Information:
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ID
25181
Description
CALGB 50901 New Malignancy Form Ofatumumab in Treating Patients With Previously Untreated Stage II, Stage III, or Stage IV Follicular Non-Hodgkin Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=9F505C29-ACEA-78C3-E040-BB89AD433B18
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Versions (2)
- 9/19/12 9/19/12 -
- 8/28/17 8/28/17 -
Uploaded on
August 28, 2017
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License
Creative Commons BY-NC 3.0 Legacy
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CALGB 50901 New Malignancy Form
Instructions: 1. Report any malignancy that is: A new histologic type A previous histologic type that is judged to be a new primary A new secondary malignancy related to cancer treatment, including AML/MDS. Recurrence of a previous malignancy 2. Submit pathology and/or cytogenetic report(s) documenting the new primary or secondary malignancy. 3. Do not use this form to report recurrences of current lymphoma. 4. All new malignancies must also be reported to NCI/CTEP via the AdEERS application.
Similar models
Instructions: 1. Report any malignancy that is: A new histologic type A previous histologic type that is judged to be a new primary A new secondary malignancy related to cancer treatment, including AML/MDS. Recurrence of a previous malignancy 2. Submit pathology and/or cytogenetic report(s) documenting the new primary or secondary malignancy. 3. Do not use this form to report recurrences of current lymphoma. 4. All new malignancies must also be reported to NCI/CTEP via the AdEERS application.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item
New Malignancy Type
integer
C2991 (NCI Thesaurus ObjectClass)
C25586 (NCI Thesaurus Property)
C17747 (NCI Thesaurus Property-2)
C15220 (NCI Thesaurus Property-3)
C25284 (NCI Thesaurus ValueDomain)
C4266456 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C0242656 (UMLS CUI [2])
C25586 (NCI Thesaurus Property)
C17747 (NCI Thesaurus Property-2)
C15220 (NCI Thesaurus Property-3)
C25284 (NCI Thesaurus ValueDomain)
C4266456 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C0242656 (UMLS CUI [2])
CL Item
New Primary Malignancy (1)
CL Item
New Secondary Malignancy (2)
CL Item
Recurrence Of Previous Malignancy (3)
Type
Item
Specify Type
text
C14143 (NCI Thesaurus ObjectClass)
C2991 (NCI Thesaurus ObjectClass-2)
C17649 (NCI Thesaurus Property)
C25626 (NCI Thesaurus Property-2)
C25685 (NCI Thesaurus ValueDomain)
C4266456 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
C2991 (NCI Thesaurus ObjectClass-2)
C17649 (NCI Thesaurus Property)
C25626 (NCI Thesaurus Property-2)
C25685 (NCI Thesaurus ValueDomain)
C4266456 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Histologic Type
Item
Specify histologic type
text
C25685 (NCI Thesaurus ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C25526 (NCI Thesaurus Property)
C25161 (NCI Thesaurus Property-2)
C0449574 (UMLS CUI [1,1])
C4266456 (UMLS CUI [1,2])
C3262 (NCI Thesaurus ObjectClass)
C25526 (NCI Thesaurus Property)
C25161 (NCI Thesaurus Property-2)
C0449574 (UMLS CUI [1,1])
C4266456 (UMLS CUI [1,2])