q.BMA-NRAS-G12-MDS-LR- NRAS G12 in MDS-LR — progression-risk marker. No targeted therapy; standard MDS-LR care (...BMA-NRAS-G13-MDS-LR- NRAS G13 in MDS-LR — progression-risk marker. No targeted therapy; standard MDS-LR care (...BMA-NRAS-Q61R-MDS-LR- NRAS in MDS — typically signals progression risk to AML. No targeted therapy in MDS-LR; H...
Algorithms
ALGO-MDS-LR-1L- ALGO-MDS-LR-1LALGO-MDS-LR-2L- ALGO-MDS-LR-2L
Disease
DIS-AML- Acute Myeloid Leukemia (non-APL)DIS-JMML- Juvenile myelomonocytic leukemia (JMML)DIS-MDS-HR- Myelodysplastic Syndromes — Higher-Risk (IPSS-R high / very high; includes MDS-EB)
Indication
IND-MDS-LR-1L-ESA- IND-MDS-LR-1L-ESAIND-MDS-LR-1L-LUSPATERCEPT- IND-MDS-LR-1L-LUSPATERCEPTIND-MDS-LR-2L-IMETELSTAT- IND-MDS-LR-2L-IMETELSTATIND-MDS-LR-LENALIDOMIDE-DEL5Q- IND-MDS-LR-LENALIDOMIDE-DEL5QIND-OCC-BENZENE-PREVENTION-INTENSIFIED-SURVEILLANCE- IND-OCC-BENZENE-PREVENTION-INTENSIFIED-SURVEILLANCE
Questionnaires
QUEST-MDS-LR-1L-STUB- Myelodysplastic Syndromes — Lower Risk — first line
Red flag
RF-IPSS-M-HIGH- MDS with IPSS-M high or very-high risk (2022 molecular update incorporating 31 gene mutat...RF-MDS-DEL-5Q-ISOLATED- MDS with isolated del(5q) (or del(5q) plus one additional non-7 abnormality) — lenalidomi...RF-MDS-FRAILTY-AGE- MDS patient elderly or frail (age ≥80, ECOG ≥3, life expectancy <2 years, multiple comorb...RF-MDS-HIGH-RISK-IPSS- MDS escalates from lower-risk to higher-risk classification by IPSS-R (high / very high,...RF-MDS-INFECTION-SCREENING- MDS patient with positive HBV / HCV / HIV serology, latent TB, or active uncontrolled inf...RF-MDS-ORGAN-DYSFUNCTION- MDS patient with organ dysfunction limiting therapy: ECOG ≥3, severe renal impairment (Cr...RF-MDS-TP53-MUTATION- MDS with TP53 mutation (mono- or biallelic) — distinct WHO 5th-ed entity with poor outcom...RF-MDS-TRANSFORMATION-PROGRESSION- MDS progressing to AML (≥20% blasts) or accelerated MDS-IB2 with rapid progression on HMA...RF-OCC-BENZENE-MALIGNANCY-PREVENTION- Documented historical occupational exposure to benzene in an individual without a current...
Sources
SRC-COMMANDS-FENAUX-2020- Luspatercept in Patients with Lower-Risk Myelodysplastic SyndromesSRC-ESMO-MDS-2021- Myelodysplastic syndromes: ESMO Clinical Practice Guidelines for diagnosis, treatment and...SRC-IMERGE-PLATZBECKER-2024- Imetelstat in patients with lower-risk myelodysplastic syndromes who have relapsed or are...SRC-IPSS-M-BERNARD-2022- Molecular International Prognostic Scoring System for Myelodysplastic SyndromesSRC-MDS-004-FENAUX-2011- A randomized phase 3 study of lenalidomide versus placebo in RBC transfusion-dependent pa...