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Follicular lymphoma NOT meeting any GELF criterion — low tumor burden — watch-and-wait ca...

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

{
  "all_of": [
    {
      "finding": "fl_gelf_high_burden",
      "value": false
    },
    {
      "finding": "b_symptoms_present",
      "value": false
    },
    {
      "finding": "rapid_progression",
      "value": false
    }
  ],
  "none_of": [
    {
      "comparator": ">=",
      "finding": "dominant_nodal_mass_cm",
      "threshold": 7.0
    },
    {
      "finding": "ldh_above_uln",
      "value": true
    },
    {
      "finding": "compressive_symptoms",
      "value": true
    },
    {
      "finding": "cytopenia_due_to_lymphoma",
      "value": true
    }
  ],
  "type": "composite_clinical"
}

Notes

Low-burden FL (no GELF criterion) is the canonical watch-and-wait population. RESORT (E4402, Kahl 2014) showed rituximab-monotherapy did not improve OS over observation; Ardeshna 2014 showed similar. ESMO FL 2024 / NCCN B-cell 2025 recommend observation as first approach for stage III-IV asymptomatic low-burden FL; rituximab monotherapy is acceptable when patient prefers active intervention and meets shared-decision threshold. de-escalate direction routes away from chemoimmunotherapy.

Used By

Algorithms

• ALGO-FL-1L - ALGO-FL-1L

Red flag

• RF-GELF-CRITERIA-MET - Follicular lymphoma meeting any GELF criterion — high tumor burden warranting systemic th...