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Multiple myeloma with malignant epidural spinal cord compression: new motor deficit, sens...

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

IDRF-MM-CORD-COMPRESSION
TypeRed flag
Statusreviewed 2026-04-27 | pending_clinical_signoff
DiseasesDIS-MM
SourcesSRC-EHA-EMN-MM-2025 SRC-ESMO-MM-2023 SRC-NCCN-MM-2025

Red Flag Origin

DefinitionMultiple myeloma with malignant epidural spinal cord compression: new motor deficit, sensory level, severe back pain with vertebral plasmacytoma / lytic lesion + canal invasion — MM is a leading hematologic cause of MESCC
Clinical directionhold
Categoryorgan-dysfunction
Shifts algorithmALGO-MM-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "spinal_cord_compression",
      "value": true
    },
    {
      "finding": "new_motor_deficit_with_back_pain",
      "value": true
    },
    {
      "finding": "vertebral_plasmacytoma_with_canal_invasion",
      "value": true
    },
    {
      "finding": "cauda_equina_syndrome",
      "value": true
    }
  ],
  "type": "composite"
}

Notes

Per NCCN-MM + ESMO-MM 2023 + EHA-EMN-MM 2025: dexamethasone 40 mg PO/IV bolus, MRI whole spine, urgent RT (8 Gy ×1 or 20-30 Gy fractionated) ± neurosurgical decompression for instability/large mass; bortezomib- based induction begun in parallel (rapid cytoreduction). Direction HOLD on routine induction start until decompression initiated; priority 8. STUB — requires clinical co-lead signoff.

Used By

Indications