Onco Wiki / Bandeira vermelha

MYC + BCL2 (and/or BCL6) rearrangement (double-/triple-hit) confirmed by FISH — DA-EPOCH-...

Visão determinística da entidade fonte YAML. A autoridade clínica permanece com os IDs de fonte citados e estado de assinatura do revisor.

IDRF-HGBL-DH-HIGH-RISK-BIOLOGY
TipoSinal de alerta
Estadoreviewed 2026-04-25 | pending_clinical_signoff
DoençasDIS-HGBL-DH
FontesSRC-ESMO-DLBCL-2024 SRC-NCCN-BCELL-2025

Origem da bandeira vermelha

DefiniçãoMYC + BCL2 (and/or BCL6) rearrangement (double-/triple-hit) confirmed by FISH — DA-EPOCH-R + IT methotrexate prophylaxis preferred over R-CHOP per multiple retrospective and small prospective series.
Direcção clínicaintensificar
Categoriahigh-risk-biology
Algoritmo de deslocamentosALGO-HGBL-DH-1L

Lógica de Desencadeamento

{
  "any_of": [
    {
      "all_of": [
        {
          "finding": "myc_rearrangement",
          "value": true
        },
        {
          "finding": "bcl2_rearrangement",
          "value": true
        }
      ]
    },
    {
      "all_of": [
        {
          "finding": "myc_rearrangement",
          "value": true
        },
        {
          "finding": "bcl6_rearrangement",
          "value": true
        }
      ]
    },
    {
      "finding": "double_hit_lymphoma",
      "value": true
    },
    {
      "finding": "triple_hit_lymphoma",
      "value": true
    }
  ],
  "type": "biomarker"
}

Notas

WHO 2022/ICC define HGBL-DH/-TH as distinct entity. NCCN explicitly endorses DA-EPOCH-R for HGBL-DH; CNS prophylaxis (IT MTX × 4-8 doses) standard regardless of CNS-IPI in this subtype.

Usado por

Algoritmos