Age >55 — pediatric-inspired protocols (GRAALL, CALGB 10403) carry excessive induction mo...

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

ID	`RF-T-ALL-FRAILTY-AGE`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-T-ALL`
Sources	`SRC-ESMO-PTCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Age >55 — pediatric-inspired protocols (GRAALL, CALGB 10403) carry excessive induction mortality; reduced-intensity backbone with selected MRD-targeted agents (nelarabine, asparaginase modifications) preferred.
Clinical direction	de-escalate
Category	frailty-age

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">",
      "finding": "age_years",
      "threshold": 55
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "ecog_status",
          "threshold": 3
        },
        {
          "comparator": ">=",
          "finding": "comorbidity_count",
          "threshold": 2
        }
      ]
    }
  ],
  "type": "composite_clinical"
}

Notes

T-ALL >55 is rare; protocols underrepresented in trials. Reduced-intensity backbone often borrowed from older B-ALL regimens with T-cell substitutions.

Used By

No reverse references found in the YAML corpus.