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Frailty profile precluding full-dose R-CHOP: ECOG ≥3, OR (age ≥80 with ≥1 grade-2 comorbi...

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

Red Flag Origin

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "ecog",
      "threshold": 3
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age",
          "threshold": 80
        },
        {
          "comparator": ">=",
          "finding": "comorbidity_grade2_count",
          "threshold": 1
        }
      ]
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age",
          "threshold": 75
        },
        {
          "comparator": "<",
          "finding": "albumin_g_dl",
          "threshold": 3.0
        },
        {
          "comparator": ">=",
          "finding": "comorbidity_count",
          "threshold": 2
        }
      ]
    }
  ],
  "type": "composite_score"
}

Notes

Tucci/Italian Lymphoma Foundation frailty score validated as predictor of R-CHOP tolerance. Frail patients: R-mini-CHOP (50% doses) per GELA LNH03-7B; R-GemOx if anthracycline contraindicated; R-bendamustine in palliative intent. This RF de-escalates from Pola-R-CHP intensification toward R-CHOP / R-mini-CHOP when frailty co-occurs with high-IPI (severity tie-break: hold > intensify > de-escalate, but here directions conflict so engine logs both and surfaces conflict to MDT).

Used By

Algorithms

• ALGO-DLBCL-1L - ALGO-DLBCL-1L
• ALGO-DLBCL-2L - ALGO-DLBCL-2L