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MDS with isolated del(5q) (or del(5q) plus one additional non-7 abnormality) — lenalidomi...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-MDS-DEL-5Q-ISOLATED
TypeRed flag
Statusreviewed 2026-04-30 | pending_clinical_signoff
DiseasesDIS-MDS-LR
SourcesSRC-ESMO-MDS-2021 SRC-NCCN-AML-2025

Red Flag Origin

DefinitionMDS with isolated del(5q) (or del(5q) plus one additional non-7 abnormality) — lenalidomide-responsive subgroup with ~67% RBC transfusion independence; favorable prognosis
Clinical directioninvestigate
Categoryhigh-risk-biology

Trigger Logic

{
  "any_of": [
    {
      "finding": "del_5q_isolated",
      "value": true
    },
    {
      "finding": "isolated_del_5q",
      "value": true
    },
    {
      "finding": "mds_del_5q",
      "value": "positive"
    },
    {
      "all_of": [
        {
          "finding": "del_5q",
          "value": true
        },
        {
          "finding": "monosomy_7",
          "value": false
        },
        {
          "finding": "complex_karyotype",
          "value": false
        }
      ]
    }
  ],
  "type": "biomarker"
}

Notes

Direction "investigate" — surfaces a treatment-option annotation (lenalidomide track) rather than a binary indication switch. Lenalidomide 10 mg/day × 21 days q28d achieves cytogenetic response ~50% + RBC transfusion independence ~67% in del(5q) MDS-LR. Monitor for cytopenias requiring dose reduction. Pregnancy gating mandatory (potent teratogen). TP53 mutation (~20% of del(5q)) co-occurrence predicts resistance + AML transformation. STUB — requires clinical co-lead signoff.

Used By

Algorithms

Biomarker

Indications