Active uncontrolled infection at HCL diagnosis — defer purine analog (cladribine/pentosta...

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ID	`RF-HCL-INFECTION-SCREENING`
Tipo	Sinal de alerta
Estado	reviewed 2026-04-25 \| pending_clinical_signoff
Doenças	`DIS-HCL`
Fontes	`SRC-ESMO-DLBCL-2024` `SRC-NCCN-BCELL-2025`

Origem da bandeira vermelha

Definição	Active uncontrolled infection at HCL diagnosis — defer purine analog (cladribine/pentostatin) until infection controlled; profound CD4 lymphopenia for 6-12 months post-treatment increases opportunistic infection risk.
Direcção clínica	aguentar
Categoria	rastreamento de infecções

Lógica de Desencadeamento

{
  "any_of": [
    {
      "finding": "active_uncontrolled_infection",
      "value": true
    },
    {
      "finding": "neutropenic_fever_active",
      "value": true
    }
  ],
  "type": "composite_clinical"
}

Notas

Active infection at diagnosis is common in HCL (severe neutropenia from disease itself). Standard practice: control infection first (G-CSF + antibiotics), then start cladribine. Hold-direction surfaces in MDT brief but doesn't shift Indication.

Usado por

Algoritmos

ALGO-HCL-1L - ALGO-HCL-1L