Smoldering/chronic ATLL transforming to acute (rising lymphocyte count, new B-symptoms, o...

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

ID	`RF-ATLL-TRANSFORMATION-PROGRESSION`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-ATLL`
Sources	`SRC-ESMO-PTCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Smoldering/chronic ATLL transforming to acute (rising lymphocyte count, new B-symptoms, organ infiltration) — switch from watch-and-wait/AZT+IFN to aggressive chemo immediately.
Clinical direction	intensify
Category	transformation-progression

Trigger Logic

{
  "any_of": [
    {
      "finding": "atll_transformation_to_acute",
      "value": true
    },
    {
      "finding": "lymphocyte_count_doubling_3_months",
      "value": true
    }
  ],
  "type": "composite_clinical"
}

Notes

Indolent ATLL transformation requires immediate algorithm reassessment — typically modeled as a re-evaluation event triggering revise_plan() rather than a 1L decision_tree branch.

Used By

Algorithms

ALGO-ATLL-2L - ALGO-ATLL-2L