Supersaturated Calcium Phosphate Rinse in Preventing Oral... | NCT01305200

NCT01305200

ID	Type	Description	Link
NCI-2011-02635	Registry Identifier	CTRP (Clinical Trial Reporting Program)
CDR0000695718	Other Identifier	Clinical Trials.gov
ACCL1031	Other Identifier	Children's Oncology Group
COG-ACCL1031	Other Identifier	DCP
ACCL1031	Other Identifier	CTEP
U10CA095861	U.S. NIH Grant/Contract		View source

Status Module

Name	Class
National Cancer Institute (NCI)	NIH

Description Module

Detailed Description

PRIMARY OBJECTIVES:

I. To determine if topically administered supersaturated calcium phosphate (Caphosol), rinsed orally four times daily at the initiation of conditioning for hematopoietic stem cell transplantation (HSCT), reduces oral mucositis as demonstrated by a decrease in duration of severe oral mucositis (World Health Organization [WHO] grade 3 or 4), compared to placebo.

SECONDARY OBJECTIVES:

I. To determine whether Caphosol administration, when compared to placebo, reduces oral mucositis as demonstrated by a decrease in incidence of severe oral mucositis (WHO grade 3 or 4); severity of mucositis according to mouth pain categorical rating scale and Oral Mucositis Daily Questionnaire (OMDQ); incidence, total dose, and duration of parenteral opioid analgesic use (morphine equivalents); and incidence and duration of total parenteral nutrition (TPN) administration.

II. To determine whether Caphosol administration, when compared to placebo, reduces the incidence of febrile neutropenia and invasive bacterial infections.

III. To validate a new pediatric measure of oral mucositis termed the Children's International Mucositis Evaluation Scale (ChIMES).

OUTLINE: This is a multicenter study. Patients are stratified according to conditioning regimen (total-body irradiation (TBI) or melphalan vs neither TBI nor melphalan) and hematopoietic stem cell transplantation (HSCT) (autologous vs allogeneic). Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute four* times daily (QID) beginning on the first day (about day -7) of the conditioning regimen.

ARM II: Patients rinse and gargle with placebo over 1 minute QID* beginning the first day (about day -7) of the conditioning regimen.

NOTE: * Patients who reach WHO grade 3 or 4 mucositis have the option to request a total of 6 rinses daily.

In both arms, treatment continues until day 20 post-transplantation OR until mucositis resolves to WHO grade =< 2 for two consecutive days OR on day 12 in patients who do not experience oral mucositis of at least WHO grade >= 1. Patients are assessed daily by trained healthcare professionals using the Oral Mucositis Daily Questionnaire (OMDQ), the Pain Rating Scale, the WHO Mucositis Scale, and the Children's International Mucositis Evaluation Scale (ChIMES) from day -1 and continuing until day 20. Patients are also observed for the incidence of total dose and duration of parenteral opioid analgesic use, duration of total parenteral nutrition (TPN) administration, febrile neutropenia, and invasive bacterial infections.

After completion of study therapy, patients are followed up for 30 days.

Conditions Module

Arms/Interventions Module

Arm Groups

Label	Type	Description	Intervention Names
Arm I (placebo)	Placebo Comparator	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation.	Other: placebo Other: questionnaire administration Procedure: quality-of-life assessment
Arm II (supersaturated calcium phosphate rinse)	Experimental	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation.	Drug: supersaturated calcium phosphate rinse Other: questionnaire administration Procedure: quality-of-life assessment

Name	Type	Description	Arm Group Labels	Other Names
supersaturated calcium phosphate rinse	Drug	Mouth rinse	Arm II (supersaturated calcium phosphate rinse)

Outcomes Module

Primary Outcomes

Measure	Description	Time Frame
Duration of Severe Oral Mucositis (WHO Grade 3 or 4)	Mean days of severe (WHO Grade 3 or 4) Mucositis.	Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

Secondary Outcomes

Measure	Description	Time Frame
Incidence of Severe Oral Mucositis	Percentage of patients with Severe Oral Mucositis (WHO Grade 3 or 4) per arm.	Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.
Oral Mucositis Daily Questionnaire (OMDQ)

Measure	Description	Time Frame
Ancillary Validation Study of ChIMES		Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

Eligibility Module

Name	Affiliation	Role
Nathaniel Treister, MD	Children's Oncology Group	Principal Investigator

Facility	Status	City	State	ZIP	Country	Contacts
Children's Oncology Group		Arcadia	California	91006-3776	United States
City of Hope

PubMed Identifier	Type	Citation	Retractions
27875526	Background	Treister N, Nieder M, Baggott C, Olson E, Chen L, Dang H, Krailo M, August A, Sung L. Caphosol for prevention of oral mucositis in pediatric myeloablative haematopoietic cell transplantation. Br J Cancer. 2017 Jan 3;116(1):21-27. doi: 10.1038/bjc.2016.380. Epub 2016 Nov 22.

Label	URL
Data Available: Select individual patient-level data from this trial can be requested from the NCTN/NCORP Data Archive.	View source

Results Section

Participant Flow Module

Arm/Group Information

ID	Title	Description
FG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
FG001

Baseline Characteristics Module

Outcome Measures Module

Adverse Events Module

More Info Module

Arm/Group Information

ID	Title	Description
BG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
BG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
BG002	Arm III (Enrolled Not Randomized)	Site not able to randomize.
BG003	Total	Total of all reporting groups

Baseline Measures

Title

Description

Population Description

Parameter Type

Dispersion Type

Unit of Measure

Calculate Percentage

Denominator Units Selected

Denominators

Classes

Age, Continuous

Mean

Standard Deviation

years

Title

Denominators

Categories

Title	Measurements
	BG00012.75± 5.05 BG00113.02± 4.54 BG00212.00± 1.73 BG003

Sex: Female, Male

Count of Participants

Participants

Title

Denominators

Categories

Title	Measurements
Female	BG00054 BG00148 BG002

Ethnicity (NIH/OMB)

Count of Participants

Participants

Title

Denominators

Categories

Title	Measurements
Hispanic or Latino	BG00025 BG00129 BG002

Race (NIH/OMB)

Count of Participants

Participants

Title

Denominators

Categories

Title	Measurements
American Indian or Alaska Native	BG0000 BG0011 BG002

Region of Enrollment

Count of Participants

Participants

Title

Denominators

Categories

Canada

Title	Measurements
	BG0005 BG0014 BG002

Type

Title

Description

Population Description

Reporting Status

Anticipated Posting Date

Parameter Type

Dispersion Type

Unit of Measure

Calculate Percentage

Time Frame

Units Analyzed

Denominator Units Selected

Arm/Group Information

Denominators

Classes

Analyses

Primary

Duration of Severe Oral Mucositis (WHO Grade 3 or 4)

Mean days of severe (WHO Grade 3 or 4) Mucositis.

Evaluable patients defined as patients with >= 11 daily WHO assessments.

Posted

Mean

Standard Deviation

Number of days

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants	OG00091 OG00191

Title

Denominators

Categories

Title	Measurements
	OG0004.5± 4.8 OG0014.5± 5

Secondary

Incidence of Severe Oral Mucositis

Percentage of patients with Severe Oral Mucositis (WHO Grade 3 or 4) per arm.

Evaluable patients defined as patients with >= 11 daily WHO assessments.

Posted

Number

percent of patients

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants

Secondary

Oral Mucositis Daily Questionnaire (OMDQ)

Area under the curve (AUC) of the Oral Mucositis Daily Questionnaire (OMDQ) subscales

Evaluable patients defined as patients with ≥11 daily WHO assessments.

Posted

Mean

Standard Deviation

units on a scale * day

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants

Secondary

Incidence of Parenteral Opioid Analgesic Use (Morphine Equivalents).

Opioid Administration = yes

Total of 210 patients evaluable for this assessment (106 Arm I & 104 Arm II)

Posted

Number

percentage of participants

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants

Secondary

Duration of Parenteral Opioid Analgesic Use (Morphine Equivalents).

Mean days of parenteral opioid analgesic use.

Total of 210 patients evaluable for this assessment (106 Arm I & 104 Arm II).

Posted

Mean

Standard Deviation

Days

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants

Secondary

Total Dose of Parenteral Opioid Analgesic Used (Morphine Equivalents).

Morphine equivalent dose in mg/kg/day

Total of 210 patients evaluable for this assessment (106 Arm I & 104 Arm II).

Posted

Median

Full Range

mg/kg/day of opioid analgesics

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants

Secondary

Incidence of Total Parenteral Nutrition (TPN) Administration.

Total Parenteral Nutrition = yes

Total of 210 patients evaluable for this assessment (106 Arm I & 104 Arm II).

Posted

Number

percentage of participants

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants

Secondary

Duration of Total Parenteral Nutrition (TPN) Administration.

Mean days of total parenteral nutrition (TPN) administration.

Total of 210 patients evaluable for this assessment (106 Arm I & 104 Arm II).

Posted

Mean

Standard Deviation

Number of days

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants

Secondary

Incidence of Febrile Neutropenia

Fever and Neutropenia = yes

Total of 210 patients evaluable for this assessment (106 Arm I & 104 Arm II).

Posted

Number

percentage of participants

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants

Secondary

Incidence of Invasive Bacterial Infections

Invasive Bacterial Infection = yes

Total of 210 patients evaluable for this assessment (106 Arm I & 104 Arm II).

Posted

Number

percentage of participants

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants

Secondary

Severity of Mucositis

Area Under the Curve of Severity of Mucositis. According to mouth pain categorical rating scale ranges 0-10 with higher scores reflecting more severe pain.

Evaluable patients defined as patients with ≥11 daily WHO assessments.

Posted

Mean

Standard Deviation

units on a scale * day

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts

Other Pre-specified

Ancillary Validation Study of ChIMES

Analysis is not performed at this time due to no available funding and no human resource allocated to this study.

Posted

Day -1 (day prior to stem cell infusion) to Day 20 following transplantation.

ID	Title	Description
OG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies
OG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies

Units	Counts
Participants

Arm/Groups

ID	Title	Description	Deaths (Affected)	Deaths (At Risk)	Serious Events (Affected)	Serious Events (At Risk)	Other Events (Affected)	Other Events (At Risk)
EG000	Arm I (Placebo)	Patients rinse and gargle with placebo over 1 minute QID beginning the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. placebo: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies			0	106	29	106
EG001	Arm II (Supersaturated Calcium Phosphate Rinse)	Patients rinse and gargle with supersaturated calcium phosphate rinse over 1 minute QID beginning on the first day (about day -7) of the conditioning regimen. Treatment continues until day 20 post-transplantation. supersaturated calcium phosphate rinse: Mouth rinse questionnaire administration: Ancillary studies quality-of-life assessment: Ancillary studies			3	104	22	104

Other Adverse Events

Term	Organ System	Statistical Information
Allergic reaction	Immune system disorders	EG0000 affected106 at risk EG0011 affected104 at risk
Anaphylaxis	Immune system disorders	EG0000 affected106 at risk EG0011 affected104 at risk
Diarrhea	Gastrointestinal disorders	EG0000 affected106 at risk EG0011 affected104 at risk
Dysgeusia	Nervous system disorders	EG0002 affected106 at risk EG0012 affected104 at risk
Hypocalcemia	Metabolism and nutrition disorders	EG0001 affected106 at risk EG0010 affected104 at risk
Hypokalemia	Metabolism and nutrition disorders	EG0001 affected106 at risk EG0010 affected104 at risk
Infections and infestations - Other, specify	Infections and infestations	EG00012 affected106 at risk EG0018 affected104 at risk
Neutrophil count decreased	Investigations	EG0000 affected106 at risk EG0011 affected104 at risk
Oral pain	Gastrointestinal disorders	EG00016 affected106 at risk EG00113 affected104 at risk
Pain	General disorders	EG0001 affected106 at risk EG0010 affected104 at risk
Rash acneiform	Skin and subcutaneous tissue disorders	EG0001 affected106 at risk EG0010 affected104 at risk
Seizure	Nervous system disorders	EG0001 affected106 at risk EG0010 affected104 at risk
Urinary tract infection	Infections and infestations	EG0001 affected106 at risk EG0010 affected104 at risk

Ancestor Terms

ID	Term
D007951	Leukemia, Myeloid
D007938	Leukemia
D009370	Neoplasms by Histologic Type
D009369	Neoplasms
D054437	Myelodysplastic-Myeloproliferative Diseases
D001855	Bone Marrow Diseases
D006402	Hematologic Diseases
D006425	Hemic and Lymphatic Diseases
D002908	Chronic Disease
D020969	Disease Attributes
D010335	Pathologic Processes
D013568	Pathological Conditions, Signs and Symptoms
D005759	Gastroenteritis
D005767	Gastrointestinal Diseases
D004066	Digestive System Diseases
D009059	Mouth Diseases
D009057	Stomatognathic Diseases
D007945	Leukemia, Lymphoid
D008232	Lymphoproliferative Disorders
D008206	Lymphatic Diseases
D007160	Immunoproliferative Disorders
D007154	Immune System Diseases
D015620	Histiocytic Disorders, Malignant
D015614	Histiocytosis
D020031	Epstein-Barr Virus Infections
D006566	Herpesviridae Infections
D004266	DNA Virus Infections
D014777	Virus Diseases
D007239	Infections
D014412	Tumor Virus Infections
D016393	Lymphoma, B-Cell
D008228	Lymphoma, Non-Hodgkin
D008223	Lymphoma
D004701	Endocrine Gland Neoplasms
D009371	Neoplasms by Site
D005834	Genital Neoplasms, Male
D014565	Urogenital Neoplasms
D005832	Genital Diseases, Male
D000091662	Genital Diseases
D000091642	Urogenital Diseases
D052801	Male Urogenital Diseases
D004700	Endocrine System Diseases
D013733	Testicular Diseases
D006058	Gonadal Disorders
D018193	Neoplasms, Complex and Mixed
D007680	Kidney Neoplasms
D014571	Urologic Neoplasms
D009386	Neoplastic Syndromes, Hereditary
D052776	Female Urogenital Diseases
D005261	Female Urogenital Diseases and Pregnancy Complications
D007674	Kidney Diseases
D014570	Urologic Diseases
D030342	Genetic Diseases, Inborn
D009358	Congenital, Hereditary, and Neonatal Diseases and Abnormalities

ID	Term
C580364	Pdgfra-Associated Chronic Eosinophilic Leukemia
D015477	Leukemia, Myelomonocytic, Chronic
D015467	Leukemia, Neutrophilic, Chronic
D054429	Leukemia, Myelomonocytic, Juvenile
D052016	Mucositis
D009196	Myeloproliferative Disorders
D054198	Precursor Cell Lymphoblastic Leukemia-Lymphoma
D054739	Dendritic Cell Sarcoma, Interdigitating
D002051	Burkitt Lymphoma
D013736	Testicular Neoplasms
D009396	Wilms Tumor
D012008	Recurrence