E2902 Treatment (Observation) Form - Arm B - Form 2052 NCT00093470 Tipifarnib in Treating Patients With Acute Myeloid Leukemia in Remission Source Form: NCI FormBuilder:

  1. 9/19/12 9/19/12 -
  2. 1/8/15 1/8/15 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
  4. 7/5/15 7/5/15 -
Uploaded on:

July 5, 2015

To request one please log in.
License :
Creative Commons BY-NC 3.0 Legacy
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

E2902 Treatment (Observation) Form - Arm B - Form 2052 NCT00093470

No Instruction available.

  1. StudyEvent: E2902 Treatment (Observation) Form - Arm B - Form 2052
    1. No Instruction available.
Observation Report Period (Choose one)
Are data amended
Vital Status
Patient Vital Status
Primary Cause of Death (if applicable)
Report Period Information
Performance status (Evaluation closest to start of Report Period)
Non-protocol Therapy
Was any non-protocol therapy given (not previously reported)
Related Forms

Similar models

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial