ID

10338

Description

GVH Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF19F489-B086-2FD8-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF19F489-B086-2FD8-E034-0003BA3F9857

Keywords

Versions (4)
  1. 9/19/12 9/19/12 -
  2. 5/28/15 5/28/15 -
  3. 5/28/15 5/28/15 -
  4. 5/28/15 5/28/15 -
Uploaded on

May 28, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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GVH

English

No Instruction available.

1 forms  
Header Module
Description

Header Module

Visit number
Description

HospitalAdmissionOrdinalNumber

Data type

double

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16696
UMLS 2011AA ObjectClass
C0019994
NCI Thesaurus Property
C25385
UMLS 2011AA Property
C0809949
Date of staging
Description

CurrentStageCompleteAssessmentDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C25471
UMLS 2011AA ObjectClass
C0521116
NCI Thesaurus ObjectClass
C16899
UMLS 2011AA ObjectClass
C1300072
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Immunosuppressant (prophylaxis) received
Description

MedicationGraftVersusHostDiseaseAdministeredType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C459
UMLS 2011AA ObjectClass
C0013227
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Metathesaurus ObjectClass
C0018133
Record most recent blood level of immunosuppressant (prophylaxis)
Description

AgentAdministeredTotalDose

Data type

double

Alias
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Thesaurus ObjectClass
C1708
UMLS 2011AA ObjectClass
C0450442
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
Record date blood sample obtained
Description

Datesampleobtained

Data type

text

Segment
Description

Segment

Data type

text

Start of GVHD assessment period
Description

StartofGVHDassessmentperiod

Data type

text

End of GVHD assessment period
Description

EndofGVHDassessmentperiod

Data type

text

Record The Highest Level Of Organ Abnormalities, The Etiologies Contributing To The Abnormalities And Any Biopsy Results Pertaining To Gvhd During The Assessment Period
Description

Record The Highest Level Of Organ Abnormalities, The Etiologies Contributing To The Abnormalities And Any Biopsy Results Pertaining To Gvhd During The Assessment Period

Skin abnormalities
Description

CommonToxicityCriteriaAdverseEventSkinRashGrade

Data type

double

Alias
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
NCI Metathesaurus Property
CL323683
Skin Etiologies
Description

Skin Etiologies

GVHD
Description

GraftVersusHostDiseaseManifestationIndicator

Data type

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Metathesaurus ObjectClass
C0018133
NCI Metathesaurus Property
CL289271
Infection
Description

AdverseEventInfectionInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C26726
UMLS 2011AA Property
C0009450
Specify other liver etiologies
Description

OtherDiseaseDiagnosisSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C17649
UMLS 2011AA ObjectClass
C0205394
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
Liver biopsy for GVHD
Description

BiopsyResultType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C15189
UMLS 2011AA ObjectClass
C0005558
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
Upper GI abnormalities
Description

CommonToxicityCriteriaAdverseEventGastrointestinalAnastomoticLeakGrade

Data type

double

Alias
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
NCI Metathesaurus Property
CL164477
Drug reaction
Description

Drugreaction

Data type

text

Conditioning regimen toxicity
Description

Conditioningregimentoxicity

Data type

text

Other
Description

Other

Data type

text

Upper Intestinal Tract Etiologies
Description

Upper Intestinal Tract Etiologies

GVHD
Description

GraftVersusHostDiseaseManifestationIndicator

Data type

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Metathesaurus ObjectClass
C0018133
NCI Metathesaurus Property
CL289271
TPN
Description

NutritionalSupportAdministeredInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C37902
UMLS 2011AA ObjectClass
C1521721
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ObjectClass
C25597
UMLS 2011AA ObjectClass
C1521739
Infection
Description

AdverseEventInfectionInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C26726
UMLS 2011AA Property
C0009450
Other
Description

Anyotherproblems

Data type

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Specify other liver etiologies
Description

OtherDiseaseDiagnosisSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C17649
UMLS 2011AA ObjectClass
C0205394
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
Liver biopsy for GVHD
Description

BiopsyResultType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C15189
UMLS 2011AA ObjectClass
C0005558
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
Lower GI abnormalities
Description

CommonToxicityCriteriaAdverseEventDiarrheaGrade

Data type

double

Alias
NCI Thesaurus Property
C2987
UMLS 2011AA Property
C0011991
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Drug reaction
Description

Drugreaction

Data type

text

Conditioning regimen toxicity
Description

Conditioningregimentoxicity

Data type

text

Lower Intestinal Tract Etiologies
Description

Lower Intestinal Tract Etiologies

GVHD
Description

GraftVersusHostDiseaseManifestationIndicator

Data type

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Metathesaurus ObjectClass
C0018133
NCI Metathesaurus Property
CL289271
TPN
Description

NutritionalSupportAdministeredInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C37902
UMLS 2011AA ObjectClass
C1521721
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ObjectClass
C25597
UMLS 2011AA ObjectClass
C1521739
Infection
Description

AdverseEventInfectionInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C26726
UMLS 2011AA Property
C0009450
Other
Description

Anyotherproblems

Data type

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Specify other liver etiologies
Description

OtherDiseaseDiagnosisSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C17649
UMLS 2011AA ObjectClass
C0205394
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
Liver biopsy for GVHD
Description

BiopsyResultType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C15189
UMLS 2011AA ObjectClass
C0005558
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
Liver abnormalities
Description

CommonToxicityCriteriaAdverseEventHepaticFailureGrade

Data type

double

Alias
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
NCI Metathesaurus Property
C0085605
Drug reaction
Description

Drugreaction

Data type

text

Conditioning regimen toxicity
Description

Conditioningregimentoxicity

Data type

text

Liver Etiologies
Description

Liver Etiologies

GVHD
Description

GraftVersusHostDiseaseManifestationIndicator

Data type

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Metathesaurus ObjectClass
C0018133
NCI Metathesaurus Property
CL289271
TPN
Description

NutritionalSupportAdministeredInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C37902
UMLS 2011AA ObjectClass
C1521721
NCI Thesaurus Property
C25382
UMLS 2011AA Property
C1521801
NCI Thesaurus ObjectClass
C25597
UMLS 2011AA ObjectClass
C1521739
Infection
Description

AdverseEventInfectionInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
NCI Thesaurus Property
C26726
UMLS 2011AA Property
C0009450
Specify other liver etiologies
Description

OtherDiseaseDiagnosisSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C17649
UMLS 2011AA ObjectClass
C0205394
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
Liver biopsy for GVHD
Description

BiopsyResultType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C15189
UMLS 2011AA ObjectClass
C0005558
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
Was treatment of GVHD modified during this assessment period
Description

TreatmentModifiedInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25572
Comments
Description

ResearchCommentsText

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
Drug reaction
Description

Drugreaction

Data type

text

Conditioning regimen toxicity
Description

Conditioningregimentoxicity

Data type

text

VOD
Description

VOD

Data type

text

Other
Description

Other

Data type

text

If yes, specify agent name
Description

Ifyes,specifyagentname

Data type

text

Specify other agent
Description

Specifyotheragent

Data type

text

Indicate treatment modification
Description

Indicatetreatmentmodification

Data type

text

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1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header Module
HospitalAdmissionOrdinalNumber
Item
Visit number
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C0019994 (UMLS 2011AA ObjectClass)
C25385 (NCI Thesaurus Property)
C0809949 (UMLS 2011AA Property)
CurrentStageCompleteAssessmentDate
Item
Date of staging
date
C25471 (NCI Thesaurus ObjectClass)
C0521116 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ObjectClass)
C1300072 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Item
Immunosuppressant (prophylaxis) received
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C459 (NCI Thesaurus ObjectClass)
C0013227 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C0018133 (NCI Metathesaurus ObjectClass)
CL.1
Code List
Immunosuppressant (prophylaxis) received
CL Item
Prednisone (Prednisone)
CL Item
Cyclosporine (Cyclosporine)
C406 (NCI Thesaurus)
C0010592 (UMLS 2011AA)
CL Item
Tacrolimus (Tacrolimus)
CL Item
Not given during assessment period (Not given during assessment period)
AgentAdministeredTotalDose
Item
Record most recent blood level of immunosuppressant (prophylaxis)
double
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C1708 (NCI Thesaurus ObjectClass)
C0450442 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
Datesampleobtained
Item
Record date blood sample obtained
text
Segment
Item
Segment
text
StartofGVHDassessmentperiod
Item
Start of GVHD assessment period
text
EndofGVHDassessmentperiod
Item
End of GVHD assessment period
text
Item Group
Record The Highest Level Of Organ Abnormalities, The Etiologies Contributing To The Abnormalities And Any Biopsy Results Pertaining To Gvhd During The Assessment Period
Item
Skin abnormalities
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL323683 (NCI Metathesaurus Property)
CL.2
Code List
Skin abnormalities
CL Item
None (No rash)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Macular Or Papular Eruption Or Erythema Without Associated Symptoms (Maculopapular rash, <25% of body surface)
CL Item
Maculopapular rash, 25-50% of body surface (Maculopapular rash, 25-50% of body surface)
CL Item
Generalized erythroderma (Generalized erythroderma)
CL Item
Generalized erythroderma with bullus formation and desquamation (Generalized erythroderma with bullus formation and desquamation)
Item Group
Skin Etiologies
Item
GVHD
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C0018133 (NCI Metathesaurus ObjectClass)
CL289271 (NCI Metathesaurus Property)
CL.26
Code List
GVHD
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Infection
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C26726 (NCI Thesaurus Property)
C0009450 (UMLS 2011AA Property)
CL.30
Code List
Infection
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
OtherDiseaseDiagnosisSpecify
Item
Specify other liver etiologies
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
Item
Liver biopsy for GVHD
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
CL.33
Code List
Liver biopsy for GVHD
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Equivocal (Equivocal)
C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)
CL Item
Unknown (Not done)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Upper GI abnormalities
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL164477 (NCI Metathesaurus Property)
CL.9
Code List
Upper GI abnormalities
CL Item
None (No protracted nausea or vomiting)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Symptomatic; Medical Intervention Indicated (Persistent nausea, vomiting, anorexia)
Item
Drug reaction
text
CL.4
Code List
Drug reaction
CL Item
Yes (Yes)
CL Item
No (No)
Item
Conditioning regimen toxicity
text
CL.5
Code List
Conditioning regimen toxicity
CL Item
Yes (Yes)
CL Item
No (No)
Item
Other
text
CL.7
Code List
Other
CL Item
Yes (Yes)
CL Item
No (No)
Item Group
Upper Intestinal Tract Etiologies
Item
GVHD
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C0018133 (NCI Metathesaurus ObjectClass)
CL289271 (NCI Metathesaurus Property)
CL.26
Code List
GVHD
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
TPN
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C37902 (NCI Thesaurus ObjectClass)
C1521721 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25597 (NCI Thesaurus ObjectClass)
C1521739 (UMLS 2011AA ObjectClass)
CL.29
Code List
TPN
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Infection
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C26726 (NCI Thesaurus Property)
C0009450 (UMLS 2011AA Property)
CL.30
Code List
Infection
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Other
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
CL.23
Code List
Other
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
OtherDiseaseDiagnosisSpecify
Item
Specify other liver etiologies
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
Item
Liver biopsy for GVHD
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
CL.33
Code List
Liver biopsy for GVHD
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Equivocal (Equivocal)
C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)
CL Item
Unknown (Not done)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Lower GI abnormalities
double
C2987 (NCI Thesaurus Property)
C0011991 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL.17
Code List
Lower GI abnormalities
CL Item
None (No diarrhea)
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Diarrhea less than or equal to 500 mL/day or <280 mL/m^2 (Diarrhea less than or equal to 500 mL/day or <280 mL/m^2)
CL Item
Increase Of <4 Stools Per Day Over Baseline; Mild Increase In Ostomy Output Compared To Baseline (Diarrhea >500 but less than or equal to 1000 mL/day or 280-555 mL/m^2)
CL Item
Increase Of 4-6 Stools Per Day Over Baseline; Iv Fluids Indicated <24 Hrs; Moderate Increase In Ostomy Output Compared To Baseline; Not Interfering With Adl (Diarrhea >1000 but less than or equal to 1500 mL/day or 556-833 mL/m^2)
CL Item
Increase Of >=7 Stools Per Day Over Baseline; Incontinence; Iv Fluids >=24 Hrs; Hospitalization; Severe Increase In Ostomy Output Compared To Baseline; Interfering With Adl (Diarrhea >1500 or > 833 mL/m^2)
CL Item
Life-threatening Consequences (e.g., Hemodynamic Collapse) (Severe abdominal pain with or without ileus, or stool with frank blood or melena)
Item
Drug reaction
text
CL.11
Code List
Drug reaction
CL Item
Yes (Yes)
CL Item
No (No)
Item
Conditioning regimen toxicity
text
CL.12
Code List
Conditioning regimen toxicity
CL Item
Yes (Yes)
CL Item
No (No)
Item Group
Lower Intestinal Tract Etiologies
Item
GVHD
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C0018133 (NCI Metathesaurus ObjectClass)
CL289271 (NCI Metathesaurus Property)
CL.26
Code List
GVHD
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
TPN
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C37902 (NCI Thesaurus ObjectClass)
C1521721 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25597 (NCI Thesaurus ObjectClass)
C1521739 (UMLS 2011AA ObjectClass)
CL.29
Code List
TPN
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Infection
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C26726 (NCI Thesaurus Property)
C0009450 (UMLS 2011AA Property)
CL.30
Code List
Infection
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Other
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
CL.23
Code List
Other
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
OtherDiseaseDiagnosisSpecify
Item
Specify other liver etiologies
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
Item
Liver biopsy for GVHD
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
CL.33
Code List
Liver biopsy for GVHD
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Equivocal (Equivocal)
C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)
CL Item
Unknown (Not done)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Liver abnormalities
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0085605 (NCI Metathesaurus Property)
CL.25
Code List
Liver abnormalities
CL Item
Bilirubin <2.0 mg/dL (Bilirubin <2.0 mg/dL)
CL Item
Bilirubin 2.0-3.0 mg/dL (Bilirubin 2.0-3.0 mg/dL)
CL Item
Bilirubin 3.1-6.0 mg/dL (Bilirubin 3.1-6.0 mg/dL)
CL Item
Bilirubin 6.1-15.0 mg/dL (Bilirubin 6.1-15.0 mg/dL)
CL Item
Bilirubin >15.0 mg/dL (Bilirubin >15.0 mg/dL)
Item
Drug reaction
text
CL.19
Code List
Drug reaction
CL Item
Yes (Yes)
CL Item
No (No)
Item
Conditioning regimen toxicity
text
CL.20
Code List
Conditioning regimen toxicity
CL Item
Yes (Yes)
CL Item
No (No)
Item Group
Liver Etiologies
Item
GVHD
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C0018133 (NCI Metathesaurus ObjectClass)
CL289271 (NCI Metathesaurus Property)
CL.26
Code List
GVHD
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
TPN
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C37902 (NCI Thesaurus ObjectClass)
C1521721 (UMLS 2011AA ObjectClass)
C25382 (NCI Thesaurus Property)
C1521801 (UMLS 2011AA Property)
C25597 (NCI Thesaurus ObjectClass)
C1521739 (UMLS 2011AA ObjectClass)
CL.29
Code List
TPN
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Infection
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C26726 (NCI Thesaurus Property)
C0009450 (UMLS 2011AA Property)
CL.30
Code List
Infection
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
OtherDiseaseDiagnosisSpecify
Item
Specify other liver etiologies
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
Item
Liver biopsy for GVHD
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
CL.33
Code List
Liver biopsy for GVHD
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Equivocal (Equivocal)
C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)
CL Item
Unknown (Not done)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Was treatment of GVHD modified during this assessment period
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15368 (NCI Thesaurus ObjectClass)
C25572 (NCI Thesaurus Property)
CL.34
Code List
Was treatment of GVHD modified during this assessment period
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
Item
Drug reaction
text
CL.27
Code List
Drug reaction
CL Item
Yes (Yes)
CL Item
No (No)
Item
Conditioning regimen toxicity
text
CL.28
Code List
Conditioning regimen toxicity
CL Item
Yes (Yes)
CL Item
No (No)
Item
VOD
text
CL.31
Code List
VOD
CL Item
Yes (Yes)
CL Item
No (No)
Item
Other
text
CL.32
Code List
Other
CL Item
Yes (Yes)
CL Item
No (No)
Item
If yes, specify agent name
text
CL.35
Code List
If yes, specify agent name
CL Item
CSA (CSA)
CL Item
FK506 (FK506)
CL Item
Topical steriods (Topical steriods)
CL Item
Prednisone (Prednisone)
CL Item
ATG (ATG)
CL Item
MMF (MMF)
CL Item
Daclizumab (Daclizumab)
CL Item
Methylprednisolone (Methylprednisolone)
CL Item
Other (Other)
Specifyotheragent
Item
Specify other agent
text
Item
Indicate treatment modification
text
CL.36
Code List
Indicate treatment modification
CL Item
Started (Started)
CL Item
Stopped (Stopped)
CL Item
Tapered (Tapered)
CL Item
Increased (Increased)
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