Ethnicity and Race
Ethnic Group
text
PatientBMTCTNSubgroupRaceCategoryType
text
OtherRaceCategoryText
text
PatientSecondaryRaceBMTCTNSubgroupCategoryType
text
PatientSecondaryRaceSpecify
text
Myeloma Follow-On Enrollment Form - Segment A
InformedConsentFormSignedDate
date
PersonAddressPostalCode
text
PatientPaymentType
text
PersonSymptomaticPlasmaCellMyelomaClinicalTrialEligibilityCriteriaInd-2
boolean
SystemicTherapyAdministeredInd-3
boolean
Treatment Begin Date
date
Treatment End Date
date
StemCellMobilizationTherapyAdministeredProjectedBeginDate
date
TransplantConditioningChemotherapyAdministeredBeginDate
date
Left Ventricular Ejection Fraction
HeartLVEFTestPercentageValue
float
HeartLVEFTestDate
date
Bilirubin
LaboratoryProcedureTotalBilirubinResultValue
float
Bilirubin, Total ULN
float
SpecimenLaboratoryProcedureCollectionDate
date
Alt
LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultUnspecifiedValue
float
LaboratoryProcedureSerumGlutamicPyruvicTransaminaseResultUpperLimitofNormalValue
float
Ast
SGOT (AST)
float
LaboratoryProcedureSerumGlutamicOxaloaceticTransferaseResultUnspecifiedUpperLimitofNormalValue
float
Serum Creatinine
Creatinine Clearance
float
LaboratoryProcedureCreatinineClearanceOutcomeDate
date
Dlco (corrected For Hemoglobin)
LungCarbonMonoxideDiffusingCapabilityTestAssessmentPredictiveValuePercentageValue
float
Fev1
LungForcedExpiratoryVolume1TestSpecifiedValue
float
Fvc
VitalLungCapacityTestSpecifiedValue
float
Patient Exclusion Criteria
Non-SecretoryMyelomaDiseaseDiagnosisInd-2
boolean
PlasmaCellLeukemiaDiseaseDiagnosisInd-2
boolean
KarnofskyPerformanceStatusScore
text
CommonToxicityCriteriaAdverseEventPeripheralSensoryNeuropathyInd-2
boolean
PatientInfectionInd-2
boolean
HumanImmunodeficiencyVirusDiagnosisInd-3
boolean
CardiovascularDiseasePresentInd-2
boolean
PatientBortezomibBoronMannitolHypersensitivityPersonalMedicalHistoryInd-2
boolean
PriorInvestigationalTherapiesAdministeredInd-2
boolean
PatientNeoplasmPersonalMedicalHistoryIndicator
text
Exclusion Criteria (cont.)
PatientEligibilityConfirmationDate
date
PriorCancerDiagnosisIndicator
boolean
PatientPregnancyInd-3b
text
ContraceptionAgreementInd
text
HematopoieticStemCellTransplantationPerformedInd-2
boolean
PreparativeRegimenMelphalanAdministeredIndicator
boolean
TransplantReceivedInd-2
boolean
DiseaseProgressionInd-3
boolean
LenalidomideAgentDiscontinuedFirstMultipleMyeloma-IgGTreatmentAdministrationInd-2
boolean
PersonThromboembolismPersonalMedicalHistoryInd-3
text
PatientDeepVeinThrombosisPreventiveInterventionConsentInd-2
boolean
PatientDenyHealthInsuranceInd-2
boolean
Donor Inclusion Criteria
BloodTissueSpecimenOtherDiseasesandDisordersFutureResearchConsentInd-2
boolean
BoneMarrowSpecimenOtherDiseasesandDisordersFutureResearchConsentInd-2
boolean
BoneMarrowAspirateDate
date
SerumSpecimenCollectedDate
date
PlasmaSpecimenCollectedDate
date
PeripheralBloodMononuclearCellSpecimenCollectedDate
date
Risk Status
PatientRiskEligibilityDeterminationStatus
text
Comments