Active or latent infection requiring resolution / prophylaxis before initiating CHOEP / C...

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

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

Red Flag Origin

Definition	Active or latent infection requiring resolution / prophylaxis before initiating CHOEP / CHP-Bv in PTCL NOS: HBsAg-positive (HBV reactivation on prolonged steroid + chemo), anti-HBc-positive (occult HBV), HCV-RNA-positive, HIV-positive (HTLV-1 differential — must exclude ATLL), HTLV-1-positive (reclassify as ATLL), EBV-driven (informs prognostication; some PTCL subsets EBV+), or active TB.
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": "htlv1_status",
      "value": "positive"
    },
    {
      "finding": "active_tb",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notes

HTLV-1 status mandatory in any PTCL workup — HTLV-1+ → reclassify as ATLL (separate algorithm: zidovudine+IFN for indolent/smoldering variants; mogamulizumab for acute/lymphoma variants). HBsAg+: entecavir /tenofovir from –7d through +12mo of last steroid-containing cycle. PJP prophylaxis (TMP-SMX) routine throughout CHOEP/CHP-Bv (T-cell lymphoma + chemo = profound CD4 lymphopenia). EBV-driven PTCL NOS variants (some "follicular helper" subsets per WHO 2022) have distinct biology but treatment paradigm unchanged at present.

Used By

No reverse references found in the YAML corpus.