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Cancer survivor with prior cumulative cyclophosphamide exposure ≥7 g/m² (or ≥30 g lifetim...

Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.

IDRF-IATROGENIC-CYCLOPHOSPHAMIDE-LATE-PREVENTION
TipoSeñal de alerta
Situaciónreviewed 2026-05-18 | pending_clinical_signoff
EnfermedadesDIS-UROTHELIAL
FuentesSRC-COG SRC-NCCN-AML-2025 SRC-NCCN-BCELL-2025 SRC-NCCN-BLADDER-2025

Origen de la bandera roja

DefiniciónCancer survivor with prior cumulative cyclophosphamide exposure ≥7 g/m² (or ≥30 g lifetime in adults). Most commonly: high-dose regimens in non-Hodgkin lymphoma (Hyper-CVAD, dose-escalated CHOP variants), pediatric ALL induction-consolidation, bone-marrow transplant conditioning (Cy-TBI, Cy-Bu), autoimmune disease cycling pre-rituximab era. Two principal late-effect second-primary domains: (1) bladder cancer — acrolein metabolite causes chronic urothelial damage → urothelial carcinoma; SIR 4-7× population baseline, cumulative incidence 3-5% at 25y post-exposure, latency typically 10-20y; (2) therapy-related AML / MDS — cyclophosphamide is an alkylator; t-MDS / t-AML peak 5-10y post-exposure, cumulative ~1-3% at 10y. Cyclophosphamide also drives non-cancer late effects (premature ovarian insufficiency, hemorrhagic cystitis if no MESNA, gonadal dysfunction) — those out-of-scope for this R...
Dirección clínicainvestigación
Categoríaotros

Lógica de activación

{
  "any_of": [
    {
      "finding": "survivor_cyclophosphamide_cumulative_ge_7g_m2",
      "value": true
    },
    {
      "finding": "survivor_cyclophosphamide_late_effect_bladder_dimension",
      "value": true
    },
    {
      "finding": "survivor_hyper_cvad_or_high_dose_cy_history",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notas

Cancer-survivor late-effects RedFlag for cumulative cyclophosphamide ≥7 g/m². Surveillance domains: bladder cancer (annual urinalysis + cytology, primary anchor) and t-AML/MDS (CBC q3-6mo for first 5y co-managed with RF-IATROGENIC-ALKYLATOR-TAML-PREVENTION). STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.

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