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Multiple myeloma high-risk cytogenetics: any of t(4;14), t(14;16), t(14;20), del(17p)/TP5...

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": "BIO-MM-CYTOGENETICS-HR",
      "value": "positive"
    },
    {
      "finding": "mm_cytogenetics_high_risk",
      "value": true
    },
    {
      "finding": "del_17p",
      "value": true
    },
    {
      "finding": "t_4_14",
      "value": true
    },
    {
      "finding": "t_14_16",
      "value": true
    },
    {
      "finding": "gain_1q",
      "value": true
    }
  ],
  "type": "biomarker"
}

Notes

Primary determinant for selecting quadruplet (D-VRd) over triplet (VRd) in transplant-eligible newly-diagnosed MM. R2-ISS captures most of these abnormalities; gain 1q21 is graded by copy count (≥4 copies = amp1q carries higher risk than 3 copies = gain1q). t(11;14) is NOT high-risk and does not trigger this flag.

Used By

Algorithms

• ALGO-MM-1L - ALGO-MM-1L

Biomarker

• BIO-TP53-MUTATION - TP53 mutation / del(17p)

Indications

• IND-MM-1L-VRD - IND-MM-1L-VRD
• IND-MM-2L-DKD - IND-MM-2L-DKD
• IND-MM-3L-ISA-KD - IND-MM-3L-ISA-KD
• IND-MM-POST-ASCT-LENALIDOMIDE-MAINTENANCE - IND-MM-POST-ASCT-LENALIDOMIDE-MAINTENANCE

Questionnaires

• QUEST-MM-1L - Multiple Myeloma — newly diagnosed (1L)

Red flag

• RF-ASCT-ELIGIBLE-COMPOSITE - Composite eligibility for autologous stem-cell transplantation (ASCT) consolidation: ECOG...
• RF-MM-T11-14-ACTIONABLE - t(11;14)(q13;q32) IGH/CCND1 translocation in multiple myeloma — ~15-20% prevalence, BCL-2...
• RF-MM-TRANSFORMATION-PROGRESSION - Aggressive plasma-cell biology indicating need for intensified MM induction: plasma cell...