History of prior cumulative alkylating-agent chemotherapy exposure (cyclophosphamide, ifo...
Deterministische Ansicht der Quelle YAML Entität. Klinische Autorität bleibt mit den zitierten Quell-IDs und Rezensenten Sign-off Zustand.
| ID | RF-IATROGENIC-ALKYLATOR-TAML-PREVENTION |
|---|---|
| Art | Warnhinweis |
| Status | reviewed 2026-05-18 | pending_clinical_signoff |
| Erkrankungen | DIS-AML |
| Quellen | SRC-NCCN-AML-2025 SRC-NCCN-BCELL-2025 |
Ursprung der Roten Flagge
| Begriffsbestimmung | History of prior cumulative alkylating-agent chemotherapy exposure (cyclophosphamide, ifosfamide, melphalan, busulfan, chlorambucil, procarbazine, bendamustine, BCNU/CCNU/lomustine, dacarbazine, temozolomide) ≥5 years prior. Therapy-related AML (t-AML) and therapy-related MDS following alkylator exposure has characteristic features: median latency 5-7 years post-exposure (longer than topoisomerase-II-inhibitor t-AML), preceded often by t-MDS phase with chromosomes 5q-/-5 or 7q-/-7 cytogenetics, complex karyotype. Cumulative incidence ~1-10% at 10y depending on dose + concurrent RT + age. Highest risk: Hodgkin lymphoma survivors (MOPP-era), multiple myeloma (melphalan), pediatric sarcoma survivors. Prevention-persona RedFlag (§20 v0.3 iatrogenic pilot). |
|---|---|
| Klinische Richtung | Untersuchung |
| Kategorie | Sonstige |
Logik auslösen
{
"any_of": [
{
"finding": "prior_alkylator_chemo_ge_5y_ago",
"value": true
},
{
"finding": "prior_high_cumulative_alkylator_dose",
"value": true
},
{
"finding": "prior_hodgkin_lymphoma_alkylator_regimen",
"value": true
},
{
"finding": "prior_melphalan_multiple_myeloma_therapy",
"value": true
}
],
"type": "lab_value"
}
Anmerkungen
Präventivpersona RedFlag für vorherige Alkylator-Chemotherapie-Exposition. Mediane t-AML Latenz 5-7y nach der Exposition; kumulative Inzidenz ~1-10% bei 10y. Motorwege zur PräventionPlan Empfehlung CBC q3-6mo für erste 10y post-chemo + niedrige Schwelle für die Markanalyse, wenn Zytopenien auftreten. STUB bis zwei-Klinik-Co-Lead Signoff pro CHARTER §6.1 dev-mode.
Verwendet von
Anwendungsgebiet
IND-IATROGENIC-ALKYLATOR-TAML-PREVENTION-OBSERVATION- IND-IATROGENIC-ALKYLATOR-TAML-PREVENTION-OBSERVATIONIND-IATROGENIC-ALKYLATOR-TAML-PREVENTION-SURVEILLANCE- IND-IATROGENIC-ALKYLATOR-TAML-PREVENTION-SURVEILLANCEIND-IATROGENIC-CYCLOPHOSPHAMIDE-LATE-PREVENTION-SURVEILLANCE- IND-IATROGENIC-CYCLOPHOSPHAMIDE-LATE-PREVENTION-SURVEILLANCEIND-IATROGENIC-PLATINUM-LATE-PREVENTION-SURVEILLANCE- IND-IATROGENIC-PLATINUM-LATE-PREVENTION-SURVEILLANCE
Warnhinweis
RF-IATROGENIC-ASCT-SECONDARY-MDS-AML-PREVENTION- Geschichte der autologen Stammzelltransplantation (ASCT) als Konsolidierung oder Rettung Therapie...RF-IATROGENIC-CYCLOPHOSPHAMIDE-LATE-PREVENTION- Krebsüberlebende mit vorheriger kumulativer cyclophosphamide Exposition ≥7 g/m² (oder ≥30 g Lebende...