HGBL double-/triple-hit lymphoma — biology alone meets CNS-prophylaxis indication indepen...

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ID	`RF-HGBL-DH-CNS-PROPHYLAXIS-TRIGGER`
Tipo	Sinal de alerta
Estado	reviewed 2026-04-27 \| pending_clinical_signoff
Doenças	`DIS-HGBL-DH`
Fontes	`SRC-ESMO-DLBCL-2024` `SRC-NCCN-BCELL-2025`

Origem da bandeira vermelha

Definição	HGBL double-/triple-hit lymphoma — biology alone meets CNS-prophylaxis indication independent of CNS-IPI; mandates HD-MTX intercalation or IT MTX
Direcção clínica	investigar
Categoria	high-risk-biology

Lógica de Desencadeamento

{
  "any_of": [
    {
      "finding": "myc_rearranged",
      "value": true
    },
    {
      "finding": "double_hit_lymphoma",
      "value": true
    },
    {
      "finding": "triple_hit_lymphoma",
      "value": true
    }
  ],
  "type": "composite"
}

Notas

Per NCCN B-cell v.X.2025 HGBL section: CNS prophylaxis recommended for all HGBL-DH/TH regardless of CNS-IPI score (biology-driven); typical approach HD-MTX 3-3.5 g/m² IV intercalated with DA-EPOCH-R cycles. Direction INVESTIGATE because RF doesn't shift main regimen — adds CNS-directed therapy as plan particularity. shifts_algorithm:[] per REDFLAG_AUTHORING_GUIDE §4 rule 2. STUB — requires clinical co-lead signoff.

Usado por

Não há referências reversas encontradas no corpus YAML.