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Slow accrual
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The purpose of this study is to evaluate how effective rituximab and acalabrutinib are when given as a combination treatment for newly diagnosed B cell post transplant lymphoproliferative disorder (PTLD). Currently there is no approved therapy for PTLD. Rituximab alone is commonly used and works in some cases, but not others. In addition, participants with PTLD have trouble tolerating therapies with large amounts of side effects due to their health conditions and medications for their transplant. Due to these reasons the study team is looking for a new treatment with novel targeted agents in order to improve outcomes and to minimize toxicity.
Based on emerging data of clinical efficacy of acalabrutinib in B cell malignancies and an unmet need for novel therapies in PTLD, this study will investigate the use of rituximab and acalabrutinib in participants with newly diagnosed B cell PTLD.
This is a non-randomized phase II study of acalabrutinib plus rituximab in newly diagnosed B-cell PTLD in participants with both solid organ transplant (SOT) and Bone marrow transplant (BMT).
Acalabrutinib is an inhibitor of Bruton Tyrosine Kinase (BTK). BTK is important in B cells and plays a role in the development of PTLD. Acalabrutinib is approved in the US for the treatment of adult participants with indolent lymphoma, mantle cell lymphoma, and is being evaluated to treat other lymphomas.
Rituximab has been approved for treatment of B cell non-Hodgkin lymphoma (NHL). While not approved for PTLD, it has become the mainstay of treatment.
The primary objective of this study is to determine the overall response rate to combination treatment with rituximab and acalabrutinib in patients with PTLD.
The secondary objectives of this study is to determine response rates, survival, failure rates, and safety elements in participants with PTLD treated with combination rituximab and acalabrutinib.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rituximab and Acalabrutinib | Experimental | Participants will receive treatment of Rituximab weekly for 4 weeks, and Acalabrutinib twice daily for 4 weeks. Response assessment via diagnostic CT scans will dictate further treatment decisions. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rituximab | Drug | Weekly x 4 weeks. If diagnostic test reveals complete response, then participant will continue with one additional 28 day cycle. If partial response, then proceed with 3 additional 28 day cycles. If stable disease or progression of disease, then go off study treatment and proceed onto Long Term Follow Up (LTFU). |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Response Rate (ORR) | ORR will be estimated along with 90% Confidence Intervals (CIs), and compared against the null using exact binomial test. Logistic regression model will be used to identify factors associated with response status. | Up to 8 weeks after treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Complete Response Rate (CRR) | CRR is defined as all patients that achieve a CR based on end of treatment scans, using the Lugano Criteria | at 6 months after treatment |
| Complete Response Rate (CRR) |
Not provided
Inclusion Criteria:
Subjects must have a biopsy confirmed newly diagnosed CD20 positive B cell PTLD.
Eastern Cooperative Oncology Group (ECOG) performance status of 0-2. ECOG 3 will be permitted if the decline in performance status is due to lymphoma. [See Appendix 1]
Subjects must have adequate hematologic, hepatic, and renal function as defined below:
Women of childbearing potential and men must agree to use adequate contraception (double barrier method of birth control or abstinence) during treatment and for 12 months after last dose of study treatment. Women who have undergone surgical sterilization or who have been postmenopausal for at least 2 years are not considered to be of childbearing potential.
Subjects must be willing and able to participate in all required evaluations and procedures in this study protocol including swallowing capsules without difficulty
Subjects must have the ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Deepa Jagadeesh, MD, MPH | Cleveland Clinic, Case Comprehensive Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cleveland Clinic, Case Comprehensive Cancer Center | Cleveland | Ohio | 44195 | United States |
There are no plans to share individual patient data in order to protect the confidentiality of the subjects who enroll on this study
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| ID | Title | Description |
|---|---|---|
| FG000 | Rituximab and Acalabrutinib | Participants will receive treatment of Rituximab weekly for 4 weeks, and Acalabrutinib twice daily for 4 weeks. Response assessment via diagnostic CT scans will dictate further treatment decisions. Rituximab: Weekly x 4 weeks. If diagnostic test reveals complete response, then participant will continue with one additional 28 day cycle. If partial response, then proceed with 3 additional 28 day cycles. If stable disease or progression of disease, then go off study treatment and proceed onto Long Term Follow Up (LTFU). Acalabrutinib: 100mg twice per day (BID) x 4 weeks (28 day cycle) If diagnostic test reveals complete response, then participant will continue with one additional 28 day cycle. If partial response, then proceed with 3 additional 28 day cycles. If stable disease or progression of disease, then go off study treatment and proceed onto LTFU. CT scans: 2 weeks (day 36 ± 5 days) after end of cycle 1 treatment. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Rituximab and Acalabrutinib | Participants will receive treatment of Rituximab weekly for 4 weeks, and Acalabrutinib twice daily for 4 weeks. Response assessment via diagnostic CT scans will dictate further treatment decisions. Rituximab: Weekly x 4 weeks. If diagnostic test reveals complete response, then participant will continue with one additional 28 day cycle. If partial response, then proceed with 3 additional 28 day cycles. If stable disease or progression of disease, then go off study treatment and proceed onto Long Term Follow Up (LTFU). Acalabrutinib: 100mg twice per day (BID) x 4 weeks (28 day cycle) If diagnostic test reveals complete response, then participant will continue with one additional 28 day cycle. If partial response, then proceed with 3 additional 28 day cycles. If stable disease or progression of disease, then go off study treatment and proceed onto LTFU. CT scans: 2 weeks (day 36 ± 5 days) after end of cycle 1 treatment. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| 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 | Overall Response Rate (ORR) | ORR will be estimated along with 90% Confidence Intervals (CIs), and compared against the null using exact binomial test. Logistic regression model will be used to identify factors associated with response status. | Sponsor terminated financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close enrollment and to cease long-term follow-up of subjects. Zero participants were followed past the end of treatment for several reasons, including removal of funding that prevented follow-up or participants reaching stable disease (per protocol, participant does not get followed). Therefore, no data was collected. | Posted | Up to 8 weeks after treatment |
|
Adverse events were assessed on all subjects from the point of Eligibility Screening (baseline) to 30 days following the last dose of the study drug (which was 10 months on average).
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Rituximab and Acalabrutinib | Participants will receive treatment of Rituximab weekly for 4 weeks, and Acalabrutinib twice daily for 4 weeks. Response assessment via diagnostic CT scans will dictate further treatment decisions. Rituximab: Weekly x 4 weeks. If diagnostic test reveals complete response, then participant will continue with one additional 28 day cycle. If partial response, then proceed with 3 additional 28 day cycles. If stable disease or progression of disease, then go off study treatment and proceed onto Long Term Follow Up (LTFU). Acalabrutinib: 100mg twice per day (BID) x 4 weeks (28 day cycle) If diagnostic test reveals complete response, then participant will continue with one additional 28 day cycle. If partial response, then proceed with 3 additional 28 day cycles. If stable disease or progression of disease, then go off study treatment and proceed onto LTFU. CT scans: 2 weeks (day 36 ± 5 days) after end of cycle 1 treatment. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Lung infection | Infections and infestations | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anemia | Blood and lymphatic system disorders | Non-systematic Assessment |
Early termination leading to small numbers of subjects, unable to perform analysis of data.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Deepa Jagadeesh | Cleveland Clinic Foundation, Case Comprehensive Cancer Center | 1-866-223-8100 | TaussigResearch@ccf.org |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 2, 2021 | Aug 22, 2023 | Prot_SAP_001.pdf |
| ICF | No | No | Yes | Informed Consent Form | Jul 2, 2021 | Jun 12, 2023 | ICF_000.pdf |
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| ID | Term |
|---|---|
| D000069283 | Rituximab |
| C000604908 | acalabrutinib |
| D014057 | Tomography, X-Ray Computed |
| ID | Term |
|---|---|
| D058846 | Antibodies, Monoclonal, Murine-Derived |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
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|
|
| Acalabrutinib | Drug | 100mg twice per day (BID) x 4 weeks (28 day cycle) If diagnostic test reveals complete response, then participant will continue with one additional 28 day cycle. If partial response, then proceed with 3 additional 28 day cycles. If stable disease or progression of disease, then go off study treatment and proceed onto LTFU. |
|
|
| CT scans | Diagnostic Test | 2 weeks (day 36 ± 5 days) after end of cycle 1 treatment. |
|
CRR is defined as all patients that achieve a CR based on end of treatment scans, using the Lugano Criteria
| at 12 months after treatment |
| Complete Response Rate (CRR) | CRR is defined as all patients that achieve a CR based on end of treatment scans, using the Lugano Criteria | at 24 months after treatment |
| Partial Response Rate (PRR) | PRR is defined as all patients that achieve a PR based on end of treatment scans, using the Lugano Criteria. | at 6 months after treatment |
| Partial Response Rate (PRR) | PRR is defined as all patients that achieve a PR based on end of treatment scans, using the Lugano Criteria. | at 12 months after treatment |
| Partial Response Rate (PRR) | PRR is defined as all patients that achieve a PR based on end of treatment scans, using the Lugano Criteria. | at 24 months after treatment |
| Duration of Response (DOR) | DOR is only measured in responders. DOR is defined as the time from documented response (CR or PR) to the time of confirmed disease progression or death due to any cause, whichever occurs first. Subjects who are still alive and free from progression at the time of data cutoff date, lost to follow-up, have discontinued study, or have initiated other non-protocol anti-tumor therapy (NPT) will be censored at the last tumor assessment when subjects are progression-free. | Up to 3 years after treatment |
| Progression Free Survival (PFS) | PFS as defined as the time from first dose to documented disease progression, or death from any cause, whichever occurs first. Data for subjects who are still alive and free from progression at the time of data cutoff date, lost to follow-up, have discontinued the study, or have initiated NPT will be censored on last assessment (or, if no post-baseline tumor assessment, at the time of first dose plus 1 day) Estimated using Kaplan-Meier method and compared using log-rank test. Cox proportional hazard model will be used to identify factors associated with survival endpoint. | at 6 months after treatment |
| Progression Free Survival (PFS) | PFS as defined as the time from first dose to documented disease progression, or death from any cause, whichever occurs first. Data for subjects who are still alive and free from progression at the time of data cutoff date, lost to follow-up, have discontinued the study, or have initiated NPT will be censored on last assessment (or, if no post-baseline tumor assessment, at the time of first dose plus 1 day) Estimated using Kaplan-Meier method and compared using log-rank test. Cox proportional hazard model will be used to identify factors associated with survival endpoint. | at 12 months after treatment |
| Progression Free Survival (PFS) | PFS as defined as the time from first dose to documented disease progression, or death from any cause, whichever occurs first. Data for subjects who are still alive and free from progression at the time of data cutoff date, lost to follow-up, have discontinued the study, or have initiated NPT will be censored on last assessment (or, if no post-baseline tumor assessment, at the time of first dose plus 1 day) Estimated using Kaplan-Meier method and compared using log-rank test. Cox proportional hazard model will be used to identify factors associated with survival endpoint. | at 24 months after treatment |
| Overall Survival (OS) | Overall survival (OS) is defined as the time from first dose to death from any cause. Data for subjects who are still alive at the time of data cutoff date, lost to follow-up, have discontinued the study (or, if no post-baseline assessment, at the time of first dose plus 1 day) will be censored on last assessment Estimated using Kaplan-Meier method and compared using log-rank test. Cox proportional hazard model will be used to identify factors associated with survival endpoint. | Up to 3 years after treatment |
| Time to Treatment Failure (TTF) | TTF is measured from the time from study entry to any treatment failure including discontinuation of treatment for any reason, such as disease progression, toxicity, patient preference, initiation of new treatment without documented progression, or death. | Up to 3 years after treatment |
| Number of Participants With a Grade 3 Adverse Event (AE) or Higher | Safety as defined by number of participants with a grade 3 AE or higher | Up to 3 years after treatment |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
| Secondary | Complete Response Rate (CRR) | CRR is defined as all patients that achieve a CR based on end of treatment scans, using the Lugano Criteria | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 6 months; therefore, no data was collected. | Posted | at 6 months after treatment |
|
|
| Secondary | Complete Response Rate (CRR) | CRR is defined as all patients that achieve a CR based on end of treatment scans, using the Lugano Criteria | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 12 months, therefore, no data was collected. | Posted | at 12 months after treatment |
|
|
| Secondary | Complete Response Rate (CRR) | CRR is defined as all patients that achieve a CR based on end of treatment scans, using the Lugano Criteria | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 24 months, therefore, no data was collected. | Posted | at 24 months after treatment |
|
|
| Secondary | Partial Response Rate (PRR) | PRR is defined as all patients that achieve a PR based on end of treatment scans, using the Lugano Criteria. | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 6 months; therefore, no data was collected. | Posted | at 6 months after treatment |
|
|
| Secondary | Partial Response Rate (PRR) | PRR is defined as all patients that achieve a PR based on end of treatment scans, using the Lugano Criteria. | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 12 months, therefore, no data was collected. | Posted | at 12 months after treatment |
|
|
| Secondary | Partial Response Rate (PRR) | PRR is defined as all patients that achieve a PR based on end of treatment scans, using the Lugano Criteria. | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 24 months; therefore, no data was collected. | Posted | at 24 months after treatment |
|
|
| Secondary | Duration of Response (DOR) | DOR is only measured in responders. DOR is defined as the time from documented response (CR or PR) to the time of confirmed disease progression or death due to any cause, whichever occurs first. Subjects who are still alive and free from progression at the time of data cutoff date, lost to follow-up, have discontinued study, or have initiated other non-protocol anti-tumor therapy (NPT) will be censored at the last tumor assessment when subjects are progression-free. | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 3 years; therefore, no data was collected. | Posted | Up to 3 years after treatment |
|
|
| Secondary | Progression Free Survival (PFS) | PFS as defined as the time from first dose to documented disease progression, or death from any cause, whichever occurs first. Data for subjects who are still alive and free from progression at the time of data cutoff date, lost to follow-up, have discontinued the study, or have initiated NPT will be censored on last assessment (or, if no post-baseline tumor assessment, at the time of first dose plus 1 day) Estimated using Kaplan-Meier method and compared using log-rank test. Cox proportional hazard model will be used to identify factors associated with survival endpoint. | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 6 months, therefore, no data was collected. | Posted | at 6 months after treatment |
|
|
| Secondary | Progression Free Survival (PFS) | PFS as defined as the time from first dose to documented disease progression, or death from any cause, whichever occurs first. Data for subjects who are still alive and free from progression at the time of data cutoff date, lost to follow-up, have discontinued the study, or have initiated NPT will be censored on last assessment (or, if no post-baseline tumor assessment, at the time of first dose plus 1 day) Estimated using Kaplan-Meier method and compared using log-rank test. Cox proportional hazard model will be used to identify factors associated with survival endpoint. | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 12 months; therefore, no data was collected. | Posted | at 12 months after treatment |
|
|
| Secondary | Progression Free Survival (PFS) | PFS as defined as the time from first dose to documented disease progression, or death from any cause, whichever occurs first. Data for subjects who are still alive and free from progression at the time of data cutoff date, lost to follow-up, have discontinued the study, or have initiated NPT will be censored on last assessment (or, if no post-baseline tumor assessment, at the time of first dose plus 1 day) Estimated using Kaplan-Meier method and compared using log-rank test. Cox proportional hazard model will be used to identify factors associated with survival endpoint. | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 24 months; therefore, no data was collected. | Posted | at 24 months after treatment |
|
|
| Secondary | Overall Survival (OS) | Overall survival (OS) is defined as the time from first dose to death from any cause. Data for subjects who are still alive at the time of data cutoff date, lost to follow-up, have discontinued the study (or, if no post-baseline assessment, at the time of first dose plus 1 day) will be censored on last assessment Estimated using Kaplan-Meier method and compared using log-rank test. Cox proportional hazard model will be used to identify factors associated with survival endpoint. | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 3 years; therefore, no data was collected. | Posted | Up to 3 years after treatment |
|
|
| Secondary | Time to Treatment Failure (TTF) | TTF is measured from the time from study entry to any treatment failure including discontinuation of treatment for any reason, such as disease progression, toxicity, patient preference, initiation of new treatment without documented progression, or death. | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 3 years; therefore, no data was collected. | Posted | Up to 3 years after treatment |
|
|
| Secondary | Number of Participants With a Grade 3 Adverse Event (AE) or Higher | Safety as defined by number of participants with a grade 3 AE or higher | Due to notification by AstraZeneca to terminate financial support of all research activity not associated with active subjects receiving study medication enrolled under this IND, it has been decided to close the study to enrollment and to cease long-term follow-up of subjects not actively receiving study medication. Participants were unable to be followed after the end of treatment for 3 years; therefore, no data was collected. | Posted | Up to 3 years after treatment |
|
|
| 1 |
| 6 |
| 2 |
| 6 |
| 3 |
| 6 |
| Dyspnea | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| Supraventricular tachycardia | Cardiac disorders | Non-systematic Assessment |
|
| Abdominal pain | Gastrointestinal disorders | Non-systematic Assessment |
|
| Anal hemorrhage | Gastrointestinal disorders | Non-systematic Assessment |
|
| Constipation | Gastrointestinal disorders | Non-systematic Assessment |
|
| Diarrhea | Gastrointestinal disorders | Non-systematic Assessment |
|
| Dyspepsia | Gastrointestinal disorders | Non-systematic Assessment |
|
| Fatigue | General disorders | Non-systematic Assessment |
|
| Fever | General disorders | Non-systematic Assessment |
|
| Infections and infestations | Infections and infestations | Non-systematic Assessment | Infections and infestations - Other, specify - COVID |
|
| Lung infection | Infections and infestations | Non-systematic Assessment |
|
| Bruising | Injury, poisoning and procedural complications | Non-systematic Assessment |
|
| Alkaline phosphatase increased | Investigations | Non-systematic Assessment |
|
| Lymphocyte count decreased | Investigations | Non-systematic Assessment |
|
| Neutrophil count decreased | Investigations | Non-systematic Assessment |
|
| White blood cell decreased | Investigations | Non-systematic Assessment |
|
| Anorexia | Metabolism and nutrition disorders | Non-systematic Assessment |
|
| Hyperglycemia | Metabolism and nutrition disorders | Non-systematic Assessment |
|
| Hypernatremia | Metabolism and nutrition disorders | Non-systematic Assessment |
|
| Hypoalbuminemia | Metabolism and nutrition disorders | Non-systematic Assessment |
|
| Hyponatremia | Metabolism and nutrition disorders | Non-systematic Assessment |
|
| Dizziness | Nervous system disorders | Non-systematic Assessment |
|
| Headache | Nervous system disorders | Non-systematic Assessment |
|
| Insomnia | Psychiatric disorders | Non-systematic Assessment |
|
| Urinary Urgency | Renal and urinary disorders | Non-systematic Assessment |
|
| Cough | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| Dyspnea | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| Sore throat | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
|
| Hypertension | Vascular disorders | Non-systematic Assessment |
|
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| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D007090 | Image Interpretation, Computer-Assisted |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D011856 | Radiographic Image Enhancement |
| D007089 | Image Enhancement |
| D010781 | Photography |
| D011859 | Radiography |
| D014056 | Tomography, X-Ray |
| D014054 | Tomography |