ALLERGY - EORTC



|ALLERGY |

|AL LER Allergy |none |transient rash, fever |urticaria, fever = 38°C, |serum sickness, |anaphylaxis |

| | |( 38°C, 100.4°F |100.4°F, mild |bronchospasm, req | |

| | | |bronchospasm |parenteral meds | |

| |Fever felt to be caused by drug allergy should be coded as ALLERGY (AL LER). Non allergic drug fever (eg. as from biologics) | | | | |

| |should be coded under FLU-LIKE SYMPTOMS (FL FEV). If fever is due to infection, code INFECTION only (IN FEC or IN NEU). NB: | | | | |

| |Protocols requiring detailed reporting of hypersensitivity reactions, will include a Hypersensitivity Reaction module. | | | | |

|AL OTH other * |none |mild |moderate |severe |life threatening |

|BLOOD/BONE MARROW (SI UNITS) |

|BL WBC White Blood Count |( 4.0 109/l |3.0 - 3.9 |2.0 - 2.9 |1.0 - 1.9 |( 1.0 |

|(WBC) | | | | | |

|BL PLT Platelets |WNL 109/l |75.0 - normal |50.0 - 7 4.9 |25.0 - 49.9 |( 25.0 |

|BL HGB Hemoglobin (Hgb) |WNL g/l |100 - normal |80 - 99 |65 - 79 |( 65 |

|BL GRA granulocytes (i.e |( 2.0 109/l |1.5 - 1.9 |1.0 - 1.4 |0.5 - 0.9 |( 0.5 |

|neuts + bands) | | | | | |

|BL LYM Lymphocytes |( 2.0 109/l |1.5 - 1.9 |1.0 - 1.4 |0.5 - 0.9 |( 0.5 |

|BL HEM Hemorrhage |none |mild, no transfusion |gross, 1 - 2 units |gross, 3 - 4 units |massive, ( 4 units |

|resulting from | |(includes |transfusion per episode |transfusion per episode |transfusion per episode |

|thrombocytopenia | |bruise/hematoma, | | | |

|(clinical) | |petechiae) | | | |

|BL OTH Other * |none |mild |moderate |severe |life threatening |

|CANCER RELATED SYMPTOMS |

|CA DEA Death from |- |- |- |- |- |

|malignant disease within | | | | | |

|30 days of treatment * | | | | | |

|(grade = 5) | | | | | |

|CA PAI Cancer pain * |none |pain, but no treatment |pain controlled with |pain controlled with |uncontrollable pain |

| | |req |non-opioids |opioids | |

|CA SEC Second malignancy |none |- |- |present |- |

|* | | | | | |

|CA OTH Other * |none |mild |moderate |severe |life threatening |

|CARDIOVASCULAR |

|CD ART Arterial * |none |- |- |transient events (eg. |permanent event |

|(non myocardial) | | | |transient ischemic |(eg. cerebral vascular |

| | | | |attack) |accident) |

|CD VEN Venous * |none |superficial (excludes IV |deep vein thrombosis not |deep vein thrombosis req |pulmonary embolism |

| | |site reaction ( code SK |req anticoagulant therapy|anticoagulant therapy | |

| | |LTO) | | | |

|CD DYS Dysrhythmias |none |asymptomatic, transient, |recurrent or persistent, |req therapy |req monitoring, or |

| | |req no therapy |req no therapy | |hypotension, or |

| | | | | |ventricular tachy-cardia,|

| | | | | |or fibrillation |

|CD EDE Edema * |none |1+ or dependent in |2+ or dependent |3+ |4+, generalized anasarca |

|(eg. peripheral edema) | |evening only |throughout day | | |

|CD FUN Function |none |asymptomatic, decline of |asymptomatic, decline of |mild CHF, responsive to |severe or refractory CHF |

| | |resting ejection fraction|resting ejection fraction|therapy | |

| | |of ( 10% but ( 20% of |by ( 20% of baseline | | |

| | |baseline value |value | | |

|CD HBP Hypertension |none or no change |asymptomatic, transient |recurrent or persistent |req therapy |hypertensive crisis |

| | |increase by ( 20mm Hg (D)|increase by ( 20mm Hg (D)| | |

| | |or to ( 150/100 if |or to ( 150/100 if | | |

| | |previously WNL. |previously WNL. | | |

| | |No therapy req |No therapy req | | |

|CD LBP Hypotension |none or no change |changes req no therapy |req fluid replacement or |req therapy + |req therapy + |

| | |(incl. transient |other therapy but no |hospitalization; resolves|hospitalization for |

| | |orthostatic hypotension) |hospitalization |within 48hrs of stopping |( 48hrs after stopping |

| | | | |agent |agent |

|CD ISC Ischemia |none |non-specific T wave |asymptomatic, ST + T wave|angina without evidence |acute myocardial |

|(myocardial) | |flattening |changes suggesting |for infarction |infarction |

| | | |ischemia | | |

|CD PAI |none |pain, but no treatment |pain controlled with |pain controlled with |uncontrollable pain |

|Pain (chest) * | |req |non-opioids |opioids | |

|CD PER Pericardial |none |asymptomatic effusion |pericarditis (rub, chest |symptomatic effusion |tamponade, drainage |

| | |no intervention req |pain, ECG changes) |drainage req |urgently req; or |

| | | | | |constrictive pericarditis|

| | | | | |req surgery |

|CD TAC |none |mild |moderate |severe |life threatening |

|Sinus tachycardia * | | | | | |

|CD OTH Other * |none |mild |moderate |severe |life threatening |

|COAGULATION | | | | | |

|CG FIB Fibrinogen |WNL |0.99 - 0.75 x N |0.74 - 0.50 x N |0.49 - 0.25 x N |( 0.24 x N |

|CG PT Prothrombin time |WNL |1.01 - 1.25 x N |1.26 - 1.50 x N |1.51 - 2.00 x N |( 2.00 x N |

|CG PTT Partial |WNL |1.01 - 1.66 x N |1.67 - 2.33 x N |2.34 - 3.00 x N |( 3.00 x N |

|thromboplastin time | | | | | |

|CG OTH Other * |none |mild |moderate |severe |life threatening |

|DENTITION (TEETH) | | | | | |

|DE DEC |none |mild |moderate |severe |- |

|Tooth decay* | | | | | |

|DE PAI Toothache* |none |pain, but no treatment |pain controlled with |pain controlled with |uncontrollable pain |

| | | |non-opioids |opioids | |

|DE OTH Other * |none |mild |moderate |severe |life threatening |

|ENDOCRINE* |

|EN AME Amenorrhea |no |irregular menses |( 3 months |- |- |

|EN CUS |normal |mild |pronounced |- |- |

|Cushingoid | | | | | |

|EN FLA |none |mild or ( 1/day |moderate & ( 1/day |frequent & interferes |- |

|Hot flashes | | | |with normal function | |

|EN GYN |normal |mild |pronounced or painful |- |- |

|Gynecomastia | | | | | |

|EN IMP |normal |decrease in normal |- |absence of function |- |

|Impotence/Libido | |function | | | |

|EN OTH Other |none |mild |moderate |severe |life threatening |

|FLU-LIKE SYMPTOMS | | | | | |

|FL FEV fever in absence |none |37.1 - 38.0°C |38.1 - 40.0°C |> 40.0°C |( 40.0°C (104.0°F) for ( |

|of infect. * | |98.7 - 100.4°F |100.5 - 104.0°F |> 104.0°F |24 hrs or fever |

|(incl. drug fever) | | | |for ( 24 hrs |accompanied by |

| | | | | |hypotension |

| |Fever felt to be caused by drug allergy should be coded as ALLERGY (AL LER). Non-allergic drug fever (eg. as from biologics) | | | |

| |should be coded under FLU-LIKE SYMPTOMS (FL FEV). If fever is due to infection, code INFECTION only (IN FEC or IN NEU). | | | |

|FL HAY Hayfever* |none |mild |moderate |severe |- |

|(includes sneezing, nasal| | | | | |

|stuffiness, post-nasal | | | | | |

|drip) | | | | | |

|FL JOI Arthralgia* (joint|none |mild |moderate |severe |- |

|pain) | | | | | |

|FL LET Lethargy* |none |mild, fall of 1 level in |moderate, fall of 2 |severe, fall of 3 levels |- |

|(fatigue, malaise) | |perf. status |levels in perf. status |in perf. status | |

|FL MYA Myalgia* (muscle |none |mild |moderate |severe |- |

|ache) | | | | | |

|FL RIG Rigors/Chills* |none |mild or brief |pronounced or /and |cyanosis |- |

|(Gr 3 incl cyanosis) | | |prolonged | | |

|FL SWE Sweating* |none |mild |moderate |severe |- |

|(diaphoresis) | | | | | |

|FL OTH Other* |none |mild |moderate |severe |life threatening |

|GASTROINTESTINAL | | | | |

|GI ANO Anorexia* |none |mild |moderate |severe |dehydration |

|GI APP |none |mild |moderate |- |- |

|Appetite increased* | | | | | |

|GI ASC Ascites |none |mild |moderate |severe |life threatening |

|(non malignant)* | | | | | |

|GI DIA Diarrhea |none |increase of 2 - 3 stools |increase of 4 - 6 stools |increase of 7 - 9 stools |increase of ( 10 stools |

| | |per day ; or mild |per day, or nocturnal |per day, or incontinence,|per day, or grossly |

| | |increase of loose watery |stools; or moderate |malabsorption; or severe |bloody diarrhea, or |

| | |colostomy output compared|increase in loose watery |increase in loose watery |grossly bloody clostomy |

| | |to pre-trt |colostomy output compared|colostomy output compared|output or loose watery |

| | | |to pre-trt |with pre-trt |colostomy output req |

| | | | | |parenteral support; |

| | | | | |dehydration |

|GI DPH |none |dys.or odyn. not req trt,|dys.or odyn. req trt |dys. or odyn. lasting |dys. or odyn. with 10% |

|Esophagitis/ | |or painless ulcers on | |( 14 days despire trt |loss of body wt, |

|dysphagia/ | |esophagoscopy | | |dehydration, hosp. req |

|odynophagia* (incl recall| | | | | |

|reaction) | | | | | |

|GI DRY Mouth, |none |mild |moderate |severe |- |

|nose dryness* | | | | | |

|GI FIS Fistula* |none |- |- |req intervention |req operation |

|(intestinal, esophageal, | | | | | |

|rectal) | | | | | |

|GI GAS |none |mild |moderate |severe |- |

|Flatulence* | | | | | |

|GI HEA |none |mild |moderate |severe |- |

|Heartburn* | | | | | |

|(incl. dyspepsia) | | | | | |

|GI HEM |none |mild, no transfusion |gross, 1 - 2 units |gross, 3 - 4 units |massive ( 4 units |

|Gastrointestinal | | |transfusion per espisode |transfusion per episode |transfusion per episode |

|bleeding * | | | | | |

| |Bleeding resulting from thrombocytopenia should be coded under BL HEM, not GI |

|GI NAU Nausea |none |able to eat reasonable |intake significantly |no significant intake |- |

| | |intake |decreased but can eat | | |

|GI OBS Small bowel |no |- |intermittent, no |req intervention |req operation |

|obstruction* | | |intervention | | |

|GI PAI |none |pain, but no treatment |pain controlled with |pain controlled with |uncontrollable pain |

|Gastrointestinal | |req |non-opioids |opioids | |

|pain/cramping* | | | | | |

|(incl. rectal pain) | | | | | |

|GI PRO Proctitis (rectal)|none |perianal itch, |tenesmus or ulcerations |tenesmus or ulcerations |mucosal necrosis with |

| | |hemorrhoids |relieved with therapy, |or other symptoms not |hemorrhage or other life |

| | | |anal fissure |relieved with therapy |threatening proctitis |

|GI STO Stomatitis/ |none |painless ulcers, |painful erythema, edema, |painful erythema, edema, |mucosal necrosis and/or |

|oral | |erythema, or mild |or ulcers, |or ulcers, and cannot eat|req parenteral or enteral|

| | |soreness |but can eat | |support, dehydration |

|GI TAS Taste, sense of |none |mild |moderate |severe |- |

|smell altered* | | | | | |

|GI ULC |none |antacid |req vigourous medical |uncontrolled by medical |perforation or bleeding |

|Gastritis/ulcer* | | |management or |management; req surgery | |

| | | |non-surgical trt |for GI ulceration | |

|GI VOM Vomiting |none |1 episode in 24hrs |2 - 5 episodes in 24hrs |6 - 10 episodes in 24hrs |> 10 episodes in 24hrs or|

| | | | | |req parenteral support, |

| | | | | |dehydration |

|GI OTH Other* |none |mild |moderate |severe |life threatening |

|GENITO-URINARY | | | | |

|GU BLA |none |light epithelial atrophy,|generalized |severe generalized |necrosis, or contracted |

|Bladder changes* | |or minor telangiectasia |telangiectasia |telangiectasia (often |bladder (capacity ( 100 |

| | | | |with petechiae) or |ml), or fibrosis |

| | | | |reduction in bladder | |

| | | | |capacity (( 15 ml) | |

|GU CRE |WNL |( 1.5 x N |1.5 - 3.0 x N |3.1 - 6.0 x N |( 6.0 x N |

|Creatinine | | | | | |

|GU CYS Cystitis* |none |mild symptoms, req no |symptoms relieved |symptoms not relieved |severe (life threatening)|

|(non bacterial) | |intervention |completely with ther. |despite therapy |cystitis |

| |Urinary tract infection should be coded under infection not GU | | | |

|GU FIS Fistula* |none |- |- |req intervention |req operation |

|(vaginal, vesicovaginal) | | | | | |

|GU FRE |none |freq of urination or |freq of urination or |freq with urgency and |- |

|Frequency* | |nocturia twice pre-trt |nocturia ( hourly |nocturia ( hourly | |

| | |habit | | | |

|GU HEM |negative |micro only |gross, no clots |gross + clots |req transfusion |

|Hematuria, bleeding per | | | | | |

|vagina | | | | | |

| |Bleeding resulting from thrombocytopenia should be coded under BL HEM not GU. |

|GU INC |none |mild |moderate |severe |- |

|Incontinence* | | | | | |

|GU OBS Ureteral |none |unilateral, no surgery |bilateral, no surgery req|not complete bilateral, |complete bilateral |

|obstruction* | | | |but stents, nephrostomy |obstruction |

| | | | |tubes or surgery req | |

|GU PAI Genito-urinary |none |pain, but no treatment |pain controlled with |pain controlled with |uncontrollable pain |

|pain * (eg : dysuria, | |req |non-opioids |opioids | |

|dysmenorrhea, | | | | | |

|dyspareunia) | | | | | |

|GU PRT Proteinuria |no change |1 + |2 - 3 + |4 + |nephrotic syndrome |

| | |or ( 0.3 g/% |or 0.3 - 1.0 g/% |or ( 1.0 g/% | |

| | |or ( 3 g/l |or 3 - 10 g/l |or ( 10 g/l | |

|GU VAG Vaginitis* |none |mild, no trt req |moderate, relieved with |severe, not relieved with|life threatening |

|(+/- vaginal discharge) | | |trt |trt | |

|(non-infectious) | | | | | |

|GU OTH Other* |none |mild |moderate |severe |life-threatening |

|HEPATIC |

|HP ALK Alk. Phos |within normal limits |( 2.5 x N (Normal) |2.6 - 5.0 x N |5.1-20.0 x N |( 20 x N |

|or 5'nucleotidase |(WNL) | | | | |

|HP ALT Transaminase SGPT |WNL |( 2.5 x N (Normal) |2.6 - 5.0 x N |5.1-20.0 x N |( 20 x N |

|(ALT) | | | | | |

|HP AST Transaminase SGOT |WNL |( 2.5 x N (Normal) |2.6 - 5.0 x N |5.1 - 20.0 x N |( 20 x N |

|(AST) | | | | | |

|HP BIL Bilirubin |WNL |- |( 1.5 x N |1.5 - 3.0 x N |( 3.0 x N |

|HP CLI Liver (clinical) |no change from baseline |- |- |precoma |hepatic coma |

|HP LDH LDH* |WNL |( 2.5 x N (Normal) |2.6 - 5.0 x N |5.1 - 20.0 x N |( 20 x N |

|HP OTH Other* |none |mild |moderate |severe |life-threatening |

| |Viral Hepatitis should be coded as infection rather than liver toxicity. | | | | |

|INFECTION |

|IN FEC Infection |none |mild, no active therapy |moderate, localized |severe systemic |life threatening sepsis, |

| | | |infection, active therapy|infection, req parenteral|specify site |

| | | |req |trt, specify site | |

|IN NEU Febrile |none |- |- |present |- |

|Neutropenia* | | | | | |

|Absolute granulocyt count|Fever felt to be caused by drug allergy should be coded as ALLERGY (AL LER). Non-allergy drug fever (eg. as from biologics) should| | | |

|( 1.0 x 109/l, fever ( |be coded under FLU-LIKE SYMPTOMS (FL FEV). If fever is due to infection, code INFECTION only (IN FEC or IN NEU). | | | |

|38.5 °C treated with | | | | |

|(or ought to have been | | | | |

|treated with ) IV | | | | |

|antibiotics | | | | |

|METABOLIC (SI UNITS) |

|MT AMY Amylase |WNL |( 1.5 x N |1.5 - 2.0 x N |2.1 - 5.0 x N |( 5.1 x N |

|MT HCA Hypercalcemia |( 2.64 mmol/l |2.64 - 2.88 |2.89 - 3.12 |3.13 - 3.37 |( 3.37 |

|MT LCA Hypocalcemia |( 2.10 mmol/l |2.10 - 1.93 |1.92 - 1.74 |1.73 - 1.51 |( 1.50 |

|MT HGL Hyperglycemia |( 6.44 mmol/l |6.44 - 8.90 |8.91 - 13.8 |13.9 - 27.8 |( 27.8 or ketoacidosis |

|MT LGL hypoglycemia |( 3.55 mmol/l |3.03 - 3.55 |2.19 - 3.02 |1.66 - 2.18 |( 1.66 |

|MT LKA Hypokalemia* |no change or ( 3.5 mmol/l|3.1 - 3.5 |2.6 - 3.0 |2.1 - 2.5 |( 2.0 |

|MT LMA Hypomagnesemia |( 0.70 mmol/l |0.70 - 0.58 |0.57 - 0.38 |0.37 - 0.30 |( 0.29 |

|MT LNA Hyponatremia* |no change or >135 mmol/l |131 - 135 |126 - 130 |121 - 125 |( 120 |

|MT OTH Other* |none |mild |moderate |severe |life threatening |

|NEUROLOGIC |

|NE CER Cerebellar |none |slight incoordination, |intention tremor, |locomotor ataxia |cerebellar necrosis |

| | |dysdiadochokinesis |dysmetria, slurred | | |

| | | |speech, nystagmus | | |

|NE CON Constipation |none or no change |mild |moderate |severe, obstipation |ileus ( 96 hrs |

|NE COR Cortical |none |mild somnolence |moderate somnolence |severe somnolence, |coma, seizures, |

|(includes drowsiness) | | | |confusion, |toxic psychosis |

| | | | |disorientation, | |

| | | | |hallucinations | |

|NE DIZ Dizziness* |none |mild |moderate |severe |- |

|(includes | | | |(includes fainting) | |

|lightheadedness) | | | | | |

|NE EXT Extrapyramidal/ |none |mild agitation |moderate agitation |torticollis, oculogyric |- |

|Involuntary movement* | |(includes restlessness) | |crisis, severe agitation | |

|NE HED Headache |none |mild |moderate or severe but |unrelenting and severe |- |

| | | |transient | | |

|NE HER |none or no change |asymptomatic hearing loss|tinnitus, symptomatic |hearing loss interfering |hearing changes or |

|Altered hearing | |on audiometry only |hearing changes not req |with function but |deafness not correctable |

| | | |hearing aid or trt |correctable with hearing | |

| | | | |aid or trt | |

|NE INS Insomnia* |none |mild |moderate |severe |- |

|NE MOO Mood |no change |mild anxiety or |moderate anxiety or |severe anxiety or |suicidal ideation |

| | |depression |depression |depression | |

|NE MOT Motor |none or no change |subjective weakness, no |mild objective weakness |objective weakness with |paralysis |

| | |objective findings |without significant |impairment of function | |

| | | |impairment of function | | |

|NE PAI |none |pain, but no treatment |pain controlled with |pain controlled with |uncontrollable pain |

|Neurologic pain* | |req |non-opioids |opioids | |

|(eg : jaw pain) | | | | | |

|NE PER |no change |change, not disruptive to|disruptive to patient or |harmful to others or self|psychosis |

|Personality change* | |patient or family |family | | |

|NE SEN Sensory |none or no change |mild paresthesias, loss |mild or moderate |sensory loss or |- |

| | |of deep tendon reflexes |objective sensory loss, |paresthesias that | |

| | |(including tingling) |moderate paresthesias |interfere with function | |

|NE VIS Vision |none or no change |blurred vision |- |symptomatic subtotal loss|blindness |

| | | | |of vision | |

|NE OTH Other * |none |mild |moderate |severe |life-threatening |

|(includes pain) | | | | | |

| |Code chest pain CD PAI, muscle aches (myalgia) FL MYA, abdominal pain GI PAI, and local pain at IV site SK LTO. For all other | | | |

| |types of pain (eg. bone pain), code NE OTH. | | | |

|OCULAR |

|OC CAT Cataract * |none |mild |moderate |severe |- |

|OC CJN Conjunctivis/ |none |erythema or chemosis not |req trt steroids or |corneal ulceration or |- |

|Keratitis | |req steroids or |antibiotics |visible opacification | |

| | |antibiotics | | | |

|OC DRY Dry eye |normal |mild |req artificial tears |severe |req enucleation |

|OC GLA Glaucoma |no change |- |- |yes |- |

|OC PAI Eye pain * |none |pain, but no treatment |pain controlled with |pain controlled with |uncontrollable pain |

| | |req |non-opioids |opioids | |

|OC TEA Tearing * (watery |none |mild |moderate |severe |- |

|eyes) | | | | | |

|OC OTH Other |none |mild |moderate |severe |life threatening |

|OSSEOUS (BONE) | | | | | |

|OS PAI Bone pain* |none |pain, but no treatment |pain controlled with |pain controlled with |uncontrollable pain |

| | |req |non-opioids |opioids | |

|OS OTH Other* (eg. |none |mild |moderate |severe |life threatening |

|avascular necrosis) | | | | | |

|PULMONARY |

|PU CMD Carbon Monoxide |( 90% |decrease to 76 - 90% |decrease to 51 - 75% |decrease to 26 - 50% |decrease to ( 25% |

|Diffusion Capacity |of pretreatment value |of pre-trt |of pre-trt |of pre-trt |of pre-trt |

|(DLCO)* | | | | | |

|PU COU Cough* |none |mild |moderate |severe |- |

|PU EDE |none |- |out-patient management |in-patient management |req intubation |

|Pulmonary edema* | | | | | |

|PU EFF |none |mild |moderate |severe |life threatening |

|Pleural effusion* | | | | | |

|(non-malignant) | | | | | |

|PU FIB Pulmonary |normal |radiographic changes, |- |changes with symptoms |- |

|fibrosis* | |no symptoms | | | |

|PU HEM |none |mild, no transfusion |gross, 1 - 2 units |gross, 3 - 4 units |massive, ( 4 units |

|Hemoptysis* | | |transfusion per episode |transfusion per episode |transfusion per episode |

| |Bleeding resulting from thrombocytopenia should be coded under BL HEM, not PU |

|PU HIC |none |mild |moderate |severe |- |

|Hiccoughs* | | | | | |

|PU PAI |none |pain , but not treatment |pain controlled with |pain controlles with |uncontrollable pain |

|Pulmonary pain* | |req |non-opioids |opioids | |

|PU PNE |normal |radiographic changes, |steroids req |oxygen req |req assisted ventilation |

|Pneumonitis* | |symptoms do not req | | | |

|(non-infectious) | |steroids | | | |

|PU SOB Shortness of |none or no change |asymptomatic, with |dyspnea on significant |dyspnea at normal level |dyspnea at rest, apnea |

|breath (dyspnea) | |abnormality in PFT's |exertion |of activity, apnea |with cyanosis |

|(incl wheezing) | | | |without cyanosis | |

|PU VOI |none |mild |moderate |severe |- |

|Voice changes* (incl. | | | | | |

|hoarseness, loss of | | | | | |

|voice) | | | | | |

|PU OTH Other* |none |mild |moderate |severe |life-threatening |

| |Pneumonia should be considered infection and not graded as pulmonary toxicity unless felt to be resultant from pulmonary changes | | | | |

| |directly induced by treatment | | | | |

|SKIN |

|SK ALO Alopecia |no loss |mild hair loss |pronounced or total head |total body hair loss |- |

| | | |hair loss | | |

|SK CHA |none |localized pigmentation |generalized pigmentation |subcut.fibrosis or |generalized ulcerations |

|Skin changes* (eg. | |changes |changes or atrophy |localized shallow |or necrosis |

|photosensitivity) | | | |ulceration | |

|SK DES |none |dry desquamation |moist desquamation |confluent moist |- |

|Desquamation* | | | |desquamation | |

|SK DRY Dry skin* |none |mild |moderate |severe |- |

|SK FAC Flushing* |none |mild |moderate |severe |- |

|(eg:-facial) | | | | | |

|SK HEM |none |mild, no transfusion |gross, 1 - 2 units |gross, 3 - 4 units |massive, ( 4 units |

|Bruising/bleeding | | |transfusion per episode |transfusion per episode |transfusion per episode |

| |Bleeding from thrombocytopenia should be coded under BL HEM, not SK |

|SK LTO |none |pain |pain and swelling, with |ulceration |plastic surgery indicated|

|Local toxicity | | |inflammation or phlebitis| | |

|(reaction at IV site) | | | | | |

|SK NAI |none |mild |moderate |severe |- |

|Nail changes* | | | | | |

|SK PAI Skin pain* |none |pain, but no treatment |pain controlled with |pain controlled with |uncontrollable pain |

|(include sclap pain) | |req |non-opioids |opioids | |

|SK RAS Rash/Itch* |none or no change |scattered macular or |scattered macular or |generalized symptomatic |exfoliative dermatitis or|

|(not due to allergy) | |papular eruption or |papular eruption or |macular, papular, or |ulcerating dermatitis |

|(includes recall | |erythema that is |erythema with pruritus or|vesicular eruption | |

|reaction) | |asymptomatic |other associated symptoma| | |

|SK OTH Other* |none |mild |moderate |severe |life threatening |

|WEIGHT |

|WT GAI |( 5.0% |5.0 - 9.9% |10.0 - 19.9% |( 20.0% |- |

|Weight Gain | | | | | |

|WT LOS |( 5.0% |5.0 - 9.9% |10.0 - 19.9% |( 20.0% |- |

|Weight Loss | | | | | |

|OTHER |

|OT OTH Other* |none |mild |moderate |severe |life-threatening |

| |For toxicity which do not have an existing code, but do fit into an existing toxicity category, use "other" variable in the | | | |

| |appropriate toxicity category (eg. code sinus tachycardia CARDIOVASCULAR OTHER (CD OTH). Only toxicities which do not fit into | | | |

| |existing categories should be coded OTHER OTHER (OT OTH). | | | |

| | | | | |

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