ID

3421

Beschrijving

AMC-064 Baseline Lymphoma Disease Activity and Assessment Form (LAA) Study of Blood and Tissue Samples From Patients With Aggressive Non-Hodgkin B-Cell Lymphoma or Hodgkin Lymphoma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=743022C4-7E4E-DCE7-E040-BB89AD430CD9

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=743022C4-7E4E-DCE7-E040-BB89AD430CD9

Trefwoorden

Versies (2)
  1. 20-09-12 20-09-12 -
  2. 20-09-21 20-09-21 -
Geüploaded op

20 september 2012

DOI

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Licentie

Creative Commons BY-NC 3.0 Legacy
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NCT00981097 On-Study - AMC-064 Baseline Lymphoma Disease Activity and Assessment Form (LAA) - 2944124v1.0

Engels

Complete this form at baseline only

1 Formulieren  
  1. StudyEvent: AMC-064 Baseline Lymphoma Disease Activity and Assessment Form (LAA)
    1. Complete this form at baseline only
Unnamed1
Beschrijving

Unnamed1

Visit Number
Beschrijving

HospitalAdmissionOrdinalNumber

Datatype

double

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16696
UMLS 2011AA ObjectClass
C0019994
NCI Thesaurus Property
C25385
UMLS 2011AA Property
C0809949
Unnamed2
Beschrijving

Unnamed2

Modified Ann Arbor Stage
Beschrijving

LymphomaAnnArborLymphomaStagingSystemClassificationStage

Datatype

text

Alias
NCI Thesaurus ObjectClass
C3208
UMLS 2011AA ObjectClass
C0024299
NCI Thesaurus ValueDomain
C16899
UMLS 2011AA ValueDomain
C1300072
NCI Thesaurus Property
C25161
UMLS 2011AA Property
C0008902
Recurring, drenching night sweats during the previous month (Does the participant have any of the following symptoms at the time of registration)
Beschrijving

LymphomaSweatingSymptomInd-3

Datatype

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C3208
UMLS 2011AA ObjectClass
C0024299
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus Property
C36172
UMLS 2011AA Property
C0038990
Unexplained, persistent fever >38 degrees C (or >100 degrees F) in the previous month (Does the participant have any of the following symptoms at the time of registration)
Beschrijving

LymphomaFeverSymptomInd-3

Datatype

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C3208
UMLS 2011AA ObjectClass
C0024299
NCI Thesaurus Property
C4876
UMLS 2011AA Property
C1457887
NCI Thesaurus Property
C3038
UMLS 2011AA Property
C0015967
Unexplained weight loss >10% of body weight in the previous 6 months (Does the participant have any of the following symptoms at the time of registration)
Beschrijving

LymphomaWeightLossInd-3

Datatype

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C3445
UMLS 2011AA Property
C0043096
NCI Thesaurus ObjectClass
C3208
UMLS 2011AA ObjectClass
C0024299
Hematopoietic Diagnosis
Beschrijving

HematopoieticDiseaseDiagnosisType

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus ObjectClass
C13324
UMLS 2011AA ObjectClass
C0229601
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
If diffuse large B-cell lymphoma, specify morphologic type
Beschrijving

DiffuseLargeB-CellLymphomaMorphologyType

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C8851
UMLS 2011AA ObjectClass
C0079744
NCI Thesaurus Property
C17943
UMLS 2011AA Property
C0700619
If Burkitt lymphoma/leukemia, specify morphologic type
Beschrijving

Burkitt'sLymphomaMorphologyType

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C2912
UMLS 2011AA ObjectClass
C0006413
NCI Thesaurus Property
C17943
UMLS 2011AA Property
C0700619
Other specify
Beschrijving

DiseaseDiagnosisHematopoieticSpecify

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus ValueDomain
C13324
UMLS 2011AA ValueDomain
C0229601
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
Other specify
Beschrijving

DiseaseDiagnosisHematopoieticSpecify

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus ValueDomain
C13324
UMLS 2011AA ValueDomain
C0229601
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
Other specify
Beschrijving

DiseaseDiagnosisHematopoieticSpecify

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C2991
UMLS 2011AA ObjectClass
C0012634
NCI Thesaurus ValueDomain
C13324
UMLS 2011AA ValueDomain
C0229601
NCI Thesaurus Property
C15220
UMLS 2011AA Property
C0011900
If Hodgkin lymphoma, specify morphologic type
Beschrijving

Hodgkin'sLymphomaMorphologyType

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C9357
UMLS 2011AA ObjectClass
C0019829
NCI Thesaurus Property
C17943
UMLS 2011AA Property
C0700619
Date of Initial Pathologic Diagnosis (mm/dd/yyyy)
Beschrijving

CancerInitialDiagnosisDate

Datatype

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
Method of Evaluation
Beschrijving

AssessmentMethodType

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
Other Specify
Beschrijving

AssessmentMethodSpecify

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
Is the participant >60 years of age (Please enter the information below to obtain International Prognostic Index poor risk features)
Beschrijving

InternationalPrognosticIndexPatientAgeAssessmentInd-2

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass
C20118
UMLS 2011AA ObjectClass
C1512894
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C25150
UMLS 2011AA Property
C0001779
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Does the participant have Stage III or IV disease (Please enter the information below to obtain International Prognostic Index poor risk features)
Beschrijving

InternationalPrognosticIndexPatientStageAssessmentInd-2

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass
C20118
UMLS 2011AA ObjectClass
C1512894
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C16899
UMLS 2011AA Property
C1300072
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Is the serum LDH elevated (Please enter the information below to obtain International Prognostic Index poor risk features)
Beschrijving

InternationalPrognosticIndexPatientLactateDehydrogenaseAssessmentInd-2

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass
C20118
UMLS 2011AA ObjectClass
C1512894
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C25184
UMLS 2011AA Property
C0022917
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Is the ECOG Performance Status 2, 3, or 4 (Please enter the information below to obtain International Prognostic Index poor risk features)
Beschrijving

InternationalPrognosticIndexPatientPerformanceStatus2-4AssessmentInd-2

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass
C20118
UMLS 2011AA ObjectClass
C1512894
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C17847
UMLS 2011AA Property
C0278957
NCI Thesaurus Property
C17848
UMLS 2011AA Property
C0278958
NCI Thesaurus Property
C17846
UMLS 2011AA Property
C0278956
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Does the participant have two or more extranodal disease sites (Please enter the information below to obtain International Prognostic Index poor risk features)
Beschrijving

InternationalPrognosticIndexPatientExtranodalDiseaseAssessmentInd-2

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus ObjectClass
C20118
UMLS 2011AA ObjectClass
C1512894
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus Property
C2991
UMLS 2011AA Property
C0012634
NCI Thesaurus Property
C25504
UMLS 2011AA Property
C1517067
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
International Prognostic Index
Beschrijving

PatientInternationalPrognosticIndexScore

Datatype

double

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C20118
UMLS 2011AA Property
C1512894
NCI Thesaurus ValueDomain
C25338
UMLS 2011AA ValueDomain
C0449820
IPI Risk Category
Beschrijving

PatientInternationalPrognosticIndexRiskCategory

Datatype

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C17102
UMLS 2011AA Property
C0035647
NCI Thesaurus Property
C20118
UMLS 2011AA Property
C1512894
NCI Thesaurus Property
C25161
UMLS 2011AA Property
C0008902
NCI Thesaurus ValueDomain
C25372
UMLS 2011AA ValueDomain
C0683312
Histogenetic Subtyping Markers
Beschrijving

Histogenetic Subtyping Markers

Histogenetic Subtyping Markers
Beschrijving

TumorMarkerAvailableAssessmentType

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C17220
UMLS 2011AA ObjectClass
C0041365
NCI Thesaurus Property
C25429
UMLS 2011AA Property
C0470187
Finding Result
Beschrijving

FindingResultStatus

Datatype

text

Alias
NCI Thesaurus ObjectClass
C3367
UMLS 2011AA ObjectClass
C0037088
NCI Metathesaurus Property
CL282989
NCI Thesaurus ValueDomain
C20200
UMLS 2011AA ValueDomain
C1274040
NCI Thesaurus ValueDomain
C3367
UMLS 2011AA ValueDomain
C0037088
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Ki-67 Staining Index Score
Beschrijving

LaboratoryProcedureTumorMarkerKi-67AntigenResultType

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property
C17220
UMLS 2011AA Property
C0041365
NCI Thesaurus Property
C17675
UMLS 2011AA Property
C0208804
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
EBV Status
Beschrijving

AntibodyEpstein-BarrVirusTestType

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C14204
UMLS 2011AA Property
C0014644
NCI Thesaurus ObjectClass
C16295
UMLS 2011AA ObjectClass
C0003241
NCI Thesaurus Property
C25294
UMLS 2011AA Property
C0022885
Bulky Disease
Beschrijving

LymphomaLymphNodeLargeDiameterIndicator

Datatype

text

Alias
NCI Thesaurus ObjectClass
C12745
UMLS 2011AA ObjectClass
C0024204
NCI Thesaurus ObjectClass
C3208
UMLS 2011AA ObjectClass
C0024299
NCI Thesaurus Property
C25285
UMLS 2011AA Property
C1301886
NCI Thesaurus Property
C49508
UMLS 2011AA Property
C0549177
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
Comments
Beschrijving

Comments

Comments
Beschrijving

ResearchCommentsText

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
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Complete this form at baseline only

1 Formulieren
  1. StudyEvent: AMC-064 Baseline Lymphoma Disease Activity and Assessment Form (LAA)
    1. Complete this form at baseline only
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Unnamed1
HospitalAdmissionOrdinalNumber
Item
Visit Number
double
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16696 (NCI Thesaurus ObjectClass)
C0019994 (UMLS 2011AA ObjectClass)
C25385 (NCI Thesaurus Property)
C0809949 (UMLS 2011AA Property)
Item
Modified Ann Arbor Stage
text
C3208 (NCI Thesaurus ObjectClass)
C0024299 (UMLS 2011AA ObjectClass)
C16899 (NCI Thesaurus ValueDomain)
C1300072 (UMLS 2011AA ValueDomain)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
CL.1
Code List
Modified Ann Arbor Stage
CL Item
I (I)
CL Item
Ie (IE)
CL Item
Ii (II)
CL Item
Iie (IIE)
CL Item
Iii (III)
CL Item
Iiie (IIIE)
CL Item
Iiie+s (IIIE+S)
CL Item
Iiis (IIIS)
CL Item
Iv (IV)
Item
Recurring, drenching night sweats during the previous month (Does the participant have any of the following symptoms at the time of registration)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C3208 (NCI Thesaurus ObjectClass)
C0024299 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C36172 (NCI Thesaurus Property)
C0038990 (UMLS 2011AA Property)
CL.2
Code List
Recurring, drenching night sweats during the previous month (Does the participant have any of the following symptoms at the time of registration)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Unexplained, persistent fever >38 degrees C (or >100 degrees F) in the previous month (Does the participant have any of the following symptoms at the time of registration)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C3208 (NCI Thesaurus ObjectClass)
C0024299 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property)
C1457887 (UMLS 2011AA Property)
C3038 (NCI Thesaurus Property)
C0015967 (UMLS 2011AA Property)
CL.3
Code List
Unexplained, persistent fever >38 degrees C (or >100 degrees F) in the previous month (Does the participant have any of the following symptoms at the time of registration)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Unexplained weight loss >10% of body weight in the previous 6 months (Does the participant have any of the following symptoms at the time of registration)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C3445 (NCI Thesaurus Property)
C0043096 (UMLS 2011AA Property)
C3208 (NCI Thesaurus ObjectClass)
C0024299 (UMLS 2011AA ObjectClass)
CL.4
Code List
Unexplained weight loss >10% of body weight in the previous 6 months (Does the participant have any of the following symptoms at the time of registration)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Hematopoietic Diagnosis
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C13324 (NCI Thesaurus ObjectClass)
C0229601 (UMLS 2011AA ObjectClass)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
CL.5
Code List
Hematopoietic Diagnosis
CL Item
Diffuse Large B-cell Lymphoma (Diffuse large B-cell lymphoma)
C8851 (NCI Thesaurus)
C0079744 (UMLS 2011AA)
CL Item
Burkitt Lymphoma/leukemia (Burkitt lymphoma/leukemia)
CL Item
Primary Effusion Lymphoma (Primary effusion lymphoma)
C6915 (NCI Thesaurus)
C1292753 (UMLS 2011AA)
CL Item
Kshv/hhv-8+ Plasmablastic Lymphoma (lymph Node) (KSHV/HHV-8+ plasmablastic lymphoma (lymph node))
CL Item
Plasma Lymphoma Of Oral Cavity (Plasma lymphoma of oral cavity)
CL Item
Polymorphic B Cell Lymphoma-ptld Type (Polymorphic B cell lymphoma-PTLD type)
CL Item
Hodgkin's Lymphoma (Hodgkin lymphoma)
C9357 (NCI Thesaurus)
C0019829 (UMLS 2011AA)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Item
If diffuse large B-cell lymphoma, specify morphologic type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C8851 (NCI Thesaurus ObjectClass)
C0079744 (UMLS 2011AA ObjectClass)
C17943 (NCI Thesaurus Property)
C0700619 (UMLS 2011AA Property)
CL.6
Code List
If diffuse large B-cell lymphoma, specify morphologic type
CL Item
Centroblastic (Centroblastic)
CL Item
Immunoblastic (Immunoblastic)
CL Item
Not Specified (Not specified)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Item
If Burkitt lymphoma/leukemia, specify morphologic type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C2912 (NCI Thesaurus ObjectClass)
C0006413 (UMLS 2011AA ObjectClass)
C17943 (NCI Thesaurus Property)
C0700619 (UMLS 2011AA Property)
CL.7
Code List
If Burkitt lymphoma/leukemia, specify morphologic type
CL Item
Classical (Classical)
CL Item
Plasmacytoid (Plasmacytoid)
CL Item
B Cell Lymphoma Unclassifiable, W/features Intermediate Between Dlbcl And Burkitt's. (atypical) (B cell lymphoma unclassifiable, w/features intermediate between DLBCL and Burkitt's. (Atypical))
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
DiseaseDiagnosisHematopoieticSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C13324 (NCI Thesaurus ValueDomain)
C0229601 (UMLS 2011AA ValueDomain)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
DiseaseDiagnosisHematopoieticSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C13324 (NCI Thesaurus ValueDomain)
C0229601 (UMLS 2011AA ValueDomain)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
DiseaseDiagnosisHematopoieticSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C2991 (NCI Thesaurus ObjectClass)
C0012634 (UMLS 2011AA ObjectClass)
C13324 (NCI Thesaurus ValueDomain)
C0229601 (UMLS 2011AA ValueDomain)
C15220 (NCI Thesaurus Property)
C0011900 (UMLS 2011AA Property)
Item
If Hodgkin lymphoma, specify morphologic type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C9357 (NCI Thesaurus ObjectClass)
C0019829 (UMLS 2011AA ObjectClass)
C17943 (NCI Thesaurus Property)
C0700619 (UMLS 2011AA Property)
CL.8
Code List
If Hodgkin lymphoma, specify morphologic type
CL Item
Mixed Cellularity (Mixed cellularity)
CL Item
Nodular Sclerosis (Nodular sclerosis)
CL Item
Lymphocyte Rich (Lymphocyte rich)
CL Item
Lymphocyte Depleted (Lymphocyte depleted)
CL Item
Unclassified (Unclassified)
C64486 (NCI Thesaurus)
C0205426 (UMLS 2011AA)
CancerInitialDiagnosisDate
Item
Date of Initial Pathologic Diagnosis (mm/dd/yyyy)
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)
Item
Method of Evaluation
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
CL.9
Code List
Method of Evaluation
CL Item
Cytology (Cytology)
C16491 (NCI Thesaurus)
C0010819 (UMLS 2011AA)
CL Item
Biopsy (Biopsy)
C15189 (NCI Thesaurus)
C0005558 (UMLS 2011AA)
C15189 (NCI Thesaurus)
C0005558 (UMLS 2011AA)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
AssessmentMethodSpecify
Item
Other Specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
Item
Is the participant >60 years of age (Please enter the information below to obtain International Prognostic Index poor risk features)
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20118 (NCI Thesaurus ObjectClass)
C1512894 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.10
Code List
Is the participant >60 years of age (Please enter the information below to obtain International Prognostic Index poor risk features)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Does the participant have Stage III or IV disease (Please enter the information below to obtain International Prognostic Index poor risk features)
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20118 (NCI Thesaurus ObjectClass)
C1512894 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C16899 (NCI Thesaurus Property)
C1300072 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.11
Code List
Does the participant have Stage III or IV disease (Please enter the information below to obtain International Prognostic Index poor risk features)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Is the serum LDH elevated (Please enter the information below to obtain International Prognostic Index poor risk features)
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20118 (NCI Thesaurus ObjectClass)
C1512894 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25184 (NCI Thesaurus Property)
C0022917 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.12
Code List
Is the serum LDH elevated (Please enter the information below to obtain International Prognostic Index poor risk features)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Is the ECOG Performance Status 2, 3, or 4 (Please enter the information below to obtain International Prognostic Index poor risk features)
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20118 (NCI Thesaurus ObjectClass)
C1512894 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17847 (NCI Thesaurus Property)
C0278957 (UMLS 2011AA Property)
C17848 (NCI Thesaurus Property)
C0278958 (UMLS 2011AA Property)
C17846 (NCI Thesaurus Property)
C0278956 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.13
Code List
Is the ECOG Performance Status 2, 3, or 4 (Please enter the information below to obtain International Prognostic Index poor risk features)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item
Does the participant have two or more extranodal disease sites (Please enter the information below to obtain International Prognostic Index poor risk features)
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20118 (NCI Thesaurus ObjectClass)
C1512894 (UMLS 2011AA ObjectClass)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C2991 (NCI Thesaurus Property)
C0012634 (UMLS 2011AA Property)
C25504 (NCI Thesaurus Property)
C1517067 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.14
Code List
Does the participant have two or more extranodal disease sites (Please enter the information below to obtain International Prognostic Index poor risk features)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item
International Prognostic Index
double
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C20118 (NCI Thesaurus Property)
C1512894 (UMLS 2011AA Property)
C25338 (NCI Thesaurus ValueDomain)
C0449820 (UMLS 2011AA ValueDomain)
CL.15
Code List
International Prognostic Index
CL Item
0 (0)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
5 (5)
Item
IPI Risk Category
text
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C17102 (NCI Thesaurus Property)
C0035647 (UMLS 2011AA Property)
C20118 (NCI Thesaurus Property)
C1512894 (UMLS 2011AA Property)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
CL.16
Code List
IPI Risk Category
CL Item
Low Risk (Low risk)
CL Item
Low-intermediate Risk (Low-intermediate risk)
CL Item
High-intermediate Risk (High-intermediate risk)
CL Item
High Risk (High risk)
Item Group
Histogenetic Subtyping Markers
Item
Histogenetic Subtyping Markers
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C17220 (NCI Thesaurus ObjectClass)
C0041365 (UMLS 2011AA ObjectClass)
C25429 (NCI Thesaurus Property)
C0470187 (UMLS 2011AA Property)
CL.17
Code List
Histogenetic Subtyping Markers
CL Item
Cd10 (CD10)
CL Item
Bcl6 (BCL6)
CL Item
Mum1 (MUM1)
CL Item
Foxp1 (FOXP1)
CL Item
Gcet1 (GCET1)
Item
Finding Result
text
C3367 (NCI Thesaurus ObjectClass)
C0037088 (UMLS 2011AA ObjectClass)
CL282989 (NCI Metathesaurus Property)
C20200 (NCI Thesaurus ValueDomain)
C1274040 (UMLS 2011AA ValueDomain)
C3367 (NCI Thesaurus ValueDomain)
C0037088 (UMLS 2011AA ValueDomain)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.18
Code List
Finding Result
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Not Assessed (Not assessed)
C25594 (NCI Thesaurus)
C1518422 (UMLS 2011AA)
C25217 (NCI Thesaurus)
C1516048 (UMLS 2011AA)
Item
Ki-67 Staining Index Score
text
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C17220 (NCI Thesaurus Property)
C0041365 (UMLS 2011AA Property)
C17675 (NCI Thesaurus Property)
C0208804 (UMLS 2011AA Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.19
Code List
Ki-67 Staining Index Score
CL Item
0% To 29% (0% to 29%)
CL Item
30% To 59% (30% to 59%)
CL Item
60% To 79% (60% to 79%)
CL Item
80% To 100% (80% to 100%)
CL Item
Not Done (Not done)
Item
EBV Status
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C14204 (NCI Thesaurus Property)
C0014644 (UMLS 2011AA Property)
C16295 (NCI Thesaurus ObjectClass)
C0003241 (UMLS 2011AA ObjectClass)
C25294 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA Property)
CL.20
Code List
EBV Status
CL Item
Eber Positive (EBER positive)
CL Item
Eber Negative (EBER negative)
CL Item
Not Done (Not done)
Item
Bulky Disease
text
C12745 (NCI Thesaurus ObjectClass)
C0024204 (UMLS 2011AA ObjectClass)
C3208 (NCI Thesaurus ObjectClass)
C0024299 (UMLS 2011AA ObjectClass)
C25285 (NCI Thesaurus Property)
C1301886 (UMLS 2011AA Property)
C49508 (NCI Thesaurus Property)
C0549177 (UMLS 2011AA Property)
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
CL.21
Code List
Bulky Disease
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
Item Group
Comments
ResearchCommentsText
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
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