Mastocytosis with C-finding (organ-damage) criteria per WHO 5th ed.: cytopenia (Hb <10, p...

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ID	`RF-MASTOCYTOSIS-ORGAN-DYSFUNCTION`
Tipo	Sinal de alerta
Estado	reviewed 2026-04-27 \| pending_clinical_signoff
Doenças	`DIS-MASTOCYTOSIS`
Fontes	`SRC-NCCN-SM-2025` `SRC-WHO-LNSC-2023`

Origem da bandeira vermelha

Definição	Mastocytosis with C-finding (organ-damage) criteria per WHO 5th ed.: cytopenia (Hb <10, platelets <100K, ANC <1.0K), hepatomegaly + ascites or hypoalbuminemia, splenomegaly + hypersplenism, malabsorption + weight loss, large osteolyses + pathological fractures
Direcção clínica	intensificar
Categoria	disfunção de órgãos
Algoritmo de deslocamentos	ALGO-ADVSM-1L

Lógica de Desencadeamento

{
  "any_of": [
    {
      "comparator": "<",
      "finding": "hemoglobin_g_dl",
      "threshold": 10
    },
    {
      "comparator": "<",
      "finding": "platelet_count_k_ul",
      "threshold": 100
    },
    {
      "comparator": "<",
      "finding": "anc_k_ul",
      "threshold": 1.0
    },
    {
      "finding": "ascites_present",
      "value": true
    },
    {
      "comparator": "<",
      "finding": "albumin_g_dl",
      "threshold": 3.5
    },
    {
      "finding": "pathologic_fracture_present",
      "value": true
    },
    {
      "finding": "malabsorption_weight_loss",
      "value": true
    }
  ],
  "type": "composite"
}

Notas

WHO 5th ed. (2022/2023) C-findings define advSM and trigger cytoreductive therapy (avapritinib, midostaurin, cladribine, IFN-α). Per NCCN-SM: presence of any C-finding mandates KIT-directed therapy regardless of symptomatic load. Direction INTENSIFY shifts toward avapritinib (KIT D816V-positive ASM/SM-AHN/MCL) per PATHFINDER trial. STUB — requires clinical co-lead signoff.

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