Multifocal disease, deep brain involvement (basal ganglia/thalamus/brainstem), or high IE...

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

ID	`RF-PCNSL-HIGH-RISK-BIOLOGY`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-PCNSL`
Sources	`SRC-ESMO-DLBCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Multifocal disease, deep brain involvement (basal ganglia/thalamus/brainstem), or high IELSG-PCNSL score (≥3) — favor consolidation with autoSCT or full-dose WBRT after induction.
Clinical direction	intensify
Category	high-risk-biology

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "ielsg_pcnsl_score",
      "threshold": 3
    },
    {
      "finding": "deep_brain_involvement",
      "value": true
    },
    {
      "finding": "multifocal_pcnsl",
      "value": true
    }
  ],
  "type": "composite_score"
}

Notes

IELSG-PCNSL prognostic model (age, ECOG, LDH, CSF protein, deep-brain involvement) stratifies 2-year OS. Flag drives consolidation strategy decisions (autoSCT vs WBRT) which sit downstream of 1L Algorithm.

Used By

No reverse references found in the YAML corpus.