Protocol ID Coordinating Group
Item
Coordinating Group Protocol No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1711341 (UMLS CUI-2)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Coordinating Group Code
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C1711341 (UMLS CUI-1)
C17005 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25462 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Protocol Title
Item
Protocol Title
text
C25191 (NCI Thesaurus ValueDomain)
C2986303 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C42774 (NCI Thesaurus Property)
Patient Study ID
Item
Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
Trial subject ID Participating Group
Item
Other Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
ParticipatingGroupIdentifierCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25608 (NCI Thesaurus ObjectClass)
C0679823 (UMLS 2011AA ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C1257890 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Person Completing Form
Item
Person Completing Form
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Data amended
Item
Are data amended (If data are amended, please circle in red when using paper form)
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
CancerInitialDiagnosisDate
Item
Date of Initial Pathologic Diagnosis (mm dd yyyy enter test date for first diagnosis of leukemia)
date
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property-2)
C0011900 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
SpecimenCollectedDate
Item
Date Specimen collected (s mm dd yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property-2)
C2745955 (UMLS 2011AA Property)
SpecimenLaboratoryReceivedDate
Item
Date of Receipt of Specimens ( mm dd yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C37984 (NCI Thesaurus Property-2)
C0022877 (UMLS 2011AA Property-2)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
Item
Source of Cells used for Analysis
text
C3161 (NCI Thesaurus ObjectClass)
C0023418 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C0370003 (UMLS 2011AA ObjectClass-2)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property-2)
C0678257 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Source of Cells used for Analysis
CL Item
Peripheral Blood (Peripheral blood)
C0229664 (NCI Metathesaurus)
CL Item
Bone Marrow (Bone marrow)
C12431 (NCI Thesaurus)
C0005953 (UMLS 2011AA)
CL Item
Cerebrospinal Fluid (Cerebrospinal fluid)
C12692 (NCI Thesaurus)
C0007806 (UMLS 2011AA)
CL Item
Pleural Fluid (Pleural fluid)
C0225778 (NCI Metathesaurus)
CL Item
Peritoneal Fluid (Peritoneal fluid)
CL Item
Lymph Node (Lymph node)
C12745 (NCI Thesaurus)
C0024204 (UMLS 2011AA)
CL Item
Soft Tissue Mass (Soft tissue mass)
C0457193 (NCI Metathesaurus)
CL Item
Other Specify (Other)
SpecimenCellSourceSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25683 (NCI Thesaurus Property-2)
C0449416 (UMLS 2011AA Property-2)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
Item
Specimen Condition
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C37984 (NCI Thesaurus ObjectClass)
C0022877 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus Property)
C0370003 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property-2)
C0348080 (UMLS 2011AA Property-2)
Code List
Specimen Condition
CL Item
Damaged Or Unusable (Damaged or unusable)
CL Item
No Specimen Received (No specimen received)
Item
RT-PCR Marker Type (RT-PCR Polymerase Chain Reaction for Chimeric Genes)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C18136 (NCI Thesaurus ObjectClass)
C0599161 (UMLS 2011AA ObjectClass)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
Code List
RT-PCR Marker Type (RT-PCR Polymerase Chain Reaction for Chimeric Genes)
CL Item
Bcr-abl1 Fusion Protein Expression (BCR/ABL)
C36715 (NCI Thesaurus)
C1516132 (UMLS 2011AA)
CL Item
Tel-aml1 Fusion Protein Expression (TEL/AML1)
C37227 (NCI Thesaurus)
C1515155 (UMLS 2011AA)
CL Item
Pml-raralpha Fusion Protein Expression (PML/RAR-alpha)
C37223 (NCI Thesaurus)
C1518798 (UMLS 2011AA)
CL Item
Plzf-raralpha Fusion Protein Expression (PLZF/RAR-alpha)
C37220 (NCI Thesaurus)
C1518796 (UMLS 2011AA)
CL Item
Mll-af4 Fusion Protein Expression (MLL/AF4)
C37228 (NCI Thesaurus)
C1518128 (UMLS 2011AA)
CL Item
Mll-af9 Fusion Protein Expression (MLL/AF9)
C38390 (NCI Thesaurus)
C1518129 (UMLS 2011AA)
CL Item
Aml1-eto Fusion Protein Expression (AML1/ETO)
C37218 (NCI Thesaurus)
C1515851 (UMLS 2011AA)
CL Item
Evi1-aml1 Fusion Protein Expression (AML1/EVI1)
C41074 (NCI Thesaurus)
C1512144 (UMLS 2011AA)
CL Item
E2a-pbx1 Fusion Protein Expression (E2A/PBX1)
C37226 (NCI Thesaurus)
C1512110 (UMLS 2011AA)
CL Item
Cbfbeta-myh11 Fusion Protein Expression (CBF-beta/MYH11)
C37219 (NCI Thesaurus)
C1511408 (UMLS 2011AA)
ReverseTranscriptase-PolymeraseChainReactionBCR-ABLOncoproteinAssessmentText
Item
Specify BCR/ABL transcript (If positive,)
text
C18136 (NCI Thesaurus ObjectClass)
C0599161 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C16325 (NCI Thesaurus Property-2)
C0004891 (UMLS 2011AA Property-2)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C20200 (NCI Thesaurus ValueDomain-2)
C1274040 (UMLS 2011AA ValueDomain-2)
Item
RT-PCR Result
text
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C18136 (NCI Thesaurus ObjectClass)
C0599161 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
Item
Marker Type (Mutational Sequence Analysis)
text
C25574 (NCI Thesaurus ObjectClass)
C1521991 (UMLS 2011AA ObjectClass)
C17565 (NCI Thesaurus ObjectClass-2)
C0162801 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Marker Type (Mutational Sequence Analysis)
CL Item
Flt3/itd (FLT3/ITD)
CL Item
Flt3 Other (FLT3 other)
Item
Mutational Sequence Analysis Result
text
C25574 (NCI Thesaurus ObjectClass)
C1521991 (UMLS 2011AA ObjectClass)
C17565 (NCI Thesaurus ObjectClass-2)
C0162801 (UMLS 2011AA ObjectClass-2)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Mutational Sequence Analysis Result
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Mutant, Specify (Mutant)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
MolecularSequenceAnalysisGeneticMarkerMutationText
Item
Mutant specify
text
C25574 (NCI Thesaurus ObjectClass)
C1521991 (UMLS 2011AA ObjectClass)
C17565 (NCI Thesaurus ObjectClass-2)
C0162801 (UMLS 2011AA ObjectClass-2)
C16885 (NCI Thesaurus Property)
C0026882 (UMLS 2011AA Property)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
Item
Southern/DNA-PCR Marker Type (Southern Blot Analysis or DNA-PCR)
text
C17003 (NCI Thesaurus ObjectClass)
C0032520 (UMLS 2011AA ObjectClass)
C449 (NCI Thesaurus ObjectClass-2)
C0012854 (UMLS 2011AA ObjectClass-2)
C25574 (NCI Thesaurus Property)
C1521991 (UMLS 2011AA Property)
C16342 (NCI Thesaurus Property-2)
C0005516 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Southern/DNA-PCR Marker Type (Southern Blot Analysis or DNA-PCR)
Item
Southern Blot/DNA-PCR Result
text
C17003 (NCI Thesaurus ObjectClass)
C0032520 (UMLS 2011AA ObjectClass)
C449 (NCI Thesaurus ObjectClass-2)
C0012854 (UMLS 2011AA ObjectClass-2)
C25574 (NCI Thesaurus Property)
C1521991 (UMLS 2011AA Property)
C16342 (NCI Thesaurus Property-2)
C0005516 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Southern Blot/DNA-PCR Result
CL Item
Rearranged (Rearranged)
CL Item
Germ Line (Germ line)
C0017473 (NCI Metathesaurus)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)