DLBCL with International Prognostic Index 0-1 (low risk) — supports R-CHOP standard backb...

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

ID	`RF-IPI-LOW`
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 0-1 (low risk) — supports R-CHOP standard backbone; no need for Pola-R-CHP intensification or CNS prophylaxis on score alone
Clinical direction	de-escalate
Category	risk-score
Shifts algorithm	ALGO-DLBCL-1L

Trigger Logic

{
  "any_of": [
    {
      "comparator": "<=",
      "finding": "ipi_score",
      "threshold": 1
    },
    {
      "finding": "ipi_risk_group",
      "value": "low"
    }
  ],
  "type": "composite_score"
}

Notes

IPI 0-1 in newly-diagnosed DLBCL identifies the low-risk cohort with 5-yr OS ~85-90% on R-CHOP-21 × 6 in the rituximab era. POLARIX did not show benefit for Pola-R-CHP in IPI 0-1 (subgroup analysis) so the intensified regimen is not justified by score alone. CNS-IPI may still shift CNS-prophylaxis decisions independently. Counterpart to RF-DLBCL-HIGH-IPI which intensifies; both kept separate so engine can pick R-CHOP affirmatively when low-risk fires.

Used By

Algorithms

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