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Frailty (ECOG ≥3 OR age ≥75 + ≥2 comorbidities) — DA-EPOCH-R infusional toxicity poorly t...

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

IDRF-PMBCL-FRAILTY-AGE
TypeRed flag
Statusreviewed 2026-04-25 | pending_clinical_signoff
DiseasesDIS-PMBCL
SourcesSRC-ESMO-DLBCL-2024 SRC-NCCN-BCELL-2025

Red Flag Origin

DefinitionFrailty (ECOG ≥3 OR age ≥75 + ≥2 comorbidities) — DA-EPOCH-R infusional toxicity poorly tolerated; R-CHOP+RT preferred for fragile elderly.
Clinical directionde-escalate
Categoryfrailty-age
Shifts algorithmALGO-PMBCL-1L

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "ecog_status",
      "threshold": 3
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age_years",
          "threshold": 75
        },
        {
          "comparator": ">=",
          "finding": "comorbidity_count",
          "threshold": 2
        }
      ]
    }
  ],
  "type": "composite_clinical"
}

Notes

DA-EPOCH-R infusional schedule + G-CSF support poorly tolerated in elderly frail; R-CHOP+ISRT acceptable per NCCN with similar EFS in this subgroup.

Used By

Algorithms

Indications