Cancer survivor with prior cumulative platinum exposure ≥400 mg/m² (cisplatin) or AUC-equ...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | RF-IATROGENIC-PLATINUM-LATE-PREVENTION |
|---|---|
| Type | Red flag |
| Status | reviewed 2026-05-18 | pending_clinical_signoff |
| Diseases | DIS-AML |
| Sources | SRC-COG SRC-NCCN-AML-2025 SRC-NCCN-BCELL-2025 SRC-NCCN-TESTICULAR-2025 |
Red Flag Origin
| Definition | Cancer survivor with prior cumulative platinum exposure ≥400 mg/m² (cisplatin) or AUC-equivalent carboplatin. Most commonly: testicular germ-cell tumor BEP cycles (cisplatin 100 mg/m² × 4 = 400 mg/m²), ovarian cancer first-line carboplatin/paclitaxel, advanced cervical cancer cisplatin-CRT, head-and-neck SCC concurrent cisplatin-CRT, esophageal cancer FOLFOX/CROSS regimens, NSCLC adjuvant cisplatin doublet. Three principal late-effect domains: (1) cardiovascular — cisplatin associated with accelerated atherosclerosis, hypertension, endothelial dysfunction, Raynaud phenomenon; coronary events SIR 1.5-2× population baseline; testicular cancer survivors with BEP exposure have 2-3× CV-mortality at 30y; (2) chronic kidney disease — cisplatin direct tubular toxicity → persistent GFR decline; ~30% of long-term survivors have CKD stage ≥2; magnesium wasting common; (3) therapy-related AML / MDS... |
|---|---|
| Clinical direction | investigate |
| Category | other |
Trigger Logic
{
"any_of": [
{
"finding": "survivor_platinum_cumulative_ge_400_mg_m2",
"value": true
},
{
"finding": "survivor_cisplatin_late_effect_cv_renal_dimension",
"value": true
},
{
"finding": "survivor_bep_or_high_dose_carboplatin_history",
"value": true
}
],
"type": "lab_value"
}
Notes
Cancer-survivor late-effects RedFlag for cumulative platinum ≥400 mg/m². Surveillance domains: cardiovascular risk modification (BP + lipid panel q1y), nephropathy (creatinine + Mg q1y), secondary AML/MDS (CBC q1y). CV risk modification is the highest-yield late-effect domain. STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.
Used By
Indications
IND-IATROGENIC-BLEOMYCIN-LATE-PREVENTION-SURVEILLANCE- IND-IATROGENIC-BLEOMYCIN-LATE-PREVENTION-SURVEILLANCEIND-IATROGENIC-PLATINUM-LATE-PREVENTION-OBSERVATION- IND-IATROGENIC-PLATINUM-LATE-PREVENTION-OBSERVATIONIND-IATROGENIC-PLATINUM-LATE-PREVENTION-SURVEILLANCE- IND-IATROGENIC-PLATINUM-LATE-PREVENTION-SURVEILLANCE