INSTRUCTIONS: Complete this form as indicated below and at the end of all protocol therapy. Submit original to the ECOG Coordinating Center. Keep a copy for your files.
INSTRUCTIONS: Complete this form as indicated below and at the end of all protocol therapy. Submit original to the ECOG Coordinating Center. Keep a copy for your files.
Febrile Neutropenia (fever Of Unknown Origin Without Clinically Or Microbiologically Documented Infection) (anc <1.0 X 10^9/l, Fever >=38.5 Degrees C) (Febrile neutropenia)
CL Item
Pyrexia (Fever (in absence of neutropenia, where neutropenia is defined as ANC <1000))
Hemorrhage/bleeding Other (Hemorrhage/Bleeding - Other)
CL Item
Alopecia (Hair loss/alopecia (head or body))
C2865 (NCI Thesaurus)
CL Item
Fatigue (Fatigue (asthenia, lethargy, malaise))
C3036 (NCI Thesaurus) C0015672 (UMLS 2011AA)
CL Item
Rigors (Rigors/Chills)
C0424790 (NCI Metathesaurus)
CL Item
Hearing: Patients Without Baseline Audiogram And Not Enrolled In A Monitoring Program (Hearing: patients without baseline audiogram and not enrolled in a monitoring program)
CL Item
Otitis Media Serous Nos (Otitis, middle ear (non-infectious))
Infection (documented Clinically Or Microbiologically) With Grade 3 Or 4 Neutrophils (anc <1.0 X 10^9/l) (CTC Adverse Event Infection (documented clinically or microbiologically) with Grade 3 or 4 neutrophils (ANC < 1.0 X 10^9/L) - Select Grade)
CL Item
Infection With Normal Anc Or Grade 1 Or 2 Neutrophils (CTC Adverse Event Infection with normal ANC or Grade 1 or 2 neutrophils - Select Grade)
CL Item
Infection With Unknown Anc (Infection with unknown ANC - Select Grade)