Hepatic dysfunction (bilirubin >3xULN OR transaminases >5xULN) — asparaginase + methotrex...

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

ID	`RF-T-ALL-ORGAN-DYSFUNCTION`
Type	Red flag
Status	reviewed 2026-04-25 \| pending_clinical_signoff
Diseases	`DIS-T-ALL`
Sources	`SRC-ESMO-PTCL-2024` `SRC-NCCN-BCELL-2025`

Red Flag Origin

Definition	Hepatic dysfunction (bilirubin >3xULN OR transaminases >5xULN) — asparaginase + methotrexate + thiopurines accumulate hepatotoxicity; dose modification or asparaginase substitution required.
Clinical direction	investigate
Category	organ-dysfunction

Trigger Logic

{
  "any_of": [
    {
      "comparator": ">",
      "finding": "bilirubin_x_uln",
      "threshold": 3
    },
    {
      "comparator": ">",
      "finding": "alt_x_uln",
      "threshold": 5
    }
  ],
  "type": "lab_value"
}

Notes

Hepatotoxicity in T-ALL induction is multi-drug; depends on regimen phase. Surveillance + dose-mod under hematology — not a 1L algorithm shift.

Used By

No reverse references found in the YAML corpus.