Monomorphic PTLD with DLBCL-type morphology / Burkitt-like / T-cell PTLD — chemoimmunothe...

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

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

Red Flag Origin

Definition	Monomorphic PTLD with DLBCL-type morphology / Burkitt-like / T-cell PTLD — chemoimmunotherapy from start (R-CHOP, EPOCH, or T-cell-specific); polymorphic forms may respond to IS-reduction ± rituximab.
Clinical direction	intensify
Category	high-risk-biology
Shifts algorithm	ALGO-PTLD-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "ptld_subtype_monomorphic_dlbcl",
      "value": true
    },
    {
      "finding": "ptld_subtype_burkitt_like",
      "value": true
    },
    {
      "finding": "ptld_subtype_t_cell",
      "value": true
    }
  ],
  "type": "biomarker"
}

Notes

Histologic subtype is the dominant treatment selector in PTLD. Polymorphic / early-lesion → IS-reduction trial first; monomorphic → chemoimmuno from start. T-cell PTLD is rare and requires CHOP-based without rituximab.

Used By

Algorithms

ALGO-PTLD-1L - ALGO-PTLD-1L