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Mantle cell lymphoma with blastoid / pleomorphic morphology OR TP53 mutation OR del(17p)...

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": [
    {
      "finding": "blastoid_morphology",
      "value": true
    },
    {
      "finding": "pleomorphic_morphology",
      "value": true
    },
    {
      "finding": "BIO-TP53-MUTATION",
      "value": "positive"
    },
    {
      "comparator": ">",
      "finding": "BIO-KI67-PROLIFERATION-INDEX",
      "threshold": 30
    },
    {
      "finding": "tp53_mutation",
      "value": true
    },
    {
      "finding": "del_17p",
      "value": true
    },
    {
      "finding": "ki67_above_30_percent",
      "value": true
    }
  ],
  "type": "composite_clinical"
}

Notes

Blastoid/pleomorphic + TP53-mutant MCL has poor response to chemoimmuno (BR/R-CHOP/R-DHAP) — survival impact substantial. Direct route to BTKi-based (acalabrutinib + rituximab; consolidation with allo-SCT or CAR-T at progression).

Used By

Algorithms

• ALGO-MCL-1L - ALGO-MCL-1L
• ALGO-MCL-2L - ALGO-MCL-2L

Biomarker

• BIO-KI67-PROLIFERATION-INDEX - Ki-67 proliferation index (IHC, % positive nuclei)
• BIO-TP53-MUTATION - TP53 mutation / del(17p)

Indications

• IND-MCL-1L-BTKI-R - IND-MCL-1L-BTKI-R
• IND-MCL-1L-INTENSIVE - IND-MCL-1L-INTENSIVE
• IND-MCL-POST-INDUCTION-RITUXIMAB-MAINTENANCE - IND-MCL-POST-INDUCTION-RITUXIMAB-MAINTENANCE

Red flag

• RF-MCL-BLASTOID-VARIANT - Blastoid or pleomorphic histologic variant of mantle cell lymphoma — ~10-15% of MCL at di...
• RF-MCL-TRANSFORMATION-PROGRESSION - MCL with morphologic progression to blastoid or pleomorphic variant (often with TP53 acqu...