Onco Wiki / Rote Flagge

HCV-assoziierter MZL-Patienten schwach oder älter: ECOG ≥ 3, ODER Alter ≥ 75 mit ≥ 2 Komorbiditäten, O...

Deterministische Ansicht der Quelle YAML Entität. Klinische Autorität bleibt mit den zitierten Quell-IDs und Rezensenten Sign-off Zustand.

Ursprung der Roten Flagge

Logik auslösen

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "ecog",
      "threshold": 3
    },
    {
      "finding": "fit_for_combination_chemo",
      "value": false
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age",
          "threshold": 75
        },
        {
          "comparator": ">=",
          "finding": "comorbidity_count",
          "threshold": 2
        }
      ]
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age",
          "threshold": 70
        },
        {
          "comparator": "<",
          "finding": "albumin_g_dl",
          "threshold": 3.0
        },
        {
          "finding": "cirrhosis_present",
          "value": true
        }
      ]
    }
  ],
  "type": "composite_score"
}

Anmerkungen

HCV-MZL is typically indolent and DAA-responsive — antiviral therapy alone (DAA: glecaprevir/pibrentasvir or sofosbuvir/velpatasvir) produces ~75% lymphoma response when achieved viral cure (Arcaini 2014). Frail patients should preferentially receive DAA-only with watch-and-wait for the lymphoma; reserve immunochemotherapy (R-bendamustine, R-CVP) for symptomatic / progressive disease after SVR. Bendamustine in elderly: high infection risk, monitor lymphocyte recovery + add PJP prophylaxis. Cirrhotic + frail: prefer rituximab- monotherapy. Geriatric assessment recommended.

Verwendet von

Algorithmen

• ALGO-HCV-MZL-1L - ALGO-HCV-MZL-1L

Anwendungsgebiet

• IND-HCV-MZL-POST-DAA-SURVEILLANCE - IND-HCV-MZL-POST-DAA-SURVEILLANCE