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Frailty profile influencing WM regimen selection: ECOG ≥3, OR (age ≥75 with G8 ≤14), OR c...

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

Red Flag Origin

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "ecog",
      "threshold": 3
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age",
          "threshold": 75
        },
        {
          "comparator": "<=",
          "finding": "g8_score",
          "threshold": 14
        }
      ]
    },
    {
      "all_of": [
        {
          "comparator": ">=",
          "finding": "age",
          "threshold": 70
        },
        {
          "comparator": ">=",
          "finding": "charlson_score",
          "threshold": 3
        },
        {
          "comparator": "<",
          "finding": "albumin_g_dl",
          "threshold": 3.5
        }
      ]
    }
  ],
  "type": "composite_score"
}

Notes

WM is overwhelmingly an elderly disease (median age 70 at diagnosis). Frail elderly: BR with reduced bendamustine doses (70 mg/m² instead of 90) per StiL elderly subgroup; or rituximab monotherapy weekly x4 + maintenance for low-burden symptomatic disease. Continuous BTKi: zanubrutinib preferred over ibrutinib in elderly with cardiac comorbidity (ASPEN — lower AF, hypertension, sudden cardiac events). IgM flare with rituximab can precipitate hyperviscosity in elderly; pre-treat with plasmapheresis if baseline IgM >40 g/L. Avoid intensive Dex-R-Cyclo in very frail (cytopenias, infection risk).

Used By

No reverse references found in the YAML corpus.