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PV or ET high-risk for thrombosis: age >60 OR prior arterial / venous thrombosis OR (ET o...

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

IDRF-PV-ET-HIGH-THROMBOSIS-RISK
TypeRed flag
Statusreviewed 2026-04-25 | pending_clinical_signoff
DiseasesDIS-ET DIS-PV
SourcesSRC-ESMO-MPN-2015 SRC-NCCN-MPN-2025 SRC-RESPONSE-VANNUCCHI-2015

Red Flag Origin

DefinitionPV or ET high-risk for thrombosis: age >60 OR prior arterial / venous thrombosis OR (ET only) JAK2 V617F + CV risk factors (IPSET-thrombosis high) — triggers cytoreduction (HU 1L) in addition to baseline phlebotomy + ASA
Clinical directionintensify
Categoryhigh-risk-biology
Shifts algorithmALGO-PV-1L, ALGO-ET-1L

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">",
      "finding": "age_years",
      "threshold": 60
    },
    {
      "finding": "prior_thrombosis_arterial_or_venous",
      "value": true
    },
    {
      "finding": "ipset_thrombosis_risk",
      "value": "high"
    },
    {
      "all_of": [
        {
          "finding": "jak2_v617f",
          "value": true
        },
        {
          "comparator": ">=",
          "finding": "cv_risk_factors_count",
          "threshold": 2
        }
      ]
    }
  ],
  "type": "composite"
}

Notes

Drives selection between low-risk (phlebotomy + ASA only for PV; ASA only for ET) and high-risk (add HU 1L cytoreduction). For PV, ELN 2018 also flags WBC ≥11 as supplementary risk. For ET, IPSET- thrombosis explicitly weights JAK2 V617F as risk-multiplying. CALR- mutated ET has lower thrombosis risk than JAK2 ET — same age cutoff but more permissive cytoreduction threshold. STUB — requires clinical co-lead signoff.

Used By

Algorithms

Indications

Red flag