Cardiac dysfunction (LVEF <50%) — anthracycline-based induction (hyper-CVAD A, BFM-style...

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

ID	`RF-B-ALL-ORGAN-DYSFUNCTION`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-B-ALL`
Sources	`SRC-ESMO-DLBCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Cardiac dysfunction (LVEF <50%) — anthracycline-based induction (hyper-CVAD A, BFM-style protocols) requires modification or substitution.
Clinical direction	investigate
Category	organ-dysfunction

Trigger Logic

{
  "any_of": [
    {
      "comparator": "<",
      "finding": "lvef_percent",
      "threshold": 50
    }
  ],
  "type": "lab_value"
}

Notes

Anthracycline-free B-ALL induction (e.g., blinatumomab-based MRD-guided) is emerging but not yet 1L standard outside trials. Flag drives cardio-onc co-management and dose modification.

Used By

Algorithms

ALGO-B-ALL-2L - ALGO-B-ALL-2L

Indications

IND-B-ALL-2L-INOTUZUMAB - IND-B-ALL-2L-INOTUZUMAB
IND-B-ALL-3L-TISAGENLECLEUCEL - IND-B-ALL-3L-TISAGENLECLEUCEL
IND-B-ALL-BLINATUMOMAB-MRD-OR-RR - IND-B-ALL-BLINATUMOMAB-MRD-OR-RR
IND-B-ALL-POST-CONSOLIDATION-POMP-MAINTENANCE - IND-B-ALL-POST-CONSOLIDATION-POMP-MAINTENANCE