Onco Wiki / Bandeira vermelha

Receptor de transplante de órgãos sólidos em imunossupressão crônica ≥ 3 anos pós-transplante, b...

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IDRF-IATROGENIC-TRANSPLANT-IMMUNOSUPPRESSION-LONGTERM-PREVENTION
TipoSinal de alerta
Estadoreviewed 2026-05-18 | pending_clinical_signoff
DoençasDIS-ANAL-SCC DIS-BCC DIS-CERVICAL DIS-DLBCL-NOS DIS-KAPOSI DIS-PTLD
FontesSRC-NCCN-ANAL-2025 SRC-NCCN-BCELL-2025 SRC-NCCN-CERVICAL-2025 SRC-NCCN-SKIN-2025

Origem da bandeira vermelha

DefiniçãoSolid-organ transplant recipient on chronic immunosuppression ≥3 years post-transplant, beyond the high-acute-rejection window — the chronic- cohort persona. Distinct from the new-transplant cohort covered by RF-IATROGENIC-TRANSPLANT-IMMUNOSUPPRESSION-PREVENTION (which focuses on the acute / early window with EBV-DNA monitoring for PTLD, peri- transplant antiviral prophylaxis). Chronic-cohort risk profile shifts toward: cumulative skin-cancer burden (squamous-cell carcinoma 65-100x background; basal-cell carcinoma 10-20x; aggressive SCC subset prone to local recurrence + metastasis), late-onset post-transplant lymphoproliferative disorder (PTLD; late-onset PTLD ≥1y post-transplant more often EBV-negative, more diffuse-large-B-cell-like histology, worse prognosis than early-onset EBV-driven PTLD), Kaposi sarcoma in HHV-8-exposed cohort, cervical intraepithelial neoplasia / cervical cance...
Direcção clínicainvestigar
CategoriaOutros

Lógica de Desencadeamento

{
  "any_of": [
    {
      "finding": "post_solid_organ_transplant_immunosuppression_ge_3y",
      "value": true
    },
    {
      "finding": "post_allogeneic_hsct_chronic_immunosuppression_ge_3y",
      "value": true
    },
    {
      "finding": "years_post_transplant_ge_3_on_immunosuppression",
      "value": true
    }
  ],
  "type": "lab_value"
}

Notas

Prevention-persona RedFlag for chronic ≥3y post-transplant immunosuppression cohort. Engine routes to PreventionPlan with long-cycle surveillance cadence appropriate to the chronic cohort (vs the acute-window EBV-DNA cadence in the new-transplant RF). Distinct from RF-IATROGENIC-TRANSPLANT-IMMUNOSUPPRESSION- PREVENTION (which covers acute / new-transplant window). Both RFs may fire simultaneously in the early-chronic window (1-3y post-transplant) — engine routes to both surveillance tracks, render layer deduplicates overlapping recommendations. Anchored to DIS-DLBCL-NOS as the primary lymphoma anchor (late- onset PTLD histology more DLBCL-like; DIS-PTLD as the canonical early-onset EBV-driven entity). Multiple cancer types listed in relevant_diseases reflect the broad cumulative-risk profile of the chronic cohort. STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.

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Algoritmos

Indicação

Sinal de alerta