PET-2 progression (Deauville 4-5 with new lesions) or end-of-induction non-CR — HGBL-DH r...

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

ID	`RF-HGBL-DH-TRANSFORMATION-PROGRESSION`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-HGBL-DH`
Sources	`SRC-ESMO-DLBCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	PET-2 progression (Deauville 4-5 with new lesions) or end-of-induction non-CR — HGBL-DH refractory disease has very poor outcomes; CAR-T (axi-cel/liso-cel) preferred over salvage chemo.
Clinical direction	investigate
Category	transformation-progression

Trigger Logic

{
  "any_of": [
    {
      "finding": "interim_pet_progression",
      "value": true
    },
    {
      "finding": "end_induction_non_cr",
      "value": true
    }
  ],
  "type": "imaging_finding"
}

Notes

Refractory HGBL-DH 12-month OS ~30% with chemo salvage; ZUMA-12 axi-cel data support CAR-T-first paradigm. Sits in 2L Algorithm not 1L; flag drives MDT priority.

Used By

Algorithms

ALGO-HGBL-DH-2L - ALGO-HGBL-DH-2L