RegistrationStep
Item
Registration Step
text
Patient'sName
Item
Patient?s Name
text
ECOGProtocolNo.
Item
ECOG Protocol No.
text
ECOGProtocolNo.
Item
ECOG Protocol No.
text
ECOGPatientID
Item
ECOG Patient ID
text
ECOGPatientID
Item
ECOG Patient ID
text
ParticipatingGroupProtocolNo.
Item
Participating Group Protocol No.
text
ParticipatingGroupPatientID
Item
Participating Group Patient ID
text
MainMemberInstitution/Affiliate
Item
Institution/Affiliate
text
SpecimenCentralLaboratorySubmissionDate
Item
Date material(s) sent to central laboratory
date
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C0205099 (NCI Metathesaurus Property)
C25694 (NCI Thesaurus Property)
C1515022 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Item
Shipped to
text
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25341 (NCI Thesaurus Property)
C0450429 (UMLS 2011AA Property)
C25639 (NCI Thesaurus Property)
C1514756 (UMLS 2011AA Property)
C37984 (NCI Thesaurus Property)
C0022877 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
CL Item
Leukemia Immunophenotyping Reference Library (Leukemia Immunophenotyping Reference Library)
CL Item
Ecog Cytogenetics Laboratory (ECOG Cytogenetics Laboratory)
CL Item
Other Central Laboratory (Other Central Laboratory)
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
SpecimenCollectionDate
Item
Date Materials collected
date
Item
Tissue/material type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Tissue/material type
CL Item
Peripheral Blood (peripheral blood)
C0229664 (NCI Metathesaurus)
CL Item
Bone Marrow Aspirate (bone marrow aspirate)
CL042344 (NCI Metathesaurus)
CL Item
Bone Marrow Biopsy (bone marrow biopsy)
C15193 (NCI Thesaurus)
C0005954 (UMLS 2011AA)
CL Item
Karyotype (karyotype)
C25215 (NCI Thesaurus)
C1261273 (UMLS 2011AA)
CL Item
Peripheral Blood Stem Cell Harvest (peripheral blood stem cell harvest)
C0457411 (NCI Metathesaurus)
CL Item
Other (other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Item
Type of collection/stain/process
text
Code List
Type of collection/stain/process
CL Item
Green Top (heparinized) (green top (heparinized))
CL Item
Red Top (red top)
CL Item
Slide, Unstained, Charged (slide, unstained, charged)
CL Item
Slide/air Dried Smear (slide/air dried smear)
CL Item
Karyotype (karyotype)
C25215 (NCI Thesaurus)
C1261273 (UMLS 2011AA)
CL Item
Stem Cell Harvest (stem cell harvest)
CL Item
Other (other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Item
Timing of material collection
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25616 (NCI Thesaurus Property)
C1948053 (UMLS 2011AA Property)
C25453 (NCI Thesaurus Property)
C1516698 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
Code List
Timing of material collection
CL Item
Baseline/pretreatment (baseline/pretreatment)
CL Item
Pre-transplant Remission Prior To Consolidation (pre-transplant remission prior to consolidation)
CL Item
Pre-transplant , Post-consolidation Chemotherapy (pre-transplant , post-consolidation chemotherapy)
CL Item
1 Mo. Post-transplant (1 mo. Post-transplant)
CL Item
6 Mos. Post-transplant (6 mos. Post-transplant)
CL Item
12 Mos. Post-transplant (12 mos. Post-transplant)
CL Item
Stem Cell Harvest (stem cell harvest)
CL Item
Relapse (relapse)
C18265 (NCI Thesaurus)
CL Item
Other (other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
numberofspecimenssubmitted
Item
number of specimens submitted
text
Item
Diagnosis
text
C25372 (NCI Thesaurus ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C3161 (NCI Thesaurus ObjectClass)
C0023418 (UMLS 2011AA ObjectClass)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
CL Item
Disease Classified As Aml, Not Otherwise Specified (nos) (acute myeloid leukemia)
CL Item
Disease Classified As All, Not Otherwise Specified (nos); (acute lymphocytic leukemia)
CL Item
Disease Classified As Chronic Myelogenous Leukemia, (cml), Blast Crisis (CML - blast cells)
CL Item
Disease Classified As Chronic Lymphocytic Leukemia (cll) (chronic lymphocytic leukemia)
CL Item
Disease Classified As Chronic Myelogenous Leukemia (cml), Chronic Phase (CML-chronic phase)
CL Item
Disease Classified As Myelodysplastic Syndrome (mds) Nos (MDS-myelodysplastic syndrome)
CL Item
Disease Classified As Specified Other Leukemia (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
CL Item
Unknown (Unknown)
Lab,Hematology,BlastCount
Item
Absolute blast count
double
ContactPersonatInstitution
Item
Institution contact name
text
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25461 (NCI Thesaurus ObjectClass)
C0337611 (UMLS 2011AA ObjectClass)
RegisteredInvestigator
Item
Principal Investigator name
text
InstitutionContactTelephoneNumber
Item
Institution contact phone number
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25395 (NCI Thesaurus Property)
C0039457 (UMLS 2011AA Property)
C25461 (NCI Thesaurus ObjectClass)
C0337611 (UMLS 2011AA ObjectClass)
InstitutionContactFaxNumber
Item
Institution contact fax number
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C21541 (NCI Thesaurus ObjectClass)
C0018704 (UMLS 2011AA ObjectClass)
C25461 (NCI Thesaurus ObjectClass)
C0337611 (UMLS 2011AA ObjectClass)
C25210 (NCI Thesaurus Property)
C0085205 (UMLS 2011AA Property)
SpecimenReceivedDate
Item
Date materials received at central lab
date
CL Item
2 (2)
C66833 (NCI Thesaurus)
C0205448 (UMLS 2011AA)
Item
Condition of material(s)
text
Code List
Condition of material(s)
CL Item
Damaged Or Unusable (not usable as received)
CL Item
Useable (usable as received)
Item
Aliquots of sample made
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
Code List
Aliquots of sample made
CL Item
No (no)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CentralLaboratoryContactPersonName
Item
Central Laboratory contact name
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C37984 (NCI Thesaurus ObjectClass)
C0022877 (UMLS 2011AA ObjectClass)
C0205099 (NCI Metathesaurus ObjectClass)
C25461 (NCI Thesaurus ObjectClass)
C0337611 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
CentralLaboratoryContactTelephoneNumber
Item
contact phone number
text
C25461 (NCI Thesaurus ObjectClass)
C0337611 (UMLS 2011AA ObjectClass)
C64207 (NCI Thesaurus ObjectClass)
C1880016 (UMLS 2011AA ObjectClass)
C25395 (NCI Thesaurus Property)
C0039457 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25395 (NCI Thesaurus ValueDomain)
C0039457 (UMLS 2011AA ValueDomain)
CentralLaboratoryContactFaxNumber
Item
Contact fax number
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25461 (NCI Thesaurus ObjectClass)
C0337611 (UMLS 2011AA ObjectClass)
C64207 (NCI Thesaurus ObjectClass)
C1880016 (UMLS 2011AA ObjectClass)
C25210 (NCI Thesaurus Property)
C0085205 (UMLS 2011AA Property)
Comments
Item
Comments
text
InvestigatorSignature
Item
Investigator signature
text
C25678 (NCI Thesaurus Property)
C1519316 (UMLS 2011AA Property)
C17089 (NCI Thesaurus ObjectClass)
C0035173 (UMLS 2011AA ObjectClass)
InvestigatorSignatureDate
Item
Date
date
PeripheralandMarrowBlastPercentage(%)
Item
Peripheral and Marrow Blast Percentage (%)
text
SampleNo.
Item
Sample No.
text