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PMF patient elderly or frail (age ≥75, ECOG ≥3, or HCT-CI ≥4) — alloHCT off the table; sy...

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

IDRF-PMF-FRAILTY-AGE
TypeRed flag
Statusreviewed 2026-04-25 | pending_clinical_signoff
DiseasesDIS-PMF
SourcesSRC-DIPSS-PLUS-GANGAT-2011 SRC-NCCN-MPN-2025

Red Flag Origin

DefinitionPMF patient elderly or frail (age ≥75, ECOG ≥3, or HCT-CI ≥4) — alloHCT off the table; symptom-directed therapy (ruxolitinib for splenomegaly + symptoms, momelotinib for anemia, transfusion + supportive care)
Clinical directionde-escalate
Categoryfrailty-age
Shifts algorithmALGO-PMF-1L

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "age_years",
      "threshold": 75
    },
    {
      "finding": "pmf_frail_unfit",
      "value": true
    },
    {
      "comparator": ">=",
      "finding": "hct_ci_score",
      "threshold": 4
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "ecog_performance_status",
          "threshold": 3
        },
        {
          "comparator": ">=",
          "finding": "comorbidities_count",
          "threshold": 2
        }
      ]
    }
  ],
  "type": "composite"
}

Notes

AlloHCT TRM in elderly PMF >40-50% — almost always off the table. Symptom-directed JAKi as the dominant track. STUB — requires clinical co-lead signoff.

Used By

Algorithms

Indications