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ID
2637
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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- 9/19/12 9/19/12 -
- 8/28/17 8/28/17 -
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September 19, 2012
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Creative Commons BY-NC 3.0 Legacy
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Lymphoma NCT01190449 On-Study - CALGB 50901 New Malignancy Form - 3210573v1.0
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.
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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
text
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C25586 (NCI Thesaurus Property)
C0205314 (UMLS 2011AA Property)
C17747 (NCI Thesaurus Property)
C0242656 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C0012634 (UMLS 2011AA ObjectClass)
C25586 (NCI Thesaurus Property)
C0205314 (UMLS 2011AA Property)
C17747 (NCI Thesaurus Property)
C0242656 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL Item
New Primary Malignancy (New primary malignancy)
CL Item
New Secondary Malignancy (New secondary malignancy)
CL Item
Recurrence Of Previous Malignancy (Recurrence of previous malignancy)
MalignantDiseaseOtherPresentSpecify
Item
Specify Type
text
C14143 (NCI Thesaurus ObjectClass)
C0205282 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C0205282 (UMLS 2011AA ObjectClass)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C17649 (NCI Thesaurus Property)
C0205394 (UMLS 2011AA Property)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
TumorHistologicCategorySpecify
Item
Specify histologic type
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
C1521902 (UMLS 2011AA ValueDomain)
C3262 (NCI Thesaurus ObjectClass)
C0027651 (UMLS 2011AA ObjectClass)
C25526 (NCI Thesaurus Property)
C0205462 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)