Active or latent infection requiring resolution / prophylaxis before initiating any anti-...
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| ID | RF-FL-INFECTION-SCREENING |
|---|---|
| Tipo | Sinal de alerta |
| Estado | reviewed 2026-04-27 | pending_clinical_signoff |
| Doenças | DIS-FL |
| Fontes | SRC-ESMO-FL-2024 SRC-NCCN-BCELL-2025 |
Origem da bandeira vermelha
| Definição | Active or latent infection requiring resolution / prophylaxis before initiating any anti-CD20-containing FL regimen (R-CHOP, BR, G-B, R-Lenalidomide, R-mono): HBsAg-positive (HBV reactivation risk), anti-HBc-positive (occult HBV — particular concern with bendamustine / obinutuzumab combinations), HCV-RNA-positive, HIV-positive, or active TB. |
|---|---|
| Direcção clínica | aguentar |
| Categoria | rastreamento de infecções |
Lógica de Desencadeamento
{
"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"
}
Notas
HBsAg+ → mandatory entecavir/tenofovir prophylaxis from –7d through +12mo post-last anti-CD20 (longer for obinutuzumab — +18 mo). anti-HBc+ HBsAg-negative ("occult HBV") with bendamustine: HBV reactivation rates up to 20% reported — prophylaxis or close monitoring with HBV-DNA q3mo. HCV+: defer DAA cure pre-treatment if disease tempo allows; coordinate hepatology. Bendamustine reactivates HSV and VZV — acyclovir prophylaxis routine. PJP prophylaxis on G-bendamustine (T-cell depletion). FL is indolent — virtually always time to complete infectious workup before treating.
Usado por
Não há referências reversas encontradas no corpus YAML.