ID

2911

Description

Leukemia Pathology Form - Immunophenotype Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1B4D88B8-2F2F-6AB9-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1B4D88B8-2F2F-6AB9-E044-0003BA3F9857

Keywords

Versions (2)
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
Uploaded on

September 19, 2012

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0 Legacy
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Pathology - Leukemia Pathology Form - Immunophenotype - 2019351v3.0

English

No Instruction available.

1 forms  
  1. StudyEvent: Leukemia Pathology Form - Immunophenotype
    1. No Instruction available.
Crf Header
Description

Crf Header

Coordinating Group Protocol No.
Description

ProtocolCoordinatingIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C25462
UMLS 2011AA Property
C0700114
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Coordinating Group Code
Description

CoordinatingGroupIdentifierCode

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C17005
UMLS 2011AA ObjectClass
C1257890
NCI Thesaurus ObjectClass
C25462
UMLS 2011AA ObjectClass
C0700114
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Protocol Title
Description

ProtocolTitleName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C25320
UMLS 2011AA ObjectClass
C1507394
NCI Thesaurus Property
C42774
UMLS 2011AA Property
C1705823
Patient Study ID
Description

PatientCoordinatingIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25462
UMLS 2011AA Property
C0700114
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Institution/Affiliate
Description

CombinedInstitutionName

Data type

text

Alias
NCI Thesaurus ObjectClass
C25454
UMLS 2011AA ObjectClass
C0205195
NCI Thesaurus ObjectClass
C21541
UMLS 2011AA ObjectClass
C0018704
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ValueDomain
C21541
UMLS 2011AA ValueDomain
C0018704
Other Patient ID
Description

PatientParticipatingIdentifierNumber

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25608
UMLS 2011AA Property
C0679823
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Participating Group Code
Description

ParticipatingGroupIdentifierCode

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C25608
UMLS 2011AA ObjectClass
C0679823
NCI Thesaurus ObjectClass
C17005
UMLS 2011AA ObjectClass
C1257890
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Initials
Description

PatientInitialsName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
Leukemia/mds: Form Administration
Description

Leukemia/mds: Form Administration

Person Completing Form
Description

ResponsiblePersonName

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C25657
UMLS 2011AA ObjectClass
C1273518
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Are data amended (If data are amended, please circle in red when using paper form)
Description

DataAmendedInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
Pathology: Immunophenotype
Description

Pathology: Immunophenotype

Date of Initial Pathologic Diagnosis (mm dd yyyy enter test date for first diagnosis of leukemia)
Description

CancerInitialDiagnosisDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C25509
UMLS 2011AA Property
C1279901
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain
C25367
Date Specimen collected (s mm dd yyyy)
Description

SpecimenCollectedDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25452
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
Date of Receipt of Specimens ( mm dd yyyy)
Description

SpecimenLaboratoryReceivedDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C25639
UMLS 2011AA Property
C1514756
NCI Thesaurus Property
C37984
UMLS 2011AA Property
C0022877
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
Source of Cells used for Analysis
Description

LeukemiaSpecimenCellSourceType

Data type

text

Alias
NCI Thesaurus ObjectClass
C3161
UMLS 2011AA ObjectClass
C0023418
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other specify
Description

SpecimenCellSourceSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C25683
UMLS 2011AA Property
C0449416
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
Type of Sample Used for Immunophenotyping
Description

ImmunophenotypeCellSpecimenType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C19157
UMLS 2011AA Property
C0370003
Other specify
Description

ImmunophenotypeCellSpecimenSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C19157
UMLS 2011AA Property
C0370003
Specimen Condition
Description

LabConditionSpecimenType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C37984
UMLS 2011AA ObjectClass
C0022877
NCI Thesaurus Property
C19157
UMLS 2011AA Property
C0370003
NCI Thesaurus Property
C25457
UMLS 2011AA Property
C0348080
Procedure Used for Immunophenotyping
Description

ImmunophenotypeMethodType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
Other specify
Description

ImmunophenotypeMethodSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
How were cells prepared for immunophenotyping
Description

ImmunophenotypeCellPreparationType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C25625
UMLS 2011AA Property
C1521827
Antigen (Antigen Expression Note: In preparing this form for a new protocol, include only those questions relevant for study evaluation)
Description

ImmunophenotypeAntigenType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
NCI Metathesaurus Property
C0003320
Was expression of the antigen detected on leukemic cells? (For each marker,)
Description

ImmunophenotypeAntigenInd

Data type

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
NCI Metathesaurus Property
C0003320
For TdT, specify Antibody source
Description

TerminalDeoxyribonucleotidylTransferaseAntigenAssayAntibodySourceText

Data type

text

Alias
NCI Thesaurus ObjectClass
C16509
UMLS 2011AA ObjectClass
C0012881
NCI Metathesaurus ObjectClass
CL201680
NCI Thesaurus Property
C16295
UMLS 2011AA Property
C0003241
NCI Thesaurus Property
C25683
UMLS 2011AA Property
C0449416
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
Antigen (Fluorochromes *Note: Groups may pre-print specific antigens being tested by flow cytometry relevant to protocol instructions.)
Description

ImmunophenotypeAntigenSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
NCI Metathesaurus Property
C0003320
Identify the fluorochrome used for analysis (For each antigen tested by Flow Cytometry,)
Description

ImmunophenotypeFlowCytometryFluorochromeType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
NCI Thesaurus Property
C16585
UMLS 2011AA Property
C0016263
NCI Thesaurus Property
C503
UMLS 2011AA Property
C0016342
Other specify
Description

ImmunophenotypeFlowCytometryFluorochromeSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
NCI Thesaurus Property
C16585
UMLS 2011AA Property
C0016263
NCI Thesaurus Property
C503
UMLS 2011AA Property
C0016342
How were leukemic cells gated?
Description

ImmunophenotypeGatingMethodType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
Other specify
Description

ImmunophenotypeGatingMethodOtherSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain
C17649
UMLS 2011AA ValueDomain
C0205394
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C20072
UMLS 2011AA ObjectClass
C0079611
If an antibody other than CD45, indicate CD used
Description

AntibodyNameOtherSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ObjectClass
C16295
UMLS 2011AA ObjectClass
C0003241
Percent Cells Viable (%)
Description

LaboratoryProcedureViableCellSpecimenOutcomePercentageValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property
C19157
UMLS 2011AA Property
C0370003
NCI Thesaurus Property
C25324
UMLS 2011AA Property
C0443348
NCI Thesaurus ValueDomain
C25613
UMLS 2011AA ValueDomain
C0439165
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
Was DNA ploidy tested by flow cytometry?
Description

DNAPloidyAssessmentFlowCytometryInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C17001
UMLS 2011AA ObjectClass
C0032246
NCI Thesaurus ObjectClass
C449
UMLS 2011AA ObjectClass
C0012854
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C16585
UMLS 2011AA Property
C0016263
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Description of DNA Ploidy Results (If yes,)
Description

DNAPloidyFlowCytometryResultType

Data type

text

Alias
NCI Thesaurus ObjectClass
C17001
UMLS 2011AA ObjectClass
C0032246
NCI Thesaurus ObjectClass
C449
UMLS 2011AA ObjectClass
C0012854
NCI Thesaurus Property
C16585
UMLS 2011AA Property
C0016263
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Provide DNA Index of Leukemic Cells
Description

DNAIndexValue

Data type

double

Alias
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Thesaurus ObjectClass
C449
UMLS 2011AA ObjectClass
C0012854
NCI Thesaurus Property
C25390
UMLS 2011AA Property
C0918012
% Cells in S-phase
Description

LaboratoryProcedureS-PhaseFractionOutcomePercentageValue

Data type

double

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C18456
UMLS 2011AA Property
C0812425
NCI Thesaurus ValueDomain
C25613
UMLS 2011AA ValueDomain
C0439165
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
% Coefficient of Variation
Description

SpecimenCoefficientofVariationPercentageValue

Data type

double

Alias
NCI Thesaurus ValueDomain
C25613
UMLS 2011AA ValueDomain
C0439165
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus ValueDomain
C25712
UMLS 2011AA ValueDomain
C1522609
NCI Metathesaurus Property
C0681921
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1 forms
  1. StudyEvent: Leukemia Pathology Form - Immunophenotype
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Crf Header
ProtocolCoordinatingIdentifierNumber
Item
Coordinating Group Protocol No.
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
CoordinatingGroupIdentifierCode
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus ObjectClass)
C0700114 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
ProtocolTitleName
Item
Protocol Title
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25320 (NCI Thesaurus ObjectClass)
C1507394 (UMLS 2011AA ObjectClass)
C42774 (NCI Thesaurus Property)
C1705823 (UMLS 2011AA Property)
PatientCoordinatingIdentifierNumber
Item
Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25462 (NCI Thesaurus Property)
C0700114 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
CombinedInstitutionName
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C0205195 (UMLS 2011AA ObjectClass)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ValueDomain)
C0018704 (UMLS 2011AA ValueDomain)
PatientParticipatingIdentifierNumber
Item
Other Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25608 (NCI Thesaurus Property)
C0679823 (UMLS 2011AA Property)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
ParticipatingGroupIdentifierCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25608 (NCI Thesaurus ObjectClass)
C0679823 (UMLS 2011AA ObjectClass)
C17005 (NCI Thesaurus ObjectClass)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientInitialsName
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
Item Group
Leukemia/mds: Form Administration
ResponsiblePersonName
Item
Person Completing Form
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Item
Are data amended (If data are amended, please circle in red when using paper form)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
CL.1
Code List
Are data amended (If data are amended, please circle in red when using paper form)
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Pathology: Immunophenotype
CancerInitialDiagnosisDate
Item
Date of Initial Pathologic Diagnosis (mm dd yyyy enter test date for first diagnosis of leukemia)
date
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
SpecimenCollectedDate
Item
Date Specimen collected (s mm dd yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25452 (NCI Thesaurus Property)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
SpecimenLaboratoryReceivedDate
Item
Date of Receipt of Specimens ( mm dd yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
Item
Source of Cells used for Analysis
text
C3161 (NCI Thesaurus ObjectClass)
C0023418 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.2
Code List
Source of Cells used for Analysis
CL Item
Peripheral Blood (Peripheral blood)
C0229664 (NCI Metathesaurus)
CL Item
Bone Marrow (Bone marrow)
C12431 (NCI Thesaurus)
C0005953 (UMLS 2011AA)
CL Item
Cerebrospinal Fluid (Cerebrospinal fluid)
C12692 (NCI Thesaurus)
C0007806 (UMLS 2011AA)
CL Item
Pleural Fluid (Pleural fluid)
C0225778 (NCI Metathesaurus)
CL Item
Peritoneal Fluid (Peritoneal fluid)
CL Item
Lymph Node (Lymph node)
C12745 (NCI Thesaurus)
C0024204 (UMLS 2011AA)
CL Item
Soft Tissue Mass (Soft tissue mass)
C0457193 (NCI Metathesaurus)
CL Item
Other Specify (Other)
SpecimenCellSourceSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25683 (NCI Thesaurus Property)
C0449416 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
Item
Type of Sample Used for Immunophenotyping
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C19157 (NCI Thesaurus Property)
C0370003 (UMLS 2011AA Property)
CL.3
Code List
Type of Sample Used for Immunophenotyping
CL Item
Fresh Cells (Fresh cells)
CL Item
Smears (Smears)
CL Item
Tissue Section (Tissue section)
CL Item
Other Specify (Other)
ImmunophenotypeCellSpecimenSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C19157 (NCI Thesaurus Property)
C0370003 (UMLS 2011AA Property)
Item
Specimen Condition
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C37984 (NCI Thesaurus ObjectClass)
C0022877 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus Property)
C0370003 (UMLS 2011AA Property)
C25457 (NCI Thesaurus Property)
C0348080 (UMLS 2011AA Property)
CL.4
Code List
Specimen Condition
CL Item
Usable (Usable)
CL Item
Damaged Or Unusable (Damaged or unusable)
CL Item
No Specimen Received (No specimen received)
Item
Procedure Used for Immunophenotyping
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
CL.5
Code List
Procedure Used for Immunophenotyping
CL Item
Flow Cytometry, Not Otherwise Specified (Flow cytometry, not otherwise specified)
CL Item
Flow Cytometry, 2 Color (Flow cytometry, 2 color)
CL Item
Flow Cytometry, 3 Color (Flow cytometry, 3 color)
CL Item
Flow Cytometry, 4 Or More Color (Flow cytometry, 4 or more color)
CL Item
Immunohistochemistry (Immunohistochemistry)
C16722 (NCI Thesaurus)
CL Item
Immunofluorescence (Immunofluorescence)
CL Item
Other Specify (Other)
ImmunophenotypeMethodSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
Item
How were cells prepared for immunophenotyping
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25625 (NCI Thesaurus Property)
C1521827 (UMLS 2011AA Property)
CL.6
Code List
How were cells prepared for immunophenotyping
CL Item
Whole Tissue (Whole tissue)
CL Item
Ficoll-isolated Mnc (Ficoll-isolated MNC)
Item
Antigen (Antigen Expression Note: In preparing this form for a new protocol, include only those questions relevant for study evaluation)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
C0003320 (NCI Metathesaurus Property)
CL.7
Code List
Antigen (Antigen Expression Note: In preparing this form for a new protocol, include only those questions relevant for study evaluation)
CL Item
Cd1a (CD1a)
CL Item
Cd2 (CD2)
CL Item
Cd3 Surface (CD3 surface)
CL Item
Cd3 Intracytoplasmic (CD3 intracytoplasmic)
CL Item
Cd4 (CD4)
CL Item
Cd5 (CD5)
CL Item
Cd7 (CD7)
CL Item
Cd8 (CD8)
CL Item
Cd10 (CD10)
CL Item
Cd11a (CD11a)
CL Item
Cd11b (CD11b)
CL Item
Cd11c (CD11c)
CL Item
Cd13 (CD13)
CL Item
Cd14 (CD14)
CL Item
Cd15 (CD15)
CL Item
Cd15s (CD15s)
CL Item
Cd16 (CD16)
CL Item
Cd19 (CD19)
CL Item
Cd20 (CD20)
CL Item
Cd22 Surface (CD22 surface)
CL Item
Cd22 Intracytoplasmic (CD22 intracytoplasmic)
CL Item
Cd23 (CD23)
CL Item
Cd24 (CD24)
CL Item
Cd25 (CD25)
CL Item
Cd30 (CD30)
CL Item
Cd33 (CD33)
CL Item
Cd34 (CD34)
CL Item
Cd36 (CD36)
CL Item
Cd38 (CD38)
CL Item
Cd40 (CD40)
CL Item
Cd41 (CD41)
CL Item
Cd42 (CD42)
CL Item
Cd43 (CD43)
CL Item
Cd45 (CD45)
CL Item
Cd52 (CD52)
CL Item
Cd56 (CD56)
CL Item
Cd57 (CD57)
CL Item
Cd61 (CD61)
CL Item
Cd64 (CD64)
CL Item
Cd71 (CD71)
CL Item
Cd79a Surface (CD79a surface)
CL Item
Cd79a Intracytoplasmic (CD79a intracytoplasmic)
CL Item
Cd79b Surface (CD79b surface)
CL Item
Cd79b Intracytoplasmic (CD79b intracytoplasmic)
CL Item
Cd103 (CD103)
CL Item
Cd117 (CD117)
CL Item
Cd133 (CD133)
CL Item
Cd138 (CD138)
CL Item
Igm Surface (IgM surface)
CL Item
Igm Intracytoplasmic (IgM intracytoplasmic)
CL Item
Iga Surface (IgA surface)
CL Item
Igd Surface (IgD surface)
CL Item
Igg Surface (IgG surface)
CL Item
Ig-kappa Surface (Ig-kappa surface)
CL Item
Ig-kappa Intracytoplasmic (Ig-kappa intracytoplasmic)
CL Item
Ig-lambda Surface (Ig-lambda surface)
CL Item
Ig-lambda Intracytoplasmic (Ig-lambda intracytoplasmic)
CL Item
Glycophorin (Glycophorin)
C0017954 (NCI Metathesaurus)
CL Item
Myeloperoxidase (Myeloperoxidase)
C0027021 (NCI Metathesaurus)
CL Item
Lactoferrin (Lactoferrin)
C0022942 (NCI Metathesaurus)
CL Item
Terminal Transferase (tdt) (Terminal Transferase (TdT))
CL Item
Bromodeoxyuridine (Bromodeoxyuridine)
C318 (NCI Thesaurus)
C0006233 (UMLS 2011AA)
CL Item
Ki67 (Ki67)
CL Item
P-glycoprotein (pgp/mdr1) (P-glycoprotein (Pgp/MDR1))
CL Item
Multidrug Resistance-associated Protein (mrp) (Multidrug resistance-associated protein (MRP))
CL Item
Lung-resistance-related Or Major Vault Protein (lrp/mvp) (Lung-resistance-related or major vault protein (LRP/MVP))
CL Item
Breast Cancer Resistance/mitoxantrone Resistance Protein (bcrp/mxr) (Breast cancer resistance/mitoxantrone resistance protein (BCRP/MXR))
Item
Was expression of the antigen detected on leukemic cells? (For each marker,)
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
C0003320 (NCI Metathesaurus Property)
CL.8
Code List
Was expression of the antigen detected on leukemic cells? (For each marker,)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
TerminalDeoxyribonucleotidylTransferaseAntigenAssayAntibodySourceText
Item
For TdT, specify Antibody source
text
C16509 (NCI Thesaurus ObjectClass)
C0012881 (UMLS 2011AA ObjectClass)
CL201680 (NCI Metathesaurus ObjectClass)
C16295 (NCI Thesaurus Property)
C0003241 (UMLS 2011AA Property)
C25683 (NCI Thesaurus Property)
C0449416 (UMLS 2011AA Property)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
ImmunophenotypeAntigenSpecify
Item
Antigen (Fluorochromes *Note: Groups may pre-print specific antigens being tested by flow cytometry relevant to protocol instructions.)
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
C0003320 (NCI Metathesaurus Property)
Item
Identify the fluorochrome used for analysis (For each antigen tested by Flow Cytometry,)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
C16585 (NCI Thesaurus Property)
C0016263 (UMLS 2011AA Property)
C503 (NCI Thesaurus Property)
C0016342 (UMLS 2011AA Property)
CL.9
Code List
Identify the fluorochrome used for analysis (For each antigen tested by Flow Cytometry,)
CL Item
Fitc (FITC)
CL Item
Percp (PerCP)
CL Item
Pe (PE)
CL Item
Apc (APC)
CL Item
Pe/tandem (PE/tandem)
CL Item
Ecd (ECD)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Other Specify (Other)
ImmunophenotypeFlowCytometryFluorochromeSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
C16585 (NCI Thesaurus Property)
C0016263 (UMLS 2011AA Property)
C503 (NCI Thesaurus Property)
C0016342 (UMLS 2011AA Property)
Item
How were leukemic cells gated?
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
CL.10
Code List
How were leukemic cells gated?
CL Item
Not Gated (Not gated)
CL Item
Abnormal Cells Using Fals Versus Rals (Abnormal cells using FALS versus RALS)
CL Item
Lymphoctye Gate Using Fals Versus Rals (Lymphoctye gate using FALS versus RALS)
CL Item
Abnormal Cells Using Cd45 And Light Scatter (Abnormal cells using CD45 and light scatter)
CL Item
Abnormal Cells Using An Antibody Other Than Cd45 And Light Scatter (Abnormal cells using an antibody other than CD45 and light scatter)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
ImmunophenotypeGatingMethodOtherSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C17649 (NCI Thesaurus ValueDomain)
C0205394 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C20072 (NCI Thesaurus ObjectClass)
C0079611 (UMLS 2011AA ObjectClass)
AntibodyNameOtherSpecify
Item
If an antibody other than CD45, indicate CD used
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C16295 (NCI Thesaurus ObjectClass)
C0003241 (UMLS 2011AA ObjectClass)
LaboratoryProcedureViableCellSpecimenOutcomePercentageValue
Item
Percent Cells Viable (%)
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C19157 (NCI Thesaurus Property)
C0370003 (UMLS 2011AA Property)
C25324 (NCI Thesaurus Property)
C0443348 (UMLS 2011AA Property)
C25613 (NCI Thesaurus ValueDomain)
C0439165 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
Item
Was DNA ploidy tested by flow cytometry?
text
C17001 (NCI Thesaurus ObjectClass)
C0032246 (UMLS 2011AA ObjectClass)
C449 (NCI Thesaurus ObjectClass)
C0012854 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C16585 (NCI Thesaurus Property)
C0016263 (UMLS 2011AA Property)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.11
Code List
Was DNA ploidy tested by flow cytometry?
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Description of DNA Ploidy Results (If yes,)
text
C17001 (NCI Thesaurus ObjectClass)
C0032246 (UMLS 2011AA ObjectClass)
C449 (NCI Thesaurus ObjectClass)
C0012854 (UMLS 2011AA ObjectClass)
C16585 (NCI Thesaurus Property)
C0016263 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.12
Code List
Description of DNA Ploidy Results (If yes,)
CL Item
Diploid (Diploid)
CL Item
Near Diploid (Near diploid)
CL Item
Hyperdiploid (Hyperdiploid)
CL Item
Hypodiploid (Hypodiploid)
CL Item
Not Evaluable (Not evaluable)
DNAIndexValue
Item
Provide DNA Index of Leukemic Cells
double
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C449 (NCI Thesaurus ObjectClass)
C0012854 (UMLS 2011AA ObjectClass)
C25390 (NCI Thesaurus Property)
C0918012 (UMLS 2011AA Property)
LaboratoryProcedureS-PhaseFractionOutcomePercentageValue
Item
% Cells in S-phase
double
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C18456 (NCI Thesaurus Property)
C0812425 (UMLS 2011AA Property)
C25613 (NCI Thesaurus ValueDomain)
C0439165 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
SpecimenCoefficientofVariationPercentageValue
Item
% Coefficient of Variation
double
C25613 (NCI Thesaurus ValueDomain)
C0439165 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25712 (NCI Thesaurus ValueDomain)
C1522609 (UMLS 2011AA ValueDomain)
C0681921 (NCI Metathesaurus Property)
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