Advanced systemic mastocytosis (advSM) patient with frailty: age ≥75 with ≥2 comorbiditie...

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

ID	`RF-MASTOCYTOSIS-FRAILTY-AGE`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-MASTOCYTOSIS`
Sources	`SRC-ESMO-MPN-2015` `SRC-NCCN-SM-2025`

Red Flag Origin

Definition	Advanced systemic mastocytosis (advSM) patient with frailty: age ≥75 with ≥2 comorbidities + albumin <3.5 g/dL, OR ECOG ≥3, OR CIRS-G ≥7 — limits tolerability of midostaurin / avapritinib + supportive complexity
Clinical direction	de-escalate
Category	frailty-age
Shifts algorithm	ALGO-ADVSM-1L

Trigger Logic

{
  "all_of": [
    {
      "any_of": [
        {
          "comparator": ">=",
          "finding": "age_years",
          "threshold": 75
        },
        {
          "comparator": ">=",
          "finding": "ecog",
          "threshold": 3
        }
      ]
    },
    {
      "any_of": [
        {
          "comparator": ">=",
          "finding": "comorbidity_count",
          "threshold": 2
        },
        {
          "comparator": "<",
          "finding": "albumin_g_dl",
          "threshold": 3.5
        }
      ]
    }
  ],
  "type": "composite"
}

Notes

AdvSM (ASM, SM-AHN, mast cell leukemia) patients are typically older (median ~65). Per NCCN-SM v.X.2025: midostaurin or avapritinib preferred for advSM but require careful monitoring (QT, hepatic); frailty steers toward supportive management + symptomatic mediator- blockade (H1/H2 antihistamines, cromolyn, omalizumab) over cytoreduction. STUB — requires clinical co-lead signoff.

Used By

No reverse references found in the YAML corpus.