ID

2001

Description

DTX Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF1A56B4-3737-1DDD-E034-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF1A56B4-3737-1DDD-E034-0003BA3F9857

Keywords

  1. 9/19/12 9/19/12 -
  2. 8/8/14 8/8/14 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
  4. 6/26/15 6/26/15 - Martin Dugas
Uploaded on

September 19, 2012

DOI

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License

Creative Commons BY-NC 3.0 Legacy

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Leukemia, Myelocytic, Acute null Treatment - DTX - 2395226v3.0

No Instruction available.

Unnamed 1
Description

Unnamed 1

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
Segment
Description

Segment

Data type

text

For Questions 1-28, Record The Highest Grade Of Toxicity Present After Initiation Of Mobilization, But Prior To Apheresis.
Description

For Questions 1-28, Record The Highest Grade Of Toxicity Present After Initiation Of Mobilization, But Prior To Apheresis.

Record The Grade Of Toxicity Present At The Time Of Contact With The Donor, Approximately 4 Weeks After Completion Of Apheresis
Description

Record The Grade Of Toxicity Present At The Time Of Contact With The Donor, Approximately 4 Weeks After Completion Of Apheresis

Flu-like Sumptoms
Description

Flu-like Sumptoms

Fever in absence of infections
Description

CTCAdverseEventFeverGrade

Data type

double

Alias
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus Property
C3038
UMLS 2011AA Property
C0015967
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
NCI Thesaurus ValueDomain
C3038
UMLS 2011AA ValueDomain
C0015967
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Constitutional Symptoms
Description

Constitutional Symptoms

Fatigue (lethargy, malaise, asthenia)
Description

CTCAdverseEventFatigueGrade

Data type

double

Alias
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus Property
C3036
UMLS 2011AA Property
C0015672
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
NCI Thesaurus ValueDomain
C3036
UMLS 2011AA ValueDomain
C0015672
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Ocular/visual
Description

Ocular/visual

Inflammation of the eyes
Description

CommonToxicityCriteriaAdverseEventOtherVisualGrade

Data type

double

Alias
NCI Thesaurus Property
C17649
UMLS 2011AA Property
C0205394
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
NCI Thesaurus Property
C38059
UMLS 2011AA Property
C0234621
Dermatologic
Description

Dermatologic

Skin (rash)
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
Local
Description

CommonToxicityCriteriaAdverseEventPruritusGrade

Data type

double

Alias
NCI Thesaurus Property
C3344
UMLS 2011AA Property
C0033774
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Ulceration
Description

CommonToxicityCriteriaAdverseEventSkinUlcerationGrade

Data type

double

Alias
NCI Thesaurus Property
C12470
UMLS 2011AA Property
C1123023
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
NCI Thesaurus Property
C25757
UMLS 2011AA Property
C0041582
Cardiac
Description

Cardiac

Hypotension (low blood pressure)
Description

CommonToxicityCriteriaAdverseEventHypotensionGrade

Data type

double

Alias
NCI Thesaurus Property
C3128
UMLS 2011AA Property
C0020649
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Pulmonary
Description

Pulmonary

Pneumothorax
Description

CommonToxicityCriteriaAdverseEventPneumothoraxGrade

Data type

double

Alias
NCI Thesaurus Property
C38006
UMLS 2011AA Property
C0032326
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Gastrointestinal
Description

Gastrointestinal

Nausea
Description

CommonToxicityCriteriaAdverseEventNauseaGrade

Data type

double

Alias
NCI Thesaurus Property
C3258
UMLS 2011AA Property
C0027497
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Vomiting
Description

CommonToxicityCriteriaAdverseEventVomitingGrade

Data type

double

Alias
NCI Thesaurus Property
C3442
UMLS 2011AA Property
C0042963
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Anorexia
Description

CTCAdverseEventAnorexiaGrade

Data type

double

Alias
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus Property
C2875
UMLS 2011AA Property
C0003123
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
NCI Thesaurus ValueDomain
C2875
UMLS 2011AA ValueDomain
C0003123
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Vascular
Description

Vascular

Venous thrombosis/embolism
Description

CommonToxicityCriteriaAdverseEventVascularAccessThrombosisGrade

Data type

text

Alias
NCI Thesaurus Property
C26891
UMLS 2011AA Property
C0040053
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
NCI Metathesaurus Property
C0750138
Neurologic
Description

Neurologic

Insomnia
Description

CommonToxicityCriteriaAdverseEventInsomniaGrade

Data type

double

Alias
NCI Thesaurus Property
C28286
UMLS 2011AA Property
C0917801
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Dizziness, vertigo, lightheadedness
Description

CommonToxicityCriteriaAdverseEventDizzinessGrade

Data type

double

Alias
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
NCI Thesaurus Property
C37943
UMLS 2011AA Property
C0012833
Syncope
Description

CommonToxicityCriteriaAdverseEventSyncopeGrade

Data type

double

Alias
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
NCI Thesaurus Property
C35053
UMLS 2011AA Property
C0039070
Hematological
Description

Hematological

Low platelet count
Description

CommonToxicityCriteriaAdverseEventPlateletCountGrade

Data type

double

Alias
NCI Metathesaurus Property
C0032181
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Infection Sites
Description

Infection Sites

For Each Of The Sites Listed Below, Indicate The Severity Of Infection Present
Description

For Each Of The Sites Listed Below, Indicate The Severity Of Infection Present

Other site
Description

CommonToxicityCriteriaAdverseEventFebrileNeutropeniaInfectionGrade

Data type

double

Alias
NCI Metathesaurus Property
C0746883
NCI Thesaurus Property
C26726
UMLS 2011AA Property
C0009450
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Specify site
Description

CTCAdverseEventSiteSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C41331
UMLS 2011AA ObjectClass
C0877248
Peripheral IV site
Description

PeripheralIVsite

Data type

text

Central catheter site
Description

Centralcathetersite

Data type

text

Pain Sites
Description

Pain Sites

For Each Of The Sites Listed Below, Indicate The Severity Of Pain Present
Description

For Each Of The Sites Listed Below, Indicate The Severity Of Pain Present

Other site
Description

CommonToxicityCriteriaAdverseEventOtherPainGrade

Data type

double

Alias
NCI Thesaurus Property
C17649
UMLS 2011AA Property
C0205394
NCI Thesaurus Property
C3303
UMLS 2011AA Property
C0030193
NCI Thesaurus ObjectClass
C49704
UMLS 2011AA ObjectClass
C1516728
NCI Thesaurus ValueDomain
C18000
UMLS 2011AA ValueDomain
C0919553
Specify site
Description

DiseaseInvolvedSiteSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C25341
UMLS 2011AA Property
C0450429
NCI Thesaurus Property
C25547
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
Back
Description

Back

Data type

text

Bone
Description

Bone

Data type

text

Limb (leg or arm)
Description

Limb(legorarm)

Data type

text

Joint
Description

Joint

Data type

text

Muscle
Description

Muscle

Data type

text

Headache
Description

Headache

Data type

text

Neck
Description

Neck

Data type

text

IV site
Description

IVsite

Data type

text

Donor Pre-apheresis Vital Signs
Description

Donor Pre-apheresis Vital Signs

Pulse
Description

PulseRate

Data type

double

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus ObjectClass
C25749
UMLS 2011AA ObjectClass
C0391850
NCI Thesaurus Property
C25636
UMLS 2011AA Property
C1521828
Blood pressure
Description

BloodSystolicPressureMeasurement

Data type

double

Alias
NCI Thesaurus ValueDomain
C25209
UMLS 2011AA ValueDomain
C0242485
NCI Thesaurus Property
C25214
UMLS 2011AA Property
C0220825
NCI Thesaurus ObjectClass
C25298
UMLS 2011AA ObjectClass
C0871470
Temperture
Description

PersonTemperature

Data type

text

Donor Pre-apheresis Hematology
Description

Donor Pre-apheresis Hematology

Date of sample collection
Description

HematologyLabCollectedDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25452
WBC
Description

LaboratoryProcedureLeukocyteCerebrospinalFluidOutcomeSpecifiedValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C12692
UMLS 2011AA Property
C0007806
NCI Thesaurus Property
C12529
UMLS 2011AA Property
C0023516
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Platelets
Description

LaboratoryProcedurePlateletResultSpecifiedValue

Data type

double

Measurement units
  • 1000/uL
Alias
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C12520
UMLS 2011AA Property
C0005821
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
1000/uL
Hematocrit
Description

LaboratoryProcedureErythrocyteResultCount

Data type

double

Alias
NCI Thesaurus Property
C12521
UMLS 2011AA Property
C0014792
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
Hemoglobin
Description

LaboratoryProcedureHemoglobinResultSpecifiedValue

Data type

double

Measurement units
  • g/dL
Alias
NCI Thesaurus Property
C16676
UMLS 2011AA Property
C0019046
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
g/dL
Apheresis Procedure
Description

Apheresis Procedure

First Apheresis
Description

First Apheresis

Time procedure started
Description

StartTime

Data type

time

Alias
NCI Thesaurus ObjectClass
C25431
UMLS 2011AA ObjectClass
C0439659
NCI Thesaurus ObjectClass
C25409
UMLS 2011AA ObjectClass
C1533734
NCI Thesaurus Property
C25207
UMLS 2011AA Property
C0040223
NCI Metathesaurus Property
CL219258
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
Time procedure ended
Description

StopTime

Data type

time

Alias
NCI Thesaurus Property
C25207
UMLS 2011AA Property
C0040223
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus ObjectClass
C25409
UMLS 2011AA ObjectClass
C1533734
NCI Thesaurus Property
C65125
UMLS 2011AA Property
C1947925
Does your center's blood cell separator calculate the time to complete the procedure
Description

SpecimenCellCountInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25256
UMLS 2011AA Property
C1265611
Volume of whole blood cell processed
Description

WholeBloodTubesSubmittedCount

Data type

double

Alias
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
NCI Thesaurus ObjectClass
C41067
UMLS 2011AA ObjectClass
C1608383
NCI Thesaurus Property
C25695
UMLS 2011AA Property
C1515023
NCI Metathesaurus Property
C0175730
Did the donor receive clacium replacement to treat or prevent symptoms of hypocalcemia
Description

CalciumNutritionalSupplementUseInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C331
UMLS 2011AA ObjectClass
C0006675
NCI Thesaurus ObjectClass
C1505
UMLS 2011AA ObjectClass
C0242295
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
Procedure time from the blood cell separator
Description

Proceduretimefromthebloodcellseparator

Data type

text

Specify Therapy
Description

Specify Therapy

Oral calcium for prevention
Description

Oralcalciumforprevention

Data type

text

IV calcium for prevention
Description

IVcalciumforprevention

Data type

text

Oral calcium for treatment
Description

Oralcalciumfortreatment

Data type

text

IV calcium for treatment
Description

IVcalciumfortreatment

Data type

text

Did the donor experience symptoms of hypocalcemia
Description

Didthedonorexperiencesymptomsofhypocalcemia

Data type

text

Specify symptoms
Description

Specifysymptoms

Data type

text

Second Apheresis
Description

Second Apheresis

Time procedure started
Description

StartTime

Data type

time

Alias
NCI Thesaurus ObjectClass
C25431
UMLS 2011AA ObjectClass
C0439659
NCI Thesaurus ObjectClass
C25409
UMLS 2011AA ObjectClass
C1533734
NCI Thesaurus Property
C25207
UMLS 2011AA Property
C0040223
NCI Metathesaurus Property
CL219258
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
Time procedure ended
Description

StopTime

Data type

time

Alias
NCI Thesaurus Property
C25207
UMLS 2011AA Property
C0040223
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus ObjectClass
C25409
UMLS 2011AA ObjectClass
C1533734
NCI Thesaurus Property
C65125
UMLS 2011AA Property
C1947925
Does your center's blood cell separator calculate the time to complete the procedure
Description

SpecimenCellCountInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25256
UMLS 2011AA Property
C1265611
Volume of whole blood cell processed
Description

WholeBloodTubesSubmittedCount

Data type

double

Alias
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
NCI Thesaurus ObjectClass
C41067
UMLS 2011AA ObjectClass
C1608383
NCI Thesaurus Property
C25695
UMLS 2011AA Property
C1515023
NCI Metathesaurus Property
C0175730
Did the donor receive clacium replacement to treat or prevent symptoms of hypocalcemia
Description

CalciumNutritionalSupplementUseInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C331
UMLS 2011AA ObjectClass
C0006675
NCI Thesaurus ObjectClass
C1505
UMLS 2011AA ObjectClass
C0242295
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
Was a second apheresis prodecure performed
Description

Wasasecondapheresisprodecureperformed

Data type

text

Procedure time from the blood cell separator
Description

Proceduretimefromthebloodcellseparator

Data type

text

Specify Therapy
Description

Specify Therapy

Oral calcium for prevention
Description

Oralcalciumforprevention

Data type

text

IV calcium for prevention
Description

IVcalciumforprevention

Data type

text

Oral calcium for treatment
Description

Oralcalciumfortreatment

Data type

text

IV calcium for treatment
Description

IVcalciumfortreatment

Data type

text

Did the donor experience symptoms of hypocalcemia
Description

Didthedonorexperiencesymptomsofhypocalcemia

Data type

text

Specify symptoms
Description

Specifysymptoms

Data type

text

Third Apheresis
Description

Third Apheresis

Time procedure started
Description

StartTime

Data type

time

Alias
NCI Thesaurus ObjectClass
C25431
UMLS 2011AA ObjectClass
C0439659
NCI Thesaurus ObjectClass
C25409
UMLS 2011AA ObjectClass
C1533734
NCI Thesaurus Property
C25207
UMLS 2011AA Property
C0040223
NCI Metathesaurus Property
CL219258
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
Time procedure ended
Description

StopTime

Data type

time

Alias
NCI Thesaurus Property
C25207
UMLS 2011AA Property
C0040223
NCI Thesaurus ValueDomain
C25207
UMLS 2011AA ValueDomain
C0040223
NCI Thesaurus ObjectClass
C25409
UMLS 2011AA ObjectClass
C1533734
NCI Thesaurus Property
C65125
UMLS 2011AA Property
C1947925
Does your center's blood cell separator calculate the time to complete the procedure
Description

SpecimenCellCountInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25256
UMLS 2011AA Property
C1265611
Volume of whole blood cell processed
Description

WholeBloodTubesSubmittedCount

Data type

double

Alias
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
NCI Thesaurus ObjectClass
C41067
UMLS 2011AA ObjectClass
C1608383
NCI Thesaurus Property
C25695
UMLS 2011AA Property
C1515023
NCI Metathesaurus Property
C0175730
Did the donor receive clacium replacement to treat or prevent symptoms of hypocalcemia
Description

CalciumNutritionalSupplementUseInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C331
UMLS 2011AA ObjectClass
C0006675
NCI Thesaurus ObjectClass
C1505
UMLS 2011AA ObjectClass
C0242295
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
Was a third apheresis prodecure performed
Description

Wasathirdapheresisprodecureperformed

Data type

text

Procedure time from the blood cell separator
Description

Proceduretimefromthebloodcellseparator

Data type

text

Specify Therapy
Description

Specify Therapy

Oral calcium for prevention
Description

Oralcalciumforprevention

Data type

text

IV calcium for prevention
Description

IVcalciumforprevention

Data type

text

Oral calcium for treatment
Description

Oralcalciumfortreatment

Data type

text

IV calcium for treatment
Description

IVcalciumfortreatment

Data type

text

Did the donor experience symptoms of hypocalcemia
Description

Didthedonorexperiencesymptomsofhypocalcemia

Data type

text

Specify symptoms
Description

Specifysymptoms

Data type

text

Donor Post-apheresis Hematology
Description

Donor Post-apheresis Hematology

Date of sample collection
Description

HematologyLabCollectedDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25452
WBC
Description

LaboratoryProcedureLeukocyteCerebrospinalFluidOutcomeSpecifiedValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C12692
UMLS 2011AA Property
C0007806
NCI Thesaurus Property
C12529
UMLS 2011AA Property
C0023516
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Platelets
Description

LaboratoryProcedurePlateletResultSpecifiedValue

Data type

double

Measurement units
  • 1000/uL
Alias
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C12520
UMLS 2011AA Property
C0005821
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
1000/uL
Hematocrit
Description

LaboratoryProcedureErythrocyteResultCount

Data type

double

Alias
NCI Thesaurus Property
C12521
UMLS 2011AA Property
C0014792
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
Hemoglobin
Description

LaboratoryProcedureHemoglobinResultSpecifiedValue

Data type

double

Measurement units
  • g/dL
Alias
NCI Thesaurus Property
C16676
UMLS 2011AA Property
C0019046
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
g/dL
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

Similar models

No Instruction available.

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Unnamed 1
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)
Segment
Item
Segment
text
Item Group
For Questions 1-28, Record The Highest Grade Of Toxicity Present After Initiation Of Mobilization, But Prior To Apheresis.
Item Group
Record The Grade Of Toxicity Present At The Time Of Contact With The Donor, Approximately 4 Weeks After Completion Of Apheresis
Item Group
Flu-like Sumptoms
Item
Fever in absence of infections
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C3038 (NCI Thesaurus Property)
C0015967 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C3038 (NCI Thesaurus ValueDomain)
C0015967 (UMLS 2011AA ValueDomain)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Fever in absence of infections
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
38.0 - 39.0 Degrees C (100.4 - 102.2 Degrees F) (38.0-39.0 degrees C (Grade 1))
CL Item
39.1 - 40.0 Degrees C (102.3 - 104.0 Degrees F) (>39.0-40.0 degrees C (Grade 2))
CL Item
>40.0 Degrees C (>104.0 Degrees F) For <=24hrs (>40.0 degrees C for less than 24 hours (Grade 3))
CL Item
>40.0 Degrees C (>104.0 Degrees F) For >24hrs (>40.0 degrees C for more than 24 hours (Grade 4))
Item Group
Constitutional Symptoms
Item
Fatigue (lethargy, malaise, asthenia)
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C3036 (NCI Thesaurus Property)
C0015672 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C3036 (NCI Thesaurus ValueDomain)
C0015672 (UMLS 2011AA ValueDomain)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Fatigue (lethargy, malaise, asthenia)
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Mild Fatigue Over Baseline (Mild fatigue over baseline (Grade 1))
CL Item
Moderate Or Causing Difficulty Performing Some Adl (Moderate or causing difficulty performing some ADL (Grade 2))
CL Item
Severe Fatigue Interfering With Adl (Severe fatigue interfering with ADL (Grade 3 ))
CL Item
Disabling (Disabling (Grade 4))
Item Group
Ocular/visual
Item
Inflammation of the eyes
double
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C38059 (NCI Thesaurus Property)
C0234621 (UMLS 2011AA Property)
Code List
Inflammation of the eyes
CL Item
Normal (None (Grade 0))
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Symptomatic Not Interfering With Function (Asymptomatic or minimally symptomatic but not interfering with function (Grade 1))
CL Item
Symptomatic And Interfering With Function, But Not Interfering With Adl (Symptomatic, interfering with function but not w/ ADL; topical intervention indicated (Grade 2))
CL Item
Symptomatic And Interfering With Adl (Symptomatic, interfering with ADL; operative intervention indicated (Grade 3))
Item Group
Dermatologic
Item
Skin (rash)
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL323683 (NCI Metathesaurus Property)
Code List
Skin (rash)
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Macular Or Papular Eruption Or Erythema Without Associated Symptoms (Macular or papular eruption or erythema that is asymptomatic (Grade 1))
CL Item
Macular Or Papular Eruption Or Erythema With Pruritus Or Other Associated Symptoms; Localized Desquamation Or Other Lesions Covering <50% Of Body Surface Area (bsa) (Macular or papular eruption or erythema with pruritus or other associated symptoms (Grade 2))
CL Item
Severe, Generalized Erythroderma Or Macular, Papular, Or Vesicular Eruption; Desquamation Covering >=50% Bsa (Severe, generalized erythroderma or macular, papular, or vasicular eruption (Grade 3))
CL Item
Generalized Exfoliative, Ulcerative, Or Bullous Dermatitis (Generalize exfoliative dermatitis or ulcerating dermititis)
Item
Local
double
C3344 (NCI Thesaurus Property)
C0033774 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Local
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Mild Or Localized (Pain; itching; erythema (Grade 1))
CL Item
Intense Or Widespread (Pain and swelling with inflammation or phlebitis (Grade 2))
CL Item
Intense Or Widespread And Interfering With Adl (Ulceration at least 2 cm size; operative intervention indicated (Grade 3))
Item
Ulceration
double
C12470 (NCI Thesaurus Property)
C1123023 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C25757 (NCI Thesaurus Property)
C0041582 (UMLS 2011AA Property)
Code List
Ulceration
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Superficial Ulceration <2 Cm Size; Local Wound Care; Medical Intervention Indicated (Superficial ulceration < 2 cm size; local wound care; medical intervention indicated (Grade 2))
CL Item
Ulceration >=2 Cm Size; Operative Debridement, Primary Closure Or Other Invasive Intervention Indicated (e.g., Hyperbaric Oxygen) (Ulceration at least 2 cm size; operative debridement, invasive intervention indicated (Grade 3))
CL Item
Life-threatening Consequences; Major Invasive Intervention Indicated (e.g., Complete Resection, Tissue Reconstruction, Flap, Or Grafting) (Life-threatening consequences; major invasive intervention indicated (Grade 4))
Item Group
Cardiac
Item
Hypotension (low blood pressure)
double
C3128 (NCI Thesaurus Property)
C0020649 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Hypotension (low blood pressure)
CL Item
None (Normal (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Changes, Intervention Not Indicated (Present, intervention not indicated (Grade 1))
CL Item
Brief (<24 Hrs) Fluid Replacement Or Other Therapy; No Physiologic Consequences (Brief (<24 hours) fluid replacement or other therapy; no physiologic consequences (Grade 2))
CL Item
Sustained (>=24 Hrs) Therapy, Resolves Without Persisting Physiologic Consequences (Sustained (at least 24 hours) therapy, resolved without physiologic consequences (Grade 3))
CL Item
Shock (e.g., Acidemia; Impairment Of Vital Organ Function) (Shock (Grade 4))
Item Group
Pulmonary
Item
Pneumothorax
double
C38006 (NCI Thesaurus Property)
C0032326 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Pneumothorax
CL Item
None (Not present (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Asymptomatic, Radiographic Findings Only (Asymptomatic, radiographic findings only (Grade 1))
CL Item
Symptomatic; Intervention Indicated (e.g., Hospitalization For Observation, Tube Placement Without Sclerosis) (Symptomatic intervention indicated (Grade 2))
CL Item
Sclerosis And/or Operative Intervention Indicated (Sclerosis and/or operative intervention indicated (Grade 3))
CL Item
Life-threatening, Causing Hemodynamic Instability (e.g., Tension Pneumothorax); Ventilatory Support Indicated (Life-threatening, causing hemodynamic instability; ventilatory support indicated (Grade 4))
Item Group
Gastrointestinal
Item
Nausea
double
C3258 (NCI Thesaurus Property)
C0027497 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Nausea
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Loss Of Appetite Without Alteration In Eating Habits (Loss of appetite without alteration in eating habits (Grade 1))
CL Item
Oral Intake Decreased Without Significant Weight Loss, Dehydration Or Malnutrition; Iv Fluids Indicated <24 Hrs (Oral intake decrease without significant weight loss, dehydration or malnutirtion (Grade 2))
CL Item
Inadequate Oral Caloric Or Fluid Intake; Iv Fluids, Tube Feedings Or Tpn Indicated >=24 Hrs (Inadequate oral caloric or fluid intake (Grade 3))
CL Item
Life-threatening Consequences (Life-threatening consequences)
Item
Vomiting
double
C3442 (NCI Thesaurus Property)
C0042963 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Vomiting
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
1 Episode In 24 Hrs (1 episode in 24 hours (Grade 1))
CL Item
2 - 5 Episodes In 24 Hrs; Iv Fluids Indicated <24 Hrs (2-5 episodes in 24 hours (Grade 2))
CL Item
>=6 Episodes In 24 Hrs; Iv Fluids, Or Tpn Indicated >=24 Hrs (At least 6 episodes in 24 hours (Grade 3 ))
CL Item
Life-threatening Consequences (Life-threatening consequences (Grade 4))
Item
Anorexia
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C2875 (NCI Thesaurus Property)
C0003123 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C2875 (NCI Thesaurus ValueDomain)
C0003123 (UMLS 2011AA ValueDomain)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Anorexia
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Loss Of Appetite Without Alteration In Eating Habits (Loss of appetite without alteration in eating habits (Grade 1))
CL Item
Oral Intake Altered Without Significant Weight Loss Or Malnutrition; Oral Nutritional Supplements Indicated (Altered intake without significant weight loss or malnutrition (Grade 2))
CL Item
Associated With Significant Weight Loss Or Malnutrition (e.g., Inadequate Oral Caloric And/or Fluid Intake); Iv Fluids, Tube Feedings Or Tpn Indicated (Significant weight loss or malnutrition (Grade 3))
CL Item
Life-threatening Consequences (Life-threatening (Grade 4))
Item Group
Vascular
Item
Venous thrombosis/embolism
text
C26891 (NCI Thesaurus Property)
C0040053 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0750138 (NCI Metathesaurus Property)
Code List
Venous thrombosis/embolism
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Deep Vein Thrombosis Or Cardiac Thrombosis; Intervention (e.g., Anticoagulation, Lysis, Filter, Invasive Procedure) Not Indicated (Deep vein thrombosis, or cardiac thrombosis; intervention not indicated (Grade 2))
CL Item
Deep Vein Thrombosis Or Cardiac Thrombosis; Intervention (e.g., Anticoagulation, Lysis, Filter, Invasive Procedure) Indicated (Deep vein thrombosis, or cardiac thrombosis; intervention indicated (Grade 3))
CL Item
Embolic Event Including Pulmonary Embolism Or Life-threatening Thrombus (Embolic event including pumonary embolism or life-threatening thrombus (Grade 4))
Item Group
Neurologic
Item
Insomnia
double
C28286 (NCI Thesaurus Property)
C0917801 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Insomnia
CL Item
Normal (Normal (Grade 0))
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Occasional Difficulty Sleeping Not Interfering With Function (Occasional difficulty sleeping, not interfering with function (Grade 1))
CL Item
Difficulty Sleeping, Interfering With Function But Not Interfering With Adl (Difficulty sleeping, interfering with function but not interfering with ASL (Grade 2))
CL Item
Frequent Difficulty Sleeping, Interfering With Adl (Frequent difficulty sleeping, interfering with ADL (Grade 3))
CL Item
Disabling (Disabling (Grade 4))
Item
Dizziness, vertigo, lightheadedness
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C37943 (NCI Thesaurus Property)
C0012833 (UMLS 2011AA Property)
Code List
Dizziness, vertigo, lightheadedness
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
With Head Movements Or Nystagmus Only; Not Interfering With Function (With head movements only; not interfering with function (Grade 1))
CL Item
Interfering With Function, But Not Interfering With Adl (Interfering with function, but not interfering with ADL (Grade 2))
CL Item
Interfering With Adl (Interfering with ADL (Grade 3))
CL Item
Disabling (Disabling (Grade 4))
Item
Syncope
double
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C35053 (NCI Thesaurus Property)
C0039070 (UMLS 2011AA Property)
Code List
Syncope
CL Item
Absent (None (Grade 0))
CL Item
Present (Persent (Grade 3))
C25626 (NCI Thesaurus)
C0150312 (UMLS 2011AA)
CL Item
Life-threatening Consequences (Life-threatening consequences (Grade 4))
Item Group
Hematological
Item
Low platelet count
double
C0032181 (NCI Metathesaurus Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Low platelet count
CL Item
Within Normal Limits (Within normal limits (Grade 0))
CL Item
<lln - 75,000/mm^3; <lln - 75.0 X 10^9 /l (<LLN - 75.0 x 10^9/L (Grade 1))
CL Item
<75,000 - 50,000/mm^3; <75.0 - 50.0 X 10^9 /l (<75.0 - 50.0 x 10^9/L (Grade 2))
CL Item
<50,000 - 25,000/mm^3; <50.0 - 25.0 X 10^9 /l (<50.0 - 25.0 x 10^9/L (Grade 3))
CL Item
<25,000/mm^3; <25.0 X 10^9 /l (<25.0 x 10^9/L (Grade 4))
Item Group
Infection Sites
Item Group
For Each Of The Sites Listed Below, Indicate The Severity Of Infection Present
Item
Other site
double
C0746883 (NCI Metathesaurus Property)
C26726 (NCI Thesaurus Property)
C0009450 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Other site
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Localized, local intervention indicated (Grade 2) (Localized, local intervention indicated (Grade 2))
CL Item
IV antibiotic, antifungal, antiviral intervention indciated (Grade 3) (IV antibiotic, antifungal, antiviral intervention indciated (Grade 3))
CL Item
Life-threatening consequences (Grade 4) (Life-threatening consequences (Grade 4))
CTCAdverseEventSiteSpecify
Item
Specify site
text
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
Item
Peripheral IV site
text
Code List
Peripheral IV site
CL Item
None (Grade 0) (None (Grade 0))
CL Item
Localized, local intervention indicated (Grade 2) (Localized, local intervention indicated (Grade 2))
CL Item
IV antibiotic, antifungal, antiviral intervention indciated (Grade 3) (IV antibiotic, antifungal, antiviral intervention indciated (Grade 3))
CL Item
Life-threatening consequences (Grade 4) (Life-threatening consequences (Grade 4))
Item
Central catheter site
text
Code List
Central catheter site
CL Item
None (Grade 0) (None (Grade 0))
CL Item
Localized, local intervention indicated (Grade 2) (Localized, local intervention indicated (Grade 2))
CL Item
IV antibiotic, antifungal, antiviral intervention indciated (Grade 3) (IV antibiotic, antifungal, antiviral intervention indciated (Grade 3))
CL Item
Life-threatening consequences (Grade 4) (Life-threatening consequences (Grade 4))
Item Group
Pain Sites
Item Group
For Each Of The Sites Listed Below, Indicate The Severity Of Pain Present
Item
Other site
double
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C3303 (NCI Thesaurus Property)
C0030193 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
Code List
Other site
CL Item
None (None (Grade 0))
C41132 (NCI Thesaurus)
C0549184 (UMLS 2011AA)
CL Item
Mild Pain Not Interfering With Function (Mild pain not interfering with function (Grade 1))
CL Item
Moderate Pain; Pain Or Analgesics Interfeing With Function, But Not Interfering With Adl (Moderate pain interfering with function but not ADL (Grade 2))
CL Item
Severe Pain; Pain Or Analgesics Severely Interfering With Adl (Severe pain severly interfering with ADL (Grade 3))
CL Item
Disabling (Disabling (Grade 4))
DiseaseInvolvedSiteSpecify
Item
Specify site
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25547 (NCI Thesaurus Property)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
Item
Back
text
Code List
Back
CL Item
None (Grade 0) (None (Grade 0))
CL Item
Mild pain not interfering with function (Grade 1) (Mild pain not interfering with function (Grade 1))
CL Item
Moderate pain interfering with function but not ADL (Grade 2) (Moderate pain interfering with function but not ADL (Grade 2))
CL Item
Severe pain severly interfering with ADL (Grade 3) (Severe pain severly interfering with ADL (Grade 3))
CL Item
Disabling (Grade 4) (Disabling (Grade 4))
Item
Bone
text
Code List
Bone
CL Item
None (Grade 0) (None (Grade 0))
CL Item
Mild pain not interfering with function (Grade 1) (Mild pain not interfering with function (Grade 1))
CL Item
Moderate pain interfering with function but not ADL (Grade 2) (Moderate pain interfering with function but not ADL (Grade 2))
CL Item
Severe pain severly interfering with ADL (Grade 3) (Severe pain severly interfering with ADL (Grade 3))
CL Item
Disabling (Grade 4) (Disabling (Grade 4))
Item
Limb (leg or arm)
text
Code List
Limb (leg or arm)
CL Item
None (Grade 0) (None (Grade 0))
CL Item
Mild pain not interfering with function (Grade 1) (Mild pain not interfering with function (Grade 1))
CL Item
Moderate pain interfering with function but not ADL (Grade 2) (Moderate pain interfering with function but not ADL (Grade 2))
CL Item
Severe pain severly interfering with ADL (Grade 3) (Severe pain severly interfering with ADL (Grade 3))
CL Item
Disabling (Grade 4) (Disabling (Grade 4))
Item
Joint
text
Code List
Joint
CL Item
None (Grade 0) (None (Grade 0))
CL Item
Mild pain not interfering with function (Grade 1) (Mild pain not interfering with function (Grade 1))
CL Item
Moderate pain interfering with function but not ADL (Grade 2) (Moderate pain interfering with function but not ADL (Grade 2))
CL Item
Severe pain severly interfering with ADL (Grade 3) (Severe pain severly interfering with ADL (Grade 3))
CL Item
Disabling (Grade 4) (Disabling (Grade 4))
Item
Muscle
text
Code List
Muscle
CL Item
None (Grade 0) (None (Grade 0))
CL Item
Mild pain not interfering with function (Grade 1) (Mild pain not interfering with function (Grade 1))
CL Item
Moderate pain interfering with function but not ADL (Grade 2) (Moderate pain interfering with function but not ADL (Grade 2))
CL Item
Severe pain severly interfering with ADL (Grade 3) (Severe pain severly interfering with ADL (Grade 3))
CL Item
Disabling (Grade 4) (Disabling (Grade 4))
Item
Headache
text
Code List
Headache
CL Item
None (Grade 0) (None (Grade 0))
CL Item
Mild pain not interfering with function (Grade 1) (Mild pain not interfering with function (Grade 1))
CL Item
Moderate pain interfering with function but not ADL (Grade 2) (Moderate pain interfering with function but not ADL (Grade 2))
CL Item
Severe pain severly interfering with ADL (Grade 3) (Severe pain severly interfering with ADL (Grade 3))
CL Item
Disabling (Grade 4) (Disabling (Grade 4))
Item
Neck
text
Code List
Neck
CL Item
None (Grade 0) (None (Grade 0))
CL Item
Mild pain not interfering with function (Grade 1) (Mild pain not interfering with function (Grade 1))
CL Item
Moderate pain interfering with function but not ADL (Grade 2) (Moderate pain interfering with function but not ADL (Grade 2))
CL Item
Severe pain severly interfering with ADL (Grade 3) (Severe pain severly interfering with ADL (Grade 3))
CL Item
Disabling (Grade 4) (Disabling (Grade 4))
Item
IV site
text
Code List
IV site
CL Item
None (Grade 0) (None (Grade 0))
CL Item
Mild pain not interfering with function (Grade 1) (Mild pain not interfering with function (Grade 1))
CL Item
Moderate pain interfering with function but not ADL (Grade 2) (Moderate pain interfering with function but not ADL (Grade 2))
CL Item
Severe pain severly interfering with ADL (Grade 3) (Severe pain severly interfering with ADL (Grade 3))
CL Item
Disabling (Grade 4) (Disabling (Grade 4))
Item Group
Donor Pre-apheresis Vital Signs
PulseRate
Item
Pulse
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25749 (NCI Thesaurus ObjectClass)
C0391850 (UMLS 2011AA ObjectClass)
C25636 (NCI Thesaurus Property)
C1521828 (UMLS 2011AA Property)
BloodSystolicPressureMeasurement
Item
Blood pressure
double
C25209 (NCI Thesaurus ValueDomain)
C0242485 (UMLS 2011AA ValueDomain)
C25214 (NCI Thesaurus Property)
C0220825 (UMLS 2011AA Property)
C25298 (NCI Thesaurus ObjectClass)
C0871470 (UMLS 2011AA ObjectClass)
PersonTemperature
Item
Temperture
text
Item Group
Donor Pre-apheresis Hematology
HematologyLabCollectedDate
Item
Date of sample collection
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus ValueDomain)
LaboratoryProcedureLeukocyteCerebrospinalFluidOutcomeSpecifiedValue
Item
WBC
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C12692 (NCI Thesaurus Property)
C0007806 (UMLS 2011AA Property)
C12529 (NCI Thesaurus Property)
C0023516 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedurePlateletResultSpecifiedValue
Item
Platelets
double
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C12520 (NCI Thesaurus Property)
C0005821 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedureErythrocyteResultCount
Item
Hematocrit
double
C12521 (NCI Thesaurus Property)
C0014792 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
LaboratoryProcedureHemoglobinResultSpecifiedValue
Item
Hemoglobin
double
C16676 (NCI Thesaurus Property)
C0019046 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Item Group
Apheresis Procedure
Item Group
First Apheresis
StartTime
Item
Time procedure started
time
C25431 (NCI Thesaurus ObjectClass)
C0439659 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus ObjectClass)
C1533734 (UMLS 2011AA ObjectClass)
C25207 (NCI Thesaurus Property)
C0040223 (UMLS 2011AA Property)
CL219258 (NCI Metathesaurus Property)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
StopTime
Item
Time procedure ended
time
C25207 (NCI Thesaurus Property)
C0040223 (UMLS 2011AA Property)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C25409 (NCI Thesaurus ObjectClass)
C1533734 (UMLS 2011AA ObjectClass)
C65125 (NCI Thesaurus Property)
C1947925 (UMLS 2011AA Property)
Item
Does your center's blood cell separator calculate the time to complete the procedure
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25256 (NCI Thesaurus Property)
C1265611 (UMLS 2011AA Property)
Code List
Does your center's blood cell separator calculate the time to complete the procedure
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
WholeBloodTubesSubmittedCount
Item
Volume of whole blood cell processed
double
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C41067 (NCI Thesaurus ObjectClass)
C1608383 (UMLS 2011AA ObjectClass)
C25695 (NCI Thesaurus Property)
C1515023 (UMLS 2011AA Property)
C0175730 (NCI Metathesaurus Property)
Item
Did the donor receive clacium replacement to treat or prevent symptoms of hypocalcemia
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C331 (NCI Thesaurus ObjectClass)
C0006675 (UMLS 2011AA ObjectClass)
C1505 (NCI Thesaurus ObjectClass)
C0242295 (UMLS 2011AA ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
Code List
Did the donor receive clacium replacement to treat or prevent symptoms of hypocalcemia
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Proceduretimefromthebloodcellseparator
Item
Procedure time from the blood cell separator
text
Item Group
Specify Therapy
Item
Oral calcium for prevention
text
Code List
Oral calcium for prevention
CL Item
Yes (Yes)
CL Item
No (No)
Item
IV calcium for prevention
text
Code List
IV calcium for prevention
CL Item
Yes (Yes)
CL Item
No (No)
Item
Oral calcium for treatment
text
Code List
Oral calcium for treatment
CL Item
Yes (Yes)
CL Item
No (No)
Item
IV calcium for treatment
text
Code List
IV calcium for treatment
CL Item
Yes (Yes)
CL Item
No (No)
Item
Did the donor experience symptoms of hypocalcemia
text
Code List
Did the donor experience symptoms of hypocalcemia
CL Item
Yes (Yes)
CL Item
No (No)
Item
Specify symptoms
text
Code List
Specify symptoms
CL Item
Transient numbness or tingling (Transient numbness or tingling)
CL Item
Persistent, moderate numbness or tingling (Persistent, moderate numbness or tingling)
CL Item
Severe numbness or tingling (Severe numbness or tingling)
CL Item
Tetany (Tetany)
Item Group
Second Apheresis
StartTime
Item
Time procedure started
time
C25431 (NCI Thesaurus ObjectClass)
C0439659 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus ObjectClass)
C1533734 (UMLS 2011AA ObjectClass)
C25207 (NCI Thesaurus Property)
C0040223 (UMLS 2011AA Property)
CL219258 (NCI Metathesaurus Property)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
StopTime
Item
Time procedure ended
time
C25207 (NCI Thesaurus Property)
C0040223 (UMLS 2011AA Property)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C25409 (NCI Thesaurus ObjectClass)
C1533734 (UMLS 2011AA ObjectClass)
C65125 (NCI Thesaurus Property)
C1947925 (UMLS 2011AA Property)
Item
Does your center's blood cell separator calculate the time to complete the procedure
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25256 (NCI Thesaurus Property)
C1265611 (UMLS 2011AA Property)
Code List
Does your center's blood cell separator calculate the time to complete the procedure
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
WholeBloodTubesSubmittedCount
Item
Volume of whole blood cell processed
double
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C41067 (NCI Thesaurus ObjectClass)
C1608383 (UMLS 2011AA ObjectClass)
C25695 (NCI Thesaurus Property)
C1515023 (UMLS 2011AA Property)
C0175730 (NCI Metathesaurus Property)
Item
Did the donor receive clacium replacement to treat or prevent symptoms of hypocalcemia
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C331 (NCI Thesaurus ObjectClass)
C0006675 (UMLS 2011AA ObjectClass)
C1505 (NCI Thesaurus ObjectClass)
C0242295 (UMLS 2011AA ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
Code List
Did the donor receive clacium replacement to treat or prevent symptoms of hypocalcemia
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Was a second apheresis prodecure performed
text
Code List
Was a second apheresis prodecure performed
CL Item
Yes (Yes)
CL Item
No (No)
Proceduretimefromthebloodcellseparator
Item
Procedure time from the blood cell separator
text
Item Group
Specify Therapy
Item
Oral calcium for prevention
text
Code List
Oral calcium for prevention
CL Item
Yes (Yes)
CL Item
No (No)
Item
IV calcium for prevention
text
Code List
IV calcium for prevention
CL Item
Yes (Yes)
CL Item
No (No)
Item
Oral calcium for treatment
text
Code List
Oral calcium for treatment
CL Item
Yes (Yes)
CL Item
No (No)
Item
IV calcium for treatment
text
Code List
IV calcium for treatment
CL Item
Yes (Yes)
CL Item
No (No)
Item
Did the donor experience symptoms of hypocalcemia
text
Code List
Did the donor experience symptoms of hypocalcemia
CL Item
Yes (Yes)
CL Item
No (No)
Item
Specify symptoms
text
Code List
Specify symptoms
CL Item
Transient numbness or tingling (Transient numbness or tingling)
CL Item
Persistent, moderate numbness or tingling (Persistent, moderate numbness or tingling)
CL Item
Severe numbness or tingling (Severe numbness or tingling)
CL Item
Tetany (Tetany)
Item Group
Third Apheresis
StartTime
Item
Time procedure started
time
C25431 (NCI Thesaurus ObjectClass)
C0439659 (UMLS 2011AA ObjectClass)
C25409 (NCI Thesaurus ObjectClass)
C1533734 (UMLS 2011AA ObjectClass)
C25207 (NCI Thesaurus Property)
C0040223 (UMLS 2011AA Property)
CL219258 (NCI Metathesaurus Property)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
StopTime
Item
Time procedure ended
time
C25207 (NCI Thesaurus Property)
C0040223 (UMLS 2011AA Property)
C25207 (NCI Thesaurus ValueDomain)
C0040223 (UMLS 2011AA ValueDomain)
C25409 (NCI Thesaurus ObjectClass)
C1533734 (UMLS 2011AA ObjectClass)
C65125 (NCI Thesaurus Property)
C1947925 (UMLS 2011AA Property)
Item
Does your center's blood cell separator calculate the time to complete the procedure
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25256 (NCI Thesaurus Property)
C1265611 (UMLS 2011AA Property)
Code List
Does your center's blood cell separator calculate the time to complete the procedure
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
WholeBloodTubesSubmittedCount
Item
Volume of whole blood cell processed
double
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C41067 (NCI Thesaurus ObjectClass)
C1608383 (UMLS 2011AA ObjectClass)
C25695 (NCI Thesaurus Property)
C1515023 (UMLS 2011AA Property)
C0175730 (NCI Metathesaurus Property)
Item
Did the donor receive clacium replacement to treat or prevent symptoms of hypocalcemia
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C331 (NCI Thesaurus ObjectClass)
C0006675 (UMLS 2011AA ObjectClass)
C1505 (NCI Thesaurus ObjectClass)
C0242295 (UMLS 2011AA ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
Code List
Did the donor receive clacium replacement to treat or prevent symptoms of hypocalcemia
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
Was a third apheresis prodecure performed
text
Code List
Was a third apheresis prodecure performed
CL Item
Yes (Yes)
CL Item
No (No)
Proceduretimefromthebloodcellseparator
Item
Procedure time from the blood cell separator
text
Item Group
Specify Therapy
Item
Oral calcium for prevention
text
Code List
Oral calcium for prevention
CL Item
Yes (Yes)
CL Item
No (No)
Item
IV calcium for prevention
text
Code List
IV calcium for prevention
CL Item
Yes (Yes)
CL Item
No (No)
Item
Oral calcium for treatment
text
Code List
Oral calcium for treatment
CL Item
Yes (Yes)
CL Item
No (No)
Item
IV calcium for treatment
text
Code List
IV calcium for treatment
CL Item
Yes (Yes)
CL Item
No (No)
Item
Did the donor experience symptoms of hypocalcemia
text
Code List
Did the donor experience symptoms of hypocalcemia
CL Item
Yes (Yes)
CL Item
No (No)
Item
Specify symptoms
text
Code List
Specify symptoms
CL Item
Transient numbness or tingling (Transient numbness or tingling)
CL Item
Persistent, moderate numbness or tingling (Persistent, moderate numbness or tingling)
CL Item
Severe numbness or tingling (Severe numbness or tingling)
Item Group
Donor Post-apheresis Hematology
HematologyLabCollectedDate
Item
Date of sample collection
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus ValueDomain)
LaboratoryProcedureLeukocyteCerebrospinalFluidOutcomeSpecifiedValue
Item
WBC
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C12692 (NCI Thesaurus Property)
C0007806 (UMLS 2011AA Property)
C12529 (NCI Thesaurus Property)
C0023516 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedurePlateletResultSpecifiedValue
Item
Platelets
double
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C12520 (NCI Thesaurus Property)
C0005821 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
LaboratoryProcedureErythrocyteResultCount
Item
Hematocrit
double
C12521 (NCI Thesaurus Property)
C0014792 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
LaboratoryProcedureHemoglobinResultSpecifiedValue
Item
Hemoglobin
double
C16676 (NCI Thesaurus Property)
C0019046 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)

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