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AML patient with organ dysfunction precluding intensive 7+3 induction: ECOG ≥3, baseline...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-AML-ORGAN-DYSFUNCTION
TypeRed flag
Statusreviewed 2026-04-25 | pending_clinical_signoff
DiseasesDIS-AML
SourcesSRC-ELN-AML-2022 SRC-ESMO-AML-2020 SRC-NCCN-AML-2025

Red Flag Origin

DefinitionAML patient with organ dysfunction precluding intensive 7+3 induction: ECOG ≥3, baseline LVEF <50%, CrCl <30 mL/min, total bilirubin >3× ULN, OR active uncontrolled organ failure
Clinical directionde-escalate
Categoryorgan-dysfunction
Shifts algorithmALGO-AML-1L

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "ecog_performance_status",
      "threshold": 3
    },
    {
      "comparator": "<",
      "finding": "lvef_percent",
      "threshold": 50
    },
    {
      "comparator": "<",
      "finding": "creatinine_clearance_ml_min",
      "threshold": 30
    },
    {
      "comparator": ">",
      "finding": "total_bilirubin_ulnratio",
      "threshold": 3
    },
    {
      "finding": "active_uncontrolled_organ_failure",
      "value": true
    },
    {
      "finding": "transplant_eligible",
      "value": false
    }
  ],
  "type": "composite"
}

Notes

Triggers de-escalation from 7+3 + (midostaurin) to ven+aza (VIALE-A) for unfit patients. Transplant-eligibility is a parallel layer also captured by this flag (organ thresholds are the same fitness gate). Cardiac assessment + baseline echo mandatory before anthracycline. STUB — requires clinical co-lead signoff before publication.

Used By

Algorithms

Indications