DLBCL with International Prognostic Index 2-3 (intermediate risk) — opens MDT discussion...

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

ID	`RF-IPI-INTERMEDIATE`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-DLBCL-NOS`
Sources	`SRC-ESMO-DLBCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	DLBCL with International Prognostic Index 2-3 (intermediate risk) — opens MDT discussion of R-CHOP vs Pola-R-CHP per POLARIX subgroup signal; shared-decision territory
Clinical direction	investigate
Category	risk-score

Trigger Logic

{
  "any_of": [
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "ipi_score",
          "threshold": 2
        },
        {
          "comparator": "<=",
          "finding": "ipi_score",
          "threshold": 3
        }
      ]
    },
    {
      "finding": "ipi_risk_group",
      "value": "intermediate"
    },
    {
      "finding": "ipi_risk_group",
      "value": "intermediate_low"
    },
    {
      "finding": "ipi_risk_group",
      "value": "intermediate_high"
    }
  ],
  "type": "composite_score"
}

Notes

IPI 2-3 cohort accounts for ~40% of newly-diagnosed DLBCL; POLARIX HR for PFS favored Pola-R-CHP in IPI ≥2 overall (HR 0.73) but the benefit was concentrated in IPI 3-5 / non-GCB / age >60 subgroups. ESMO 2024 frames IPI 2-3 as MDT discussion: R-CHOP-21 × 6 remains acceptable when access to polatuzumab is constrained (Ukraine: not НСЗУ-reimbursed). Direction `investigate` because flag surfaces the decision for the MDT brief but does not auto-shift indication — RF-DLBCL-HIGH-IPI (≥2 also fires) takes precedence in the engine.

Used By

Algorithms

ALGO-DLBCL-1L - ALGO-DLBCL-1L