Active or latent infection requiring resolution / prophylaxis before initiating doxorubic...

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

ID	`RF-CHONDROSARCOMA-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-CHONDROSARCOMA`
Sources	`SRC-ESMO-BONE-SARCOMA` `SRC-NCCN-BONE-SARCOMA`

Red Flag Origin

Definition	Active or latent infection requiring resolution / prophylaxis before initiating doxorubicin + ifosfamide adjuvant (dedifferentiated / mesenchymal subtypes) or pazopanib / ivosidenib for advanced disease: HBsAg-positive (HBV reactivation on cytotoxic chemotherapy), anti-HBc-positive (occult HBV), HIV-positive, or active TB.
Clinical direction	hold
Category	infection-screening

Trigger Logic

{
  "any_of": [
    {
      "finding": "hbsag",
      "value": "positive"
    },
    {
      "finding": "anti_hbc_total",
      "value": "positive"
    },
    {
      "finding": "hiv_status",
      "value": "positive"
    },
    {
      "finding": "active_tb",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

Sarcoma chemotherapy regimens (AI / VDC-IE) and TKI-class agents (pazopanib) all carry meaningful HBV reactivation risk — entecavir / tenofovir prophylaxis indicated for HBsAg+ or anti-HBc+. HIV+ patients treatable but require ART coordination (avoid CYP3A4 conflicts with pazopanib / ivosidenib). Active TB: complete anti-TB before starting systemic therapy when feasible. Surfaces hold via parallel pre-treatment workup rather than indication switch.

Used By

No reverse references found in the YAML corpus.