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HCV-associated MZL patient frail or elderly: ECOG ≥3, OR age ≥75 with ≥2 comorbidities, O...

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
    },
    {
      "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"
}

Notes

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.

Used By

Algorithms

• ALGO-HCV-MZL-1L - ALGO-HCV-MZL-1L

Indications

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