Components of a comprehensive treatment summary.
| Essential Elements . | Details . |
|---|---|
| Demographics | Name, date of birth, treating institution, treatment team |
| Cancer diagnosis | Date, site(s), stage |
| Medical history | Hereditary/congenital history, major medical events (in addition to cancer diagnosis) |
| Relapse(s) | Date(s) and site(s), if applicable |
| Subsequent malignant neoplasms | Date(s), types, if applicable |
| Protocol(s) | Title(s)/number(s), dates initiated and completed |
| Completion of therapy | Date |
| Chemotherapy | Names and administration routes for all agents Cumulative doses per m2 for alkylators, anthracyclines, and bleomycin Determination of intermediate/high (>1000 mg/m2) dose vs. standard dose for cytarabine and methotrexate |
| Bioimmunotherapy | Drug name, route and cumulative dose |
| Radiation | Dates, type, fields, total dose, # fractions/dose per fraction |
| Surgical procedures | Type(s), date(s) |
| Hematopoietic cell transplant | Type(s), date(s), graft-versus-host disease prophylaxis/treatment |
| Complications/late effects | Major medical events with potential for residual/late effects; identified late effects |
| Adverse drug reactions/allergies | Name of drug, type of reaction |
| Essential Elements . | Details . |
|---|---|
| Demographics | Name, date of birth, treating institution, treatment team |
| Cancer diagnosis | Date, site(s), stage |
| Medical history | Hereditary/congenital history, major medical events (in addition to cancer diagnosis) |
| Relapse(s) | Date(s) and site(s), if applicable |
| Subsequent malignant neoplasms | Date(s), types, if applicable |
| Protocol(s) | Title(s)/number(s), dates initiated and completed |
| Completion of therapy | Date |
| Chemotherapy | Names and administration routes for all agents Cumulative doses per m2 for alkylators, anthracyclines, and bleomycin Determination of intermediate/high (>1000 mg/m2) dose vs. standard dose for cytarabine and methotrexate |
| Bioimmunotherapy | Drug name, route and cumulative dose |
| Radiation | Dates, type, fields, total dose, # fractions/dose per fraction |
| Surgical procedures | Type(s), date(s) |
| Hematopoietic cell transplant | Type(s), date(s), graft-versus-host disease prophylaxis/treatment |
| Complications/late effects | Major medical events with potential for residual/late effects; identified late effects |
| Adverse drug reactions/allergies | Name of drug, type of reaction |