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AML emergency triad: hyperleukocytosis (WBC ≥100 K/μL), tumor lysis syndrome (LDH >2× ULN...

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IDRF-AML-EMERGENCY-TLS-LEUKOSTASIS
TipoSinal de alerta
Estadoreviewed 2026-04-25 | pending_clinical_signoff
DoençasDIS-AML
FontesSRC-ELN-AML-2022 SRC-ESMO-AML-2020 SRC-NCCN-AML-2025

Origem da bandeira vermelha

DefiniçãoAML emergency triad: hyperleukocytosis (WBC ≥100 K/μL), tumor lysis syndrome (LDH >2× ULN, uric acid >7.5 mg/dL, K+ rising, phosphate rising, Ca2+ falling), or symptomatic leukostasis (dyspnea, altered mental status, retinal hemorrhage)
Direcção clínicaaguentar
Categoriadisfunção de órgãos
Algoritmo de deslocamentosALGO-AML-1L

Lógica de Desencadeamento

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "wbc_k_ul",
      "threshold": 100
    },
    {
      "finding": "leukostasis_symptoms",
      "value": true
    },
    {
      "finding": "tls_active",
      "value": true
    },
    {
      "comparator": ">",
      "finding": "uric_acid_mg_dl",
      "threshold": 7.5
    },
    {
      "comparator": ">",
      "finding": "ldh_ulnratio",
      "threshold": 2
    },
    {
      "comparator": ">",
      "finding": "potassium_mmol_l",
      "threshold": 5.5
    }
  ],
  "type": "composite"
}

Notas

Triggers HOLD on regimen selection until emergency stabilization: cytoreduction with hydroxyurea ± leukapheresis, IV hydration + rasburicase / allopurinol for TLS, electrolyte correction, urgent ICU/heme consult. Plan generation does not start induction — it describes the emergency-management workup. Per CHARTER §15.2 C2 this is partially time-critical; OpenOnco scope is the workup brief, not the bedside order. Priority bumped to 10 to win all conflicts. STUB — requires clinical co-lead signoff.

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Algoritmos

Indicação