Active or latent infection requiring resolution / prophylaxis before initiating any anti-...

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

ID	`RF-MCL-INFECTION-SCREENING`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-MCL`
Sources	`SRC-ESMO-MCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Active or latent infection requiring resolution / prophylaxis before initiating any anti-CD20-containing MCL induction (R-CHOP, BR, R-DHAP, Nordic, R-bendamustine + cytarabine): HBsAg-positive, anti-HBc-positive (occult HBV), HCV-RNA-positive, HIV-positive, or active TB. Particular vigilance with bendamustine combinations (HBV reactivation rates highest among anti-CD20 partners).
Clinical direction	hold
Category	infection-screening

Trigger Logic

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

Notes

HBsAg+ → entecavir/tenofovir prophylaxis from –7d through +12-18 mo post-last anti-CD20 (extended given autoSCT consolidation often follows). occult HBV (anti-HBc+ HBsAg-negative) on bendamustine: reactivation rates 10-20% — monitor HBV-DNA q1-3mo or pre-emptive prophylaxis. Bendamustine reactivates HSV / VZV — acyclovir prophylaxis routine. PJP prophylaxis (TMP-SMX) on prolonged R-CHOP / Nordic (T-cell lymphopenia post HD-AraC) and ongoing BTKi maintenance. HIV+ MCL: rare; full-dose chemoimmuno + ART optimization. autoSCT feasible in HIV+ if controlled.

Used By

Indications

IND-MCL-3L-LISOCEL - IND-MCL-3L-LISOCEL