OpenOnco · Prepared for clinician assessment

DLBCL first-line review packet

Clinical status: awaiting independent clinician review.

Synthetic review only. Engineering checks are not clinical approval. No treatment decision should be based on this packet.

Inspect actual engine outputs, source provenance and edge cases before assessing the clinical rules. These isolated rule probes use supplied scores, not scores recalculated from a complete clinical vignette. They do not change the knowledge base.

26Synthetic scenarios
109/109Engineering checks
7Targeted input findings
PendingClinical review

What to assess

  1. Confirm each route and threshold against the applicable source, disease population and current evidence.
  2. Check contraindications, monitoring, supportive care and local availability in both tracks.
  3. Check how unknown, missing, negative and contradictory inputs are represented.
  4. Check whether the original questionnaire captures the information used by the engine.

Expected results below are existing rule contracts, not independently validated treatment choices. A PASS does not establish source grounding or clinical suitability. A recorded source date is not a fresh literature search.

Questionnaire gaps to assess (3)
  • findings.ipi_score: Exact engine field is not asked by the current DLBCL questionnaire; verify alias/default coverage.
  • findings.lvef_percent: Exact engine field is not asked by the current DLBCL questionnaire; verify alias/default coverage.
  • QUEST-DLBCL-NOS-1L-STUB: The questionnaire is explicitly an auto-generated STUB awaiting clinical review.
Technical reportBlank review templateProvenance

Review comments stay in this browser. Export to retain a copy. No upload occurs.

routingipi-0

IPI score 0

Observed default: IND-DLBCL-1L-RCHOP

Age
54
ECOG
1
IPI
0
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
routingipi-1

IPI score 1

Observed default: IND-DLBCL-1L-RCHOP

Age
54
ECOG
1
IPI
1
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
routingipi-2

IPI score 2

Observed default: IND-DLBCL-1L-POLA-R-CHP

Age
54
ECOG
1
IPI
2
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-POLA-R-CHP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Double-expressor (BCL2-IHC + MYC-IHC) phenotype — Pola-R-CHP may particularly benefit DEL subgroup; rule out HGBL-DH.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Activated B-cell-like (ABC / non-GCB) showed greater Pola-R-CHP benefit in POLARIX subgroup.
routingipi-5

IPI score 5

Observed default: IND-DLBCL-1L-POLA-R-CHP

Age
54
ECOG
1
IPI
5
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-POLA-R-CHP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Double-expressor (BCL2-IHC + MYC-IHC) phenotype — Pola-R-CHP may particularly benefit DEL subgroup; rule out HGBL-DH.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Activated B-cell-like (ABC / non-GCB) showed greater Pola-R-CHP benefit in POLARIX subgroup.
fitnessecog-2

IPI 4 with ECOG 2

Observed default: IND-DLBCL-1L-POLA-R-CHP

Age
67
ECOG
2
IPI
4
CD20
positive
LVEF (%)
58
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-POLA-R-CHP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Double-expressor (BCL2-IHC + MYC-IHC) phenotype — Pola-R-CHP may particularly benefit DEL subgroup; rule out HGBL-DH.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Activated B-cell-like (ABC / non-GCB) showed greater Pola-R-CHP benefit in POLARIX subgroup.
fitnessecog-3

IPI 4 with ECOG 3

Observed default: IND-DLBCL-1L-RCHOP

Age
67
ECOG
3
IPI
4
CD20
positive
LVEF (%)
58
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Trace exposes RF-DLBCL-FRAILTY-AGE: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
fitnessecog-4

IPI 4 with ECOG 4

Observed default: None

Age
67
ECOG
4
IPI
4
CD20
positive
LVEF (%)
58
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: None. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Trace exposes RF-DLBCL-FRAILTY-AGE: PASS
Engine's open MDT questions (1)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
organ functionlvef_percent-49

IPI 4 with LVEF 49

Observed default: IND-DLBCL-1L-RCHOP

Age
67
ECOG
2
IPI
4
CD20
positive
LVEF (%)
49
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Trace exposes RF-DLBCL-ORGAN-DYSFUNCTION: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
organ functionlvef_percent-50

IPI 4 with LVEF 50

Observed default: IND-DLBCL-1L-POLA-R-CHP

Age
67
ECOG
2
IPI
4
CD20
positive
LVEF (%)
50
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-POLA-R-CHP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Double-expressor (BCL2-IHC + MYC-IHC) phenotype — Pola-R-CHP may particularly benefit DEL subgroup; rule out HGBL-DH.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Activated B-cell-like (ABC / non-GCB) showed greater Pola-R-CHP benefit in POLARIX subgroup.
organ functioncreatinine_clearance_ml_min-29

IPI 4 with CrCl 29

Observed default: IND-DLBCL-1L-RCHOP

Age
67
ECOG
2
IPI
4
CD20
positive
LVEF (%)
58
CrCl (mL/min)
29
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Trace exposes RF-DLBCL-ORGAN-DYSFUNCTION: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
organ functioncreatinine_clearance_ml_min-30

IPI 4 with CrCl 30

Observed default: IND-DLBCL-1L-POLA-R-CHP

Age
67
ECOG
2
IPI
4
CD20
positive
LVEF (%)
58
CrCl (mL/min)
30
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-POLA-R-CHP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Double-expressor (BCL2-IHC + MYC-IHC) phenotype — Pola-R-CHP may particularly benefit DEL subgroup; rule out HGBL-DH.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Activated B-cell-like (ABC / non-GCB) showed greater Pola-R-CHP benefit in POLARIX subgroup.
organ functionbilirubin_ratio_to_uln-2-9

IPI 4 with Bilirubin / ULN 2.9

Observed default: IND-DLBCL-1L-POLA-R-CHP

Age
67
ECOG
2
IPI
4
CD20
positive
LVEF (%)
58
CrCl (mL/min)
90
Bilirubin / ULN
2.9
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-POLA-R-CHP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Double-expressor (BCL2-IHC + MYC-IHC) phenotype — Pola-R-CHP may particularly benefit DEL subgroup; rule out HGBL-DH.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Activated B-cell-like (ABC / non-GCB) showed greater Pola-R-CHP benefit in POLARIX subgroup.
organ functionbilirubin_ratio_to_uln-3

IPI 4 with Bilirubin / ULN 3

Observed default: IND-DLBCL-1L-RCHOP

Age
67
ECOG
2
IPI
4
CD20
positive
LVEF (%)
58
CrCl (mL/min)
90
Bilirubin / ULN
3
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Trace exposes RF-DLBCL-ORGAN-DYSFUNCTION: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
organ functiondlco_percent-59

IPI 4 with DLCO 59

Observed default: IND-DLBCL-1L-RCHOP

Age
67
ECOG
2
IPI
4
CD20
positive
LVEF (%)
58
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
59
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Trace exposes RF-DLBCL-ORGAN-DYSFUNCTION: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
organ functiondlco_percent-60

IPI 4 with DLCO 60

Observed default: IND-DLBCL-1L-POLA-R-CHP

Age
67
ECOG
2
IPI
4
CD20
positive
LVEF (%)
58
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
60
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-POLA-R-CHP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Double-expressor (BCL2-IHC + MYC-IHC) phenotype — Pola-R-CHP may particularly benefit DEL subgroup; rule out HGBL-DH.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Activated B-cell-like (ABC / non-GCB) showed greater Pola-R-CHP benefit in POLARIX subgroup.
infectionhbsag-positive

hbsag positive

Observed default: IND-DLBCL-1L-RCHOP

Age
54
ECOG
1
IPI
1
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
positive
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
infectionanti_hbc_total-positive

anti_hbc_total positive

Observed default: IND-DLBCL-1L-RCHOP

Age
54
ECOG
1
IPI
1
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
positive

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
missing datamissing-ipi_score

Missing findings.ipi_score

Observed default: IND-DLBCL-1L-RCHOP

Age
54
ECOG
1
IPI
Not supplied
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
  • Not supplied in this probe; inspect missing-data handling before relying on its output.
Engine's open MDT questions (5)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
  • What is the status of International Prognostic Index (IPI) for DLBCL (BIO-DLBCL-IPI)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: IPI 0-5; R-CHOP preferred for IPI 0-1; for IPI ≥2 see Pola-R-CHP.
missing datamissing-ecog

Missing demographics.ecog

Observed default: IND-DLBCL-1L-RCHOP

Age
54
ECOG
Not supplied
IPI
1
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
  • Not supplied in this probe; inspect missing-data handling before relying on its output.
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
missing datamissing-hbsag

Missing findings.hbsag

Observed default: IND-DLBCL-1L-RCHOP

Age
54
ECOG
1
IPI
1
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
Not supplied
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
  • Not supplied in this probe; inspect missing-data handling before relying on its output.
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
missing datamissing-lvef_percent

Missing findings.lvef_percent

Observed default: IND-DLBCL-1L-RCHOP

Age
54
ECOG
1
IPI
1
CD20
positive
LVEF (%)
Not supplied
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
  • Not supplied in this probe; inspect missing-data handling before relying on its output.
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
missing datacd20-unknown

CD20 result unknown

Observed default: IND-DLBCL-1L-RCHOP

Age
54
ECOG
1
IPI
1
CD20
unknown
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
  • The CD20 value is missing or unknown; review how eligibility is communicated.
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
eligibilitycd20-negative

CD20 result negative

Observed default: IND-DLBCL-1L-RCHOP

Age
54
ECOG
1
IPI
1
CD20
negative
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-RCHOP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
  • IND-DLBCL-1L-RCHOP remains present with a negative value beside its authored positive requirement.
  • IND-DLBCL-1L-POLA-R-CHP remains present with a negative value beside its authored positive requirement.
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: BCL2-IHC ≥50% combined with MYC-IHC ≥40% defines double-expressor (DEL) phenotype — poorer prognosis but not an excluder; HGBL-DH (FISH double-hit) must be ruled out.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-RCHOP, IND-DLBCL-1L-POLA-R-CHP. Expected value: GCB or non-GCB by Hans algorithm — non-GCB has worse R-CHOP outcomes; some centres consider R-CHOEP for non-GCB.
conflicting dataipi-conflict

IPI 1 conflicts with high_ipi=true

Observed default: IND-DLBCL-1L-POLA-R-CHP

Age
54
ECOG
1
IPI
1
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: IND-DLBCL-1L-POLA-R-CHP. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Alternatives visible: PASS
  • The boolean conflicts with the numeric IPI trigger in the authored rule.
Engine's open MDT questions (4)
  • Чи виконано повне стадіювання (Lugano + PET/CT або CT)?
  • Який актуальний LDH? Маркер пухлинного навантаження і трансформації.
  • What is the status of BCL2 expression by IHC (BIO-BCL2-EXPRESSION-IHC)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Double-expressor (BCL2-IHC + MYC-IHC) phenotype — Pola-R-CHP may particularly benefit DEL subgroup; rule out HGBL-DH.
  • What is the status of Cell-of-origin classification (Hans IHC algorithm) (BIO-DLBCL-COO-HANS)? It is required by track(s): IND-DLBCL-1L-POLA-R-CHP, IND-DLBCL-1L-RCHOP. Expected value: Activated B-cell-like (ABC / non-GCB) showed greater Pola-R-CHP benefit in POLARIX subgroup.
scopeunknown-disease

Unresolvable disease identifier

Observed default: None

Age
54
ECOG
1
IPI
1
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: None. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Unresolvable scope emits no current treatment tracks: PASS
Engine's open MDT questions (0)
  • No questions emitted.
scopeunsupported-line

Unmodeled line of therapy 99

Observed default: None

Age
54
ECOG
1
IPI
1
CD20
positive
LVEF (%)
62
CrCl (mL/min)
90
Bilirubin / ULN
1
DLCO (%)
85
HBsAg
negative
Anti-HBc total
negative

Expected engineering route: None. This is not a clinical verdict.

Technical checks and observed input issues
  • Authored routing contract: PASS
  • Resolved regimen references: PASS
  • Repeat run produces identical decision and trace: PASS
  • Unresolvable scope emits no current treatment tracks: PASS
Engine's open MDT questions (0)
  • No questions emitted.

Sources referenced by the generated plans

Listed as recorded in the KB. Applicability and currency remain review questions.

IDTitleLast verified (recorded)Link
SRC-AASLD-HCC-2023AASLD Practice Guidance on HCC2026-04-27Source
SRC-BSH-MZL-2024British Society for Haematology — Marginal Zone Lymphoma Guideline2026-04-27Source
SRC-CTCAE-V5Common Terminology Criteria for Adverse Events (CTCAE) v5.02026-04-27Source
SRC-EASL-HCV-2023EASL Clinical Practice Guidelines on Hepatitis C Virus Infection2026-04-27Source
SRC-EHA-EMN-MM-2025EHA-EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma2026-04-27Source
SRC-EHA-WORKUP-2024EHA Practical Guidelines on Diagnostic Workup of Hematologic Disorders2026-04-27Source
SRC-ESMO-DLBCL-2024ESMO Clinical Practice Guideline on Diffuse Large B-Cell Lymphoma2026-04-27Source
SRC-ESMO-LYMPHOMA-2025Lymphomas: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up2026-05-04Source
SRC-ESMO-MM-2023ESMO Clinical Practice Guideline on Multiple Myeloma2026-04-27Source
SRC-ESMO-MZL-2024ESMO Clinical Practice Guideline on Marginal Zone Lymphomas2026-04-27Source
SRC-GRIFFIN-VOORHEES-2020Daratumumab, lenalidomide, bortezomib, and dexamethasone for transplant-eligible newly diagnosed multiple myeloma (GRIFFIN)2026-04-27Source
SRC-MAIA-FACON-2019Daratumumab plus Lenalidomide and Dexamethasone for Untreated Myeloma2026-04-27Source
SRC-MOZ-UA-LYMPH-2013Уніфікований клінічний протокол первинної, вторинної (спеціалізованої) медичної допомоги: Лімфоми2026-05-01Source
SRC-NCCN-AML-2025NCCN Clinical Practice Guidelines in Oncology: Acute Myeloid Leukemia2026-05-01Source
SRC-NCCN-BCELL-2025NCCN Clinical Practice Guidelines in Oncology: B-Cell Lymphomas2026-05-01Source
SRC-NCCN-HCC-2025NCCN Hepatocellular Carcinoma2026-04-27Source
SRC-NCCN-MM-2025NCCN Clinical Practice Guidelines in Oncology: Multiple Myeloma2026-04-27Source
SRC-NCCN-MPN-2025NCCN Clinical Practice Guidelines in Oncology: Myeloproliferative Neoplasms2026-05-01Source
SRC-PERSEUS-SONNEVELD-2024Daratumumab, Bortezomib, Lenalidomide, and Dexamethasone for Multiple Myeloma2026-05-07Source
SRC-POLARIX-TILLY-2022Polatuzumab Vedotin in Previously Untreated Diffuse Large B-Cell Lymphoma2026-05-07Source