Description:

E2902 Long-Term Follow-up Form - Form 2049 NCT00093470 Tipifarnib in Treating Patients With Acute Myeloid Leukemia in Remission Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DBE2127B-9F53-454A-E034-0003BA12F5E7

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=DBE2127B-9F53-454A-E034-0003BA12F5E7
Keywords:
  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

DOI:
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License :
Creative Commons BY-NC 3.0 Legacy
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E2902 Long-Term Follow-up Form - Form 2049 NCT00093470

No Instruction available.

  1. StudyEvent: E2902 Long-Term Follow-up Form - Form 2049
    1. No Instruction available.
Header
Off Treatment Report Period (since registration)
Are data amended
Section I - Vital Status
Patient Vital Status
Primary Cause of Death (if applicable)
Section Ii - Reporting Period
Section Iii - Disease Follow-up Status
Has the patient had a documented clinical assessment for this cancer (since submission of the previous follow-up form?)
Has the patient developed a first progression (relapse) that has not been previously reported?
Did a physician make a formal diagnosis of progression?
Section Iv - Notice Of New Primary
Has a new primary cancer or myelodysplastic syndrome (MDS) been diagnosed that has not been previously reported?
Section V - Adverse Events
Has the patient experienced (prior to diagnosis of progression/relapse) any severe (Grade >=3) long term toxicity that has not been previously reported?
Section Vi - Non-protocol Therapy Prior To Progression
Has the patient received any non-protocol cancer therapy prior to first progression (not previously reported)?
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