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PMF patient with organ dysfunction limiting JAK-inhibitor or alloHCT eligibility: severe...

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

IDRF-PMF-ORGAN-DYSFUNCTION
TypeRed flag
Statusreviewed 2026-04-25 | pending_clinical_signoff
DiseasesDIS-PMF
SourcesSRC-COMFORT-I-VERSTOVSEK-2012 SRC-NCCN-MPN-2025

Red Flag Origin

DefinitionPMF patient with organ dysfunction limiting JAK-inhibitor or alloHCT eligibility: severe thrombocytopenia (plt <50K — affects ruxolitinib dose; pacritinib option), severe hepatic dysfunction, or significant cardiac/pulmonary comorbidity
Clinical directioninvestigate
Categoryorgan-dysfunction

Trigger Logic

{
  "any_of": [
    {
      "comparator": "<",
      "finding": "platelet_count_k_ul",
      "threshold": 50
    },
    {
      "finding": "child_pugh_class",
      "value": "C"
    },
    {
      "comparator": "<",
      "finding": "creatinine_clearance_ml_min",
      "threshold": 30
    },
    {
      "comparator": "<",
      "finding": "lvef_percent",
      "threshold": 40
    }
  ],
  "type": "composite"
}

Notes

Direction "investigate" — surfaces JAKi-selection / dose-attenuation annotation. Severe thrombocytopenia: ruxolitinib 5 mg BID (or pacritinib 200 mg BID, no dose adjust for plt). Hepatic dysfunction: avoid ruxolitinib (CYP3A4). AlloHCT also likely off-table. STUB — requires clinical co-lead signoff.

Used By

Algorithms

Indications