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Cancer survivor with prior cumulative platinum exposure ≥400 mg/m² (cisplatin) or AUC-equ...

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IDRF-IATROGENIC-PLATINUM-LATE-PREVENTION
TipoSinal de alerta
Estadoreviewed 2026-05-18 | pending_clinical_signoff
DoençasDIS-AML
FontesSRC-COG SRC-NCCN-AML-2025 SRC-NCCN-BCELL-2025 SRC-NCCN-TESTICULAR-2025

Origem da bandeira vermelha

DefiniçãoCancer survivor with prior cumulative platinum exposure ≥400 mg/m² (cisplatin) or AUC-equivalent carboplatin. Most commonly: testicular germ-cell tumor BEP cycles (cisplatin 100 mg/m² × 4 = 400 mg/m²), ovarian cancer first-line carboplatin/paclitaxel, advanced cervical cancer cisplatin-CRT, head-and-neck SCC concurrent cisplatin-CRT, esophageal cancer FOLFOX/CROSS regimens, NSCLC adjuvant cisplatin doublet. Three principal late-effect domains: (1) cardiovascular — cisplatin associated with accelerated atherosclerosis, hypertension, endothelial dysfunction, Raynaud phenomenon; coronary events SIR 1.5-2× population baseline; testicular cancer survivors with BEP exposure have 2-3× CV-mortality at 30y; (2) chronic kidney disease — cisplatin direct tubular toxicity → persistent GFR decline; ~30% of long-term survivors have CKD stage ≥2; magnesium wasting common; (3) therapy-related AML / MDS...
Direcção clínicainvestigar
CategoriaOutros

Lógica de Desencadeamento

{
  "any_of": [
    {
      "finding": "survivor_platinum_cumulative_ge_400_mg_m2",
      "value": true
    },
    {
      "finding": "survivor_cisplatin_late_effect_cv_renal_dimension",
      "value": true
    },
    {
      "finding": "survivor_bep_or_high_dose_carboplatin_history",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notas

Cancer-survivor late-effects RedFlag for cumulative platinum ≥400 mg/m². Surveillance domains: cardiovascular risk modification (BP + lipid panel q1y), nephropathy (creatinine + Mg q1y), secondary AML/MDS (CBC q1y). CV risk modification is the highest-yield late-effect domain. STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.

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