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1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Header module
Visit number
Item
Visit Number
float
C25337 (NCI Thesaurus ValueDomain)
C1549755 (UMLS CUI-1)
C16696 (NCI Thesaurus ObjectClass)
C25385 (NCI Thesaurus Property)
Segment
Item
Segment
text
Startofassessmentperiod
Item
Start of assessment period
text
Endofassessmentperiod
Item
End of assessment period
text
Item Group
Answer Questions 3-8 Relating To Acute Gvhd
Item
Maximum overall grade of acute GVHD during this assessment period
text
C4980 (NCI Thesaurus ObjectClass)
C0856825 (UMLS 2011AA ObjectClass)
C14140 (NCI Thesaurus ObjectClass-2)
C0205178 (UMLS 2011AA ObjectClass-2)
C25217 (NCI Thesaurus Property)
C1516048 (UMLS 2011AA Property)
C12981 (NCI Thesaurus Property-2)
C0332835 (UMLS 2011AA Property-2)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CL.1
Code List
Maximum overall grade of acute GVHD during this assessment period
CL Item
0 (No symptoms of acute GVHD)
C0919414 (NCI Metathesaurus)
CL Item
1 (I)
CL Item
2 (II)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
CL Item
3 (III)
CL Item
4 (IV)
DidthepatientdevelopacuteGVHD?
Item
Did clinical signs and/or symptoms of acute GVHD develop during this assessment
boolean
TransplantAcuteGVHDBeginDate
Item
Date of diagnosis of acute GVHD
date
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C14140 (NCI Thesaurus Property)
C0205178 (UMLS 2011AA Property)
C0018133 (NCI Metathesaurus Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
C0439659 (UMLS 2011AA ValueDomain-2)
Item
Record method used to diagnose acute GVHD
text
CL.3
Code List
Record method used to diagnose acute GVHD
CL Item
Histologic Evidence (Histologic Evidence)
CL Item
Clinical Evidence (Clinical Evidence)
CL Item
Both (Both)
WasprophylaxisforGVHDgivenduringthisassessmentperiod
Item
Was prophylaxis for GVHD given during this assessment period
boolean
Item Group
If Yes, Specify All Immuno Suppressants Used For Gvhd Prophylaxis
MedicationGraftVersusHostDiseaseAdministeredType
Item
Cyclosporine
boolean
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)
PriorChemotherapyOtherName
Item
Specify other agent used
text
C15632 (NCI Thesaurus ObjectClass)
C0392920 (UMLS 2011AA ObjectClass)
C25629 (NCI Thesaurus ObjectClass-2)
C0332152 (UMLS 2011AA ObjectClass-2)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property-2)
C0600091 (UMLS 2011AA Property-2)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ValueDomain-2)
C0205394 (UMLS 2011AA ValueDomain-2)
Tacrolimus
Item
Tacrolimus
boolean
Sirolumis
Item
Sirolumis
boolean
MMF
Item
MMF
boolean
Prednisone
Item
Prednisone
boolean
Other
Item
Other
boolean
Ifno,specifythedateGVHDprophylaxiswasdiscontinued
Item
If no, specify the date GVHD prophylaxis was discontinued
text
Item Group
Answer Questions 9-19 Relating To Chronic Gvhd
Item
Maximum overall severity of chronic GVHD during this assessment period
text
C25499 (NCI Thesaurus ObjectClass)
C0441471 (UMLS 2011AA ObjectClass)
C42614 (NCI Thesaurus ValueDomain)
C0027365 (UMLS 2011AA ValueDomain)
C25676 (NCI Thesaurus Property)
C0439793 (UMLS 2011AA Property)
CL.11
Code List
Maximum overall severity of chronic GVHD during this assessment period
CL Item
No symptoms of chronic GVHD (No symptoms of chronic GVHD)
CL Item
Mild (Mild)
C70666 (NCI Thesaurus)
C2945599 (UMLS 2011AA)
CL Item
Moderate (Moderate)
CL Item
Severe (Severe)
Item
Maximum overall grade of chronic GVHD during this assessment period
text
C14141 (NCI Thesaurus ObjectClass)
C0205191 (UMLS 2011AA ObjectClass)
C0018133 (NCI Metathesaurus ObjectClass)
C12981 (NCI Thesaurus Property)
C0332835 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C48309 (NCI Thesaurus ValueDomain)
C0441800 (UMLS 2011AA ValueDomain)
CL.12
Code List
Maximum overall grade of chronic GVHD during this assessment period
CL Item
Limited (Limited)
CL110648 (NCI Metathesaurus)
CL Item
Extensive (Extensive)
C47863 (NCI Thesaurus)
C0205231 (UMLS 2011AA)
CL Item
Did clinical signs and/or symptoms of chronic GVHD develop during this assessment (Did clinical signs and/or symptoms of chronic GVHD develop during this assessment)
CL Item
Yes (Yes)
CL Item
No (No)
Item
Current Karnofsky/Lansky score
text
C25367 (NCI Thesaurus Property)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
CL.63
Code List
Current Karnofsky/Lansky score
CL Item
Normal, No Complaints, No Evidence Of Disease (100 (Normal; No Complaints/Fully Active))
CL Item
Able To Carry On Normal Activity; Minor Signs Or Symptoms Of Disease (90 (Normal activity/minor restriction in strenuous play))
CL Item
Normal Activity With Effort; Some Signs Or Symptoms Of Disease (80 (Normal acitvity with efforts/restricted in strenuous play))
CL Item
Cares For Self, Unable To Carry On Normal Activity Or To Do Active Work (70 (Unable to carry on normal activity/less time spent in play))
CL Item
Requires Occasional Assistance, But Is Able To Care For Most Of His/her Needs (60 (Requires occasional assistance/minimal active play))
CL Item
Requires Considerable Assistance And Frequent Medical Care (50 (Requires considerable assistance/no active play))
CL Item
Disabled, Requires Special Care And Assistance (40 (Disabled/Able to initiate quiet activities))
CL Item
Severely Disabled, Hospitalization Indicated. Death Not Imminent (30 (Severely disabled/needs assistance for quiet play))
CL Item
Very Sick, Hospitalization Indicated. Death Not Imminent (20 (Very sick/limited to very passive activity))
CL Item
Moribund, Fatal Processes Progressing Rapidly (10 (Moribund; Completely disabled))
Item
Record method used to diagnose chronic GVHD
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C15220 (NCI Thesaurus ObjectClass)
C0011900 (UMLS 2011AA ObjectClass)
CL.13
Code List
Record method used to diagnose chronic GVHD
CL Item
Histology (Histologic Evidence)
C16681 (NCI Thesaurus)
C0019638 (UMLS 2011AA)
C16681 (NCI Thesaurus-3)
C0019638 (UMLS 2011AA-4)
CL Item
Clinical (Clinical Evidence)
C25398 (NCI Thesaurus)
C0205210 (UMLS 2011AA)
CL Item
Both (Both)
Platelets
Item
Current platelet count
float
C20200 (NCI Thesaurus Property)
C0005821 (UMLS CUI-1)
C12520 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
RelevantDiagnosticTestResultDate
Item
Date of diagnosis of chronic GVHD
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)
Patient Weight
Item
Current weight
float
C25209 (NCI Thesaurus ValueDomain)
C0005910 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25208 (NCI Thesaurus Property)
HepaticAlkalinePhosphataseLabValue
Item
Alkaline phosphatase at time of diagnosis
float
C13308 (NCI Thesaurus ObjectClass)
C0205054 (UMLS 2011AA ObjectClass)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C16276 (NCI Thesaurus Property-2)
C0002059 (UMLS 2011AA Property-2)
HepaticBilirubinLabValue
Item
Total bilirubin at time of diagnosis
float
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C305 (NCI Thesaurus Property-2)
C0005437 (UMLS 2011AA Property-2)
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Body Surface Area
Item
Body surface area involved with rash at time of diagnosis
float
C25209 (NCI Thesaurus ValueDomain)
C0005902 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25157 (NCI Thesaurus Property)
Item Group
Indicate The Maximum Severity Of Involvement For The Following Organ Systems During This Assessment Period
CommonToxicityCriteriaAdverseEventDyspneaGrade
Item
Dyspnea
float
C2998 (NCI Thesaurus Property)
C0013404 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CommonToxicityCriteriaAdverseEventPulmonaryFibrosisGrade
Item
Pulmonary fibrosis
float
C26869 (NCI Thesaurus Property)
C0034069 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CommonToxicityCriteriaAdverseEventForcedExpiratoryVolumein1SecondGrade
Item
FEV1
float
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C38084 (NCI Thesaurus Property)
C0849974 (UMLS 2011AA Property)
OxygenSaturation
Item
Oxygen saturation
float
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C0150411 (NCI Metathesaurus ObjectClass)
CL105480 (NCI Metathesaurus Property)
CommonToxicityCriteriaAdverseEventNauseaGrade
Item
Nausea and vomiting
float
C3258 (NCI Thesaurus Property)
C0027497 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CommonToxicityCriteriaAdverseEventDiarrheaGrade
Item
Diarrhea
float
C2987 (NCI Thesaurus Property)
C0011991 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CommonToxicityCriteriaAdverseEventGastrointestinalMalabsorptionSyndromeGrade
Item
Malabsorption
float
C13359 (NCI Thesaurus Property)
C0521362 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0024523 (NCI Metathesaurus Property)
CTCAdverseEventBilirubinGrade
Item
Bilirubin level
float
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C305 (NCI Thesaurus Property)
C0005437 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property-2)
C0678257 (UMLS 2011AA Property-2)
C305 (NCI Thesaurus ValueDomain)
C0005437 (UMLS 2011AA ValueDomain)
C18000 (NCI Thesaurus ValueDomain-2)
C0919553 (UMLS 2011AA ValueDomain-2)
CommonToxicityCriteriaAdverseEventVaginitisGrade
Item
Vaginitis
float
C26911 (NCI Thesaurus Property)
C0042267 (UMLS 2011AA Property)
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
CommonToxicityCriteriaAdverseEventMyositisGrade
Item
Myositis
boolean
C49704 (NCI Thesaurus ObjectClass)
C1516728 (UMLS 2011AA ObjectClass)
C18000 (NCI Thesaurus ValueDomain)
C0919553 (UMLS 2011AA ValueDomain)
C0027121 (NCI Metathesaurus Property)
DiseaseInvolvedSiteSpecify
Item
Specify other organ
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25547 (NCI Thesaurus Property-2)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
Item
Extent of skin involvement
text
CL.15
Code List
Extent of skin involvement
CL Item
No Rash (No Rash)
CL Item
<25% of BSA involvement (<25% of BSA involvement)
CL Item
25-50% of BSA involvement (25-50% of BSA involvement)
CL Item
>50% of BSA involvement (>50% of BSA involvement)
CL Item
Generalized involvement (Generalized involvement)
Ifthereisskininvolvement,indicatethetypeofrash
Item
If there is skin involvement, indicate the type of rash
text
Lichenoid
Item
Lichenoid
boolean
Maculpapular
Item
Maculpapular
boolean
Sclerodermatous
Item
Sclerodermatous
boolean
Item
Xerophthalmia
text
CL.19
Code List
Xerophthalmia
CL Item
No symptoms (No symptoms)
CL Item
Minimal symptoms, normal diet (Minimal symptoms, normal diet)
CL Item
Symptomatic but can eat and swallow modified diet (Symptomatic but can eat and swallow modified diet)
CL Item
Symptomatic and unable to adequately aliment or hydrate orally (Symptomatic and unable to adequately aliment or hydrate orally)
Item
Bronchiolitis obliterans
text
CL.22
Code List
Bronchiolitis obliterans
CL Item
Yes, histologic diagnosis (Yes, histologic diagnosis)
CL Item
Yes, clinical diagnosis (Yes, clinical diagnosis)
CL Item
No (No)
CL Item
Unknown (Unknown)
Item
Esophagus
text
CL.25
Code List
Esophagus
CL Item
No changes (No changes)
CL Item
Symptomatic but can ear regular diet (Symptomatic but can ear regular diet)
CL Item
Dysphagia or odynophagia requiring dietary changes (Dysphagia or odynophagia requiring dietary changes)
CL Item
Need for parenteral nutrition (Need for parenteral nutrition)
Answeroneofthenexttwoquestions
Item
Answer one of the next two questions
text
Item
Diarrhea (number of stools)
text
CL.28
Code List
Diarrhea (number of stools)
CL Item
Increase of <4 stools/day over baseline; mild increase in ostomy output compared to baseline (Increase of <4 stools/day over baseline; mild increase in ostomy output compared to baseline)
CL Item
Increase of 4-6 stools;IV fluids indicated <24 hrs;moderate increase in ostomy output (Increase of 4-6 stools;IV fluids indicated <24 hrs;moderate increase in ostomy output)
CL Item
Increase of 7 or more stools/day, IV fluids indicated <24 hrs;moderate increase in ostomy output (Increase of 7 or more stools/day, IV fluids indicated <24 hrs;moderate increase in ostomy output)
CL Item
Life-threatening consequences (e.g., hemodynamic collapse) (Life-threatening consequences (e.g., hemodynamic collapse))
CL Item
Death (Death)
Item
Diarrhea (volume of stools)
text
CL.29
Code List
Diarrhea (volume of stools)
CL Item
Diarrhea less than or equal to 500 mL/day or <280 mL/m^s (Diarrhea less than or equal to 500 mL/day or <280 mL/m^s)
CL Item
Diarrhea >500 but less than or equal to 1000 mL/day or 280-555 mL/m^2 (Diarrhea >500 but less than or equal to 1000 mL/day or 280-555 mL/m^2)
CL Item
Diarrhea >1000 but less than or equal to 1500 mL/day or 556-833 mL/m^2 (Diarrhea >1000 but less than or equal to 1500 mL/day or 556-833 mL/m^2)
CL Item
Diarrhea >1500 mL/day or >833 mL/m^2 (Diarrhea >1500 mL/day or >833 mL/m^2)
CL Item
Severe abdominal pain with or without ileus, stool with frank blood or melena (Severe abdominal pain with or without ileus, stool with frank blood or melena)
Item
Contractures
text
CL.33
Code List
Contractures
CL Item
No symptoms (No symptoms)
CL Item
Mild joint contractures (does not affect ADL) (Mild joint contractures (does not affect ADL))
CL Item
Severe joint contractures (intereferes with ADL) (Severe joint contractures (intereferes with ADL))
Eosinophilia
Item
Eosinophilia
boolean
Serositis
Item
Serositis
boolean
Fascitis
Item
Fascitis
boolean
Wasthereotherorganinvolvement
Item
Was there other organ involvement
text
Item Group
Answer Questions 42-48 Related To Biopsies Performed During This Assessment Period
BiopsyPerformedInd-3
Item
Were any biopsies performed during this assessment period for suspected GVHD
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C15189 (NCI Thesaurus ObjectClass)
C0005558 (UMLS 2011AA ObjectClass)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
Biopsy Date
Item
Date of biopsy
date
C25164 (NCI Thesaurus ValueDomain)
C0005558 (UMLS CUI-1)
C25367 (NCI Thesaurus ValueDomain-2)
C15189 (NCI Thesaurus ObjectClass)
C0011008 (UMLS CUI-2)
C25275 (NCI Thesaurus Property)
Item
Result of biopsy
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.40
Code List
Result of biopsy
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)
Item
Type of biopsy
text
CL.39
Code List
Type of biopsy
CL Item
Skin biopsy (Skin biopsy)
CL Item
Oral biopsy (Oral biopsy)
CL Item
Upper GI biopsy (Upper GI biopsy)
CL Item
Lower GI biopsy (Lower GI biopsy)
CL Item
Liver biopsy (Liver biopsy)
CL Item
Lung biopse (Lung biopse)
Item Group
Answer Questions 49-52 Relating To Gvhd
Item
Was a specific therapy used to treat GVHD during this assessment period
text
CL.41
Code List
Was a specific therapy used to treat GVHD during this assessment period
CL Item
Yes, initiated this assessment period (Yes, initiated this assessment period)
CL Item
Yes, continuing from previous assessment period (Yes, continuing from previous assessment period)
CL Item
No (No)
Item Group
If Yes, Indicate Whether Or Not The Agents Listed Below Were Used To Treat Gvhd During This Assessment Period
Item
Other
text
C17649 (NCI Thesaurus ObjectClass)
C0205394 (UMLS 2011AA ObjectClass)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C459 (NCI Thesaurus ObjectClass-2)
C0013227 (UMLS 2011AA ObjectClass-2)
C25409 (NCI Thesaurus Property)
C1533734 (UMLS 2011AA Property)
CL.60
Code List
Other
CL Item
Yes (Yes, still taking drug)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No (No, drug not given)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
other,specify
Item
Specify other agent used
text
C25179 (NCI Thesaurus ObjectClass)
C0019993 (UMLS 2011AA ObjectClass)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
PatientOff-TreatmentInd
Item
Has treatment been discontinued
boolean
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25601 (NCI Thesaurus Property)
C1518544 (UMLS 2011AA Property)
OffTreatmentDate
Item
If yes, enter date of discontinuation
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25601 (NCI Thesaurus ObjectClass)
C1518544 (UMLS 2011AA ObjectClass)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
Item
ALS, ALG, ATS, ATG
text
CL.42
Code List
ALS, ALG, ATS, ATG
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Azathioprine
text
CL.43
Code List
Azathioprine
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Cyclosporine
text
CL.44
Code List
Cyclosporine
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Systemic corticosteriods
text
CL.45
Code List
Systemic corticosteriods
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Topical corticosteroids
text
CL.46
Code List
Topical corticosteroids
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Thalidomide
text
CL.47
Code List
Thalidomide
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Tacrolimus
text
CL.48
Code List
Tacrolimus
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Mycophenolate Mofetil
text
CL.49
Code List
Mycophenolate Mofetil
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
PUVA (Psoralen and UVA)
text
CL.50
Code List
PUVA (Psoralen and UVA)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
ECP (Extra-corporeal photopheresis)
text
CL.51
Code List
ECP (Extra-corporeal photopheresis)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Sirolumis
text
CL.52
Code List
Sirolumis
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Etretinate
text
CL.53
Code List
Etretinate
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Lamprene
text
CL.54
Code List
Lamprene
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Etanercept
text
CL.55
Code List
Etanercept
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Zenapax
text
CL.56
Code List
Zenapax
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Chloroquine phosphate
text
CL.57
Code List
Chloroquine phosphate
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
In vivo anti T-lymphocyte monoclonal antibody
text
CL.58
Code List
In vivo anti T-lymphocyte monoclonal antibody
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Item
Specify in vivo anti T-lymphocyte monoclonal antibody used
text
CL.59
Code List
Specify in vivo anti T-lymphocyte monoclonal antibody used
CL Item
In vivo immunotoxin (In vivo immunotoxin)
CL Item
Yes, still taking drug (Yes, still taking drug)
CL Item
Yes, no longer taking drug (Yes, no longer taking drug)
CL Item
No, drug not given (No, drug not given)
Specifyinvivoimmunotoxin
Item
Specify in vivo immunotoxin
text
IndicatethebestresponsetoGVHDtherapyduringthisassessmentperiod
Item
Indicate the best response to GVHD therapy during this assessment period
text
Item Group
Answer Questions 53-56 Relating To Current Patient Status
DiseaseSymptomInd-3
Item
Are symptoms of GVHD still present
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
Item
Current Karnofsky/Lansky score
text
C25367 (NCI Thesaurus Property)
C20641 (NCI Thesaurus ObjectClass)
C1518965 (UMLS 2011AA ObjectClass)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
CL.63
Code List
Current Karnofsky/Lansky score
CL Item
Normal, No Complaints, No Evidence Of Disease (100 (Normal; No Complaints/Fully Active))
CL Item
Able To Carry On Normal Activity; Minor Signs Or Symptoms Of Disease (90 (Normal activity/minor restriction in strenuous play))
CL Item
Normal Activity With Effort; Some Signs Or Symptoms Of Disease (80 (Normal acitvity with efforts/restricted in strenuous play))
CL Item
Cares For Self, Unable To Carry On Normal Activity Or To Do Active Work (70 (Unable to carry on normal activity/less time spent in play))
CL Item
Requires Occasional Assistance, But Is Able To Care For Most Of His/her Needs (60 (Requires occasional assistance/minimal active play))
CL Item
Requires Considerable Assistance And Frequent Medical Care (50 (Requires considerable assistance/no active play))
CL Item
Disabled, Requires Special Care And Assistance (40 (Disabled/Able to initiate quiet activities))
CL Item
Severely Disabled, Hospitalization Indicated. Death Not Imminent (30 (Severely disabled/needs assistance for quiet play))
CL Item
Very Sick, Hospitalization Indicated. Death Not Imminent (20 (Very sick/limited to very passive activity))
CL Item
Moribund, Fatal Processes Progressing Rapidly (10 (Moribund; Completely disabled))
Platelets
Item
Current platelet count
float
C20200 (NCI Thesaurus Property)
C0005821 (UMLS CUI-1)
C12520 (NCI Thesaurus Property-2)
C25294 (NCI Thesaurus ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
Patient Weight
Item
Current weight
float
C25209 (NCI Thesaurus ValueDomain)
C0005910 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25208 (NCI Thesaurus Property)
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
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