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Administration of high dose chemotherapy

1 forms  
Body dimensions
Description

Body dimensions

Body height
Description

Height

Data type

integer

Measurement units
  • cm
Alias
UMLS CUI-1
C0005890
cm
Body weight
Description

Weight

Data type

float

Measurement units
  • kg
Alias
UMLS CUI-1
C0005910
kg
Body surface area
Description

BSA

Data type

float

Measurement units
  • m²
Alias
UMLS CUI-1
C0005902
m²
BSA calculated
Description

BSA calculated

Data type

float

Measurement units
  • m²
Alias
UMLS CUI-1
C0005902
m²
Patient < 1 Year or < 10 kg
Description

Patient younger than 1 year or weight under 10 kg

Data type

integer

High dose chemotherapy course
Description

High dose chemotherapy course

Day 1 of this course
Description

Day 1 of course

Data type

date

Delay >5 days
Description

Delay of course more than 5 days

Data type

boolean

Reason for delay
Description

Reason for delay of course

Data type

integer

Other reason
Description

Reason for delay of course specified

Data type

text

High dose chemotherapy regimen
Description

High dose chemotherapy regimen

High dose regimen
Description

High dose regimen

Data type

integer

Other regimen
Description

Other high dose regimen specified

Data type

text

Deviation of high dose chemotherapy
Description

Deviation of high dose chemotherapy

Schedule deviation in this course
Description

Schedule deviation

Data type

integer

Reason
Description

Reason for schedule deviation

Data type

integer

Other reason
Description

Reason for schedule deviation specified

Data type

text

Adminstration of high dose chemotherapy
Description

Adminstration of high dose chemotherapy

Busulfan (BU) IV cumulative dose per course
Description

BU IV cumulative dose per course

Data type

integer

Measurement units
  • mg
mg
Busulfan (BU) IV cumulative dose per course acc. to protocol
Description

BU IV cumulative dose per course acc. to protocol

Data type

integer

Measurement units
  • mg
mg
Busulfan (BU) IV administrated over
Description

BU IV number of administration days

Data type

integer

Measurement units
  • Days
Days
Treosulfan (TREO) cumulative dose per course
Description

TREO cumulative dose per course

Data type

integer

Measurement units
  • mg
mg
Treosulfan (TREO) cumulative dose per course acc. to protocol
Description

TREO cumulative dose per course acc. to protocol

Data type

integer

Measurement units
  • mg
mg
Treosulfan (TREO) administrated over
Description

TREO number of administration days

Data type

integer

Measurement units
  • Days
Days
Melphalan (MEL) cumulative dose per course
Description

MEL cumulative dose per course

Data type

integer

Measurement units
  • mg
mg
Melphalan (MEL) cumulative dose per course acc. to protocol
Description

MEL cumulative dose per course acc. to protocol

Data type

integer

Measurement units
  • mg
mg
Melphalan (MEL) administrated over
Description

MEL number of administration days

Data type

integer

Measurement units
  • Days
Days
Other cytotoxic drug
Description

Other cytotoxic drug administered

Data type

integer

Other cytotoxic drug
Description

Other cytotoxic drug

Generic drug name
Description

Generic Name

Data type

text

Other generic, specifiy
Description

Generic name specified

Data type

text

Cumulative dose per course
Description

Other drug cumulative dose per course

Data type

float

Measurement units
  • mg
mg
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Similar models

Administration of high dose chemotherapy

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Height
Item
Body height
integer
C0005890 (UMLS CUI-1)
Weight
Item
Body weight
float
C0005910 (UMLS CUI-1)
BSA
Item
Body surface area
float
C0005902 (UMLS CUI-1)
BSA calculated
Item
BSA calculated
float
C0005902 (UMLS CUI-1)
Item
Patient < 1 Year or < 10 kg
integer
NoYes
Code List
Patient < 1 Year or < 10 kg
CL Item
No (0)
CL Item
Yes (1)
Day 1 of course
Item
Day 1 of this course
date
Delay of course more than 5 days
Item
Delay >5 days
boolean
Item
Reason for delay
integer
Reason for delay of high dose course
Code List
Reason for delay
CL Item
Due to surgical complications (1)
CL Item
Due to problems in stem cell collection (2)
CL Item
Due to decreased general status (3)
CL Item
Other reason (4)
Reason for delay of course specified
Item
Other reason
text
Item
High dose regimen
integer
High dose regimen
Code List
High dose regimen
CL Item
Bu-Mel (1)
CL Item
Treo-Mel (3)
CL Item
Other (2)
Other high dose regimen specified
Item
Other regimen
text
Item
Schedule deviation in this course
integer
NoYes
Code List
Schedule deviation in this course
CL Item
No (0)
CL Item
Yes (1)
Reason for schedule deviation
Code List
Reason
CL Item
Due to cardiac toxicity (1)
CL Item
Due to renal failure (2)
CL Item
Due to pulmonary toxicity (3)
CL Item
Due to liver toxicity (4)
CL Item
Other reason (5)
Reason for schedule deviation specified
Item
Other reason
text
BU IV cumulative dose per course
Item
Busulfan (BU) IV cumulative dose per course
integer
BU IV cumulative dose per course acc. to protocol
Item
Busulfan (BU) IV cumulative dose per course acc. to protocol
integer
BU IV number of administration days
Item
Busulfan (BU) IV administrated over
integer
TREO cumulative dose per course
Item
Treosulfan (TREO) cumulative dose per course
integer
TREO cumulative dose per course acc. to protocol
Item
Treosulfan (TREO) cumulative dose per course acc. to protocol
integer
TREO number of administration days
Item
Treosulfan (TREO) administrated over
integer
MEL cumulative dose per course
Item
Melphalan (MEL) cumulative dose per course
integer
MEL cumulative dose per course acc. to protocol
Item
Melphalan (MEL) cumulative dose per course acc. to protocol
integer
MEL number of administration days
Item
Melphalan (MEL) administrated over
integer
Item
Other cytotoxic drug
integer
NoYes
Code List
Other cytotoxic drug
CL Item
No (0)
CL Item
Yes (1)
Item
Generic drug name
text
Generic Name
Code List
Generic drug name
CL Item
Aclarubicin (1)
CL Item
Actinomycin D (Dactinomycin) (3)
CL Item
Alemtuzumab (62)
CL Item
Amsacrine (Acridinyl, Anisidide, m-AMSA, AMSA, Amsidyl) (4)
CL Item
Antibody 14G2a (14G2a)
CL Item
Antibody ch14.18 (CH1418)
CL Item
Antithymozyten globuline (ATG)
CL Item
Asparaginase (L-asparaginase, Colaspase, L-ASP, Crasnitin, Elspar) (6)
CL Item
Azacytidine (12)
CL Item
Beclomethasone (BEC)
CL Item
Bleomycin (14)
CL Item
Budesonide (59)
CL Item
Busulfan (Busulphan, Busulfanum, Myelosan, BSF) (15)
CL Item
Carboplatin (CBDCA, JM8, NSC 241240) (16)
CL Item
Carmustine (BCNU, 1,3-bis(2-chloroethyl)-l-nitrosourea) (13)
CL Item
Chlorambucil (Chlorambucilum, NSC-3088, WR-139013, Chlorbutinum) (19)
CL Item
Ciclosporin (Cyclosporin) (21)
CL Item
Cisplatin, (Cis-platinum, cis-diamminedichloroplatinum, CDDP, DDP, CIS, Platinum) (22)
CL Item
Cladribine (CdA, 2-CdA, 2-chloro-2'-deoxyadenosine, NSC-105014-F) (18)
CL Item
Coli Asparaginase (9)
CL Item
Dexamethasone (23)
CL Item
Co-trimoxazol (93)
CL Item
Cyclophosphamide (Cyclo, CPA, CPM, CTX, CYC, CYT) (20)
CL Item
Cytarabine (Cytosine Arabinoside, Ara-C, Arabinosylcytosine) (5)
CL Item
Dacarbazine (DIC, Imidazole carboxamide, dimethyl-triazeno-imidazole-carboxamide) (26)
CL Item
Daunorubicin (daunomycin, DNR, rubidomycin) (24)
CL Item
Daunoxome (56)
CL Item
Doxorubicin (Adriamycin, Hydroxyl daunorubicin, Dox, Adria) (25)
CL Item
Epirubicin (4'-epi-doxorubicin, NSC-256942, IMI28, epi DX) (27)
CL Item
Epoetin alfa (Erythropoetin) (ERYPOa)
CL Item
Epoetin beta (Erythropoetin) (ERYPOb)
CL Item
Erwinia-Asparaginase (NSC-106977, Porton Asparaginase) (10)
CL Item
Etanercept (ETAN)
CL Item
Etoposide (VP-16, VP-16-213, EPEG, EPE, epipodophyllotoxin) (55)
CL Item
Fludarabine (2-F-ara-AMP, FAMP, NSC-312887, Fludarabine phosphate) (28)
CL Item
Fluorouracil (5-Fluorouracil, 5FU) (29)
CL Item
Folinic Acid (LV, calcium leucovorin, calcium folinate, citrovorum factor) (37)
CL Item
G-CSF (30)
CL Item
GM-CSF (31)
CL Item
Hydrocortisone (94)
CL Item
Hydroxyurea (32)
CL Item
Idarubicin (33)
CL Item
Ifosfamide (36)
CL Item
Imatinib (STI571)
CL Item
Immunglobuline (human) (60)
CL Item
Interferon ALPHA (34)
CL Item
Interferon GAMMA (35)
CL Item
Interleukin 1 (IL1)
CL Item
Interleukin 12 (IL12)
CL Item
Interleukin 13 (IL13)
CL Item
Interleukin 2 (IL2)
CL Item
Interleukin 3 (IL3)
CL Item
Interleukin 4 (IL4)
CL Item
Interleukin 6 (IL6)
CL Item
Interleukin 7 (IL7)
CL Item
Interleukin 8 (IL8)
CL Item
Lomustine (17)
CL Item
Mechlorethamine (38)
CL Item
Melphalan (39)
CL Item
Mitomycin (MIT)
CL Item
Monoclonal AB (MonoAB)
CL Item
Muromonab (OKT3)
CL Item
Mycophenolat (MMF)
CL Item
Mesna (40)
CL Item
Mitoxantrone (42)
CL Item
Mercaptopurine (43)
CL Item
Methotrexate (44)
CL Item
Nimustine (2)
CL Item
Paclitaxel (47)
CL Item
PEG-ASP (11)
CL Item
Prednisone (45)
CL Item
Procarbazine (46)
CL Item
Rasburicase (57)
CL Item
Rituximab (58)
CL Item
Tacrolimus (FK506)
CL Item
Teniposid (54)
CL Item
Thiotepa (48)
CL Item
Tioguanine (49)
CL Item
Topotecan (TOPO)
CL Item
Treosulfan (61)
CL Item
Tretinoin (ATRA) (ATRA)
CL Item
Trofosfamide (50)
CL Item
Vinblastine (51)
CL Item
Vincristine (52)
CL Item
Vindesine (53)
CL Item
Other (999)
Generic name specified
Item
Other generic, specifiy
text
Other drug cumulative dose per course
Item
Cumulative dose per course
float
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