Active uncontrolled infection at HCL diagnosis — defer purine analog (cladribine/pentosta...

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

ID	`RF-HCL-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-HCL`
Sources	`SRC-ESMO-DLBCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Active uncontrolled infection at HCL diagnosis — defer purine analog (cladribine/pentostatin) until infection controlled; profound CD4 lymphopenia for 6-12 months post-treatment increases opportunistic infection risk.
Clinical direction	hold
Category	infection-screening

Trigger Logic

{
  "any_of": [
    {
      "finding": "active_uncontrolled_infection",
      "value": true
    },
    {
      "finding": "neutropenic_fever_active",
      "value": true
    }
  ],
  "type": "composite_clinical"
}

Notes

Active infection at diagnosis is common in HCL (severe neutropenia from disease itself). Standard practice: control infection first (G-CSF + antibiotics), then start cladribine. Hold-direction surfaces in MDT brief but doesn't shift Indication.

Used By

No reverse references found in the YAML corpus.