IFS pediátrica con edad neonatal (<3 meses), bajo peso al nacer / fracaso en la...

Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.

ID	`RF-IFS-FRAILTY-AGE`
Tipo	Señal de alerta
Situación	reviewed 2026-04-27 \| pending_clinical_signoff
Enfermedades	`DIS-IFS`
Fuentes	`SRC-NCCN-PEDIATRIC-SARCOMA`

Origen de la bandera roja

Definición	Pediatric IFS with neonatal age (<3 months), low birth weight / failure to thrive (weight <-2SD for age), or hemodynamic instability — VAC cytotoxic protocols poorly tolerated in this very-young population; larotrectinib / entrectinib are the substantially safer alternative. This is the pediatric counterpart of adult frailty-age.
Dirección clínica	decreciente
Categoría	edad de fragilidad

Lógica de activación

{
  "any_of": [
    {
      "comparator": "<",
      "finding": "age_months",
      "threshold": 3
    },
    {
      "comparator": "<",
      "finding": "weight_for_age_zscore",
      "threshold": -2
    },
    {
      "finding": "hemodynamic_instability",
      "value": true
    }
  ],
  "type": "composite_clinical"
}

Notas

IFS often presents at birth or in the first 6 months of life; very young infants tolerate cytotoxic chemotherapy poorly (myelosuppression, hepatic immaturity, cardiac sensitivity to anthracyclines). VAC protocol carries significant infectious mortality in <3 months. The emergence of TRK-inhibitors (larotrectinib pediatric label down to newborns; entrectinib down to 1 month) has transformed practice — these agents have ORR >90% and are the preferred 1L for fusion-positive IFS in this age group. This frailty flag pushes harder toward TRK- inhibitor monotherapy when fusion-positive (>90% of cases).

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