Frailty profile influencing MF/Sézary therapy selection: ECOG ≥3, OR (age ≥75 with G8 ≤14...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | RF-MF-SEZARY-FRAILTY-AGE |
|---|---|
| Type | Red flag |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | DIS-MF-SEZARY |
| Sources | SRC-ESMO-CTCL-2024 SRC-NCCN-BCELL-2025 |
Red Flag Origin
| Definition | Frailty profile influencing MF/Sézary therapy selection: ECOG ≥3, OR (age ≥75 with G8 ≤14), OR composite frailty (age ≥70 + Charlson ≥3 + albumin <3.5). Triggers preference for skin-directed therapy (PUVA, topical mechlorethamine), low-dose oral methotrexate, IFN, or mogamulizumab (well-tolerated systemically) over multi-agent chemotherapy regimens. |
|---|---|
| Clinical direction | de-escalate |
| Category | frailty-age |
Trigger Logic
{
"any_of": [
{
"comparator": ">=",
"finding": "ecog",
"threshold": 3
},
{
"all_of": [
{
"comparator": ">=",
"finding": "age",
"threshold": 75
},
{
"comparator": "<=",
"finding": "g8_score",
"threshold": 14
}
]
},
{
"all_of": [
{
"comparator": ">=",
"finding": "age",
"threshold": 70
},
{
"comparator": ">=",
"finding": "charlson_score",
"threshold": 3
},
{
"comparator": "<",
"finding": "albumin_g_dl",
"threshold": 3.5
}
]
}
],
"type": "composite_score"
}
Notes
MF/Sézary is typically chronic / indolent in early stages, allowing skin-directed approach (topical corticosteroids, mechlorethamine gel, bexarotene topical, narrowband UVB, PUVA) for stage IA-IIA regardless of age. Frail elderly with stage IIB+ or Sézary: low-dose oral MTX (10-25 mg weekly), IFN-α, or mogamulizumab — all well-tolerated. Avoid multi-agent gem-doxo / CHOP-like regimens in frail (no curative endpoint, considerable toxicity, marginal PFS gains). AlloHCT is the only curative modality but typically off-table for frail elderly.
Used By
No reverse references found in the YAML corpus.