Description:

CALGB: 10603 Adverse Event (AE) Form NCT00651261 Daunorubicin, Cytarabine, and Midostaurin in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=43B71921-CF4D-54F5-E044-0003BA3F9857

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=43B71921-CF4D-54F5-E044-0003BA3F9857
Keywords:
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
  4. 7/8/15 7/8/15 -
Uploaded on:

July 8, 2015

DOI:
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License :
Creative Commons BY-NC 3.0 Legacy
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CALGB: 10603 Adverse Event (AE) Form DRKS00003845 NCT00651261

If data are amended, circle amended items and check the "Yes" box. If submitting by mail, retain a copy for your records.

Header
Are data amended
Patient demographics
Adverse Drug Reaction Report
Has an Adverse Drug Reaction Report been filed? (with Central Office based on an event reported below)
Treatment Phase
Expected Adverse Events
CTC AE Attribution Code (^2)
CTC AE Attribution Code (^2)

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