Withdrawal date
Item
Date of wlthdrawal from study
date
C2349954 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Reason for withdrawal from study (check primary reason only)
integer
C2349954 (UMLS CUI [1,1])
C0392360 (UMLS CUI [1,2])
C0008976 (UMLS CUI [1,3])
Code List
Reason for withdrawal from study (check primary reason only)
CL Item
Patient was lost to follow-up (explain below). (1)
CL Item
Patient wished to withdraw from study (explain below). (2)
CL Item
Patient received alternative therapy (explain below). (3)
CL Item
Patient had progressive disease. (4)
CL Item
Patient died (complete Form 39). (5)
CL Item
Other (specify) (6)
Date of last contact
Item
Date of last contact
date
C0805839 (UMLS CUI [1])
Explanation of withdrawal
Item
Explanation of withdrawal (when appropriate)
text
C2349954 (UMLS CUI [1,1])
C0681841 (UMLS CUI [1,2])
Date of status
Item
Date of status
date
C0011008 (UMLS CUI [1,1])
C0449437 (UMLS CUI [1,2])
Item
Patient status:
integer
C0449437 (UMLS CUI [1])
Code List
Patient status:
CL Item
Dead (complete "Notification of Patient Death" Form) (2)
CL Item
Lost to follow-up (3)
Item
How was contact made:
integer
C1705415 (UMLS CUI [1,1])
C0337611 (UMLS CUI [1,2])
Code List
How was contact made:
CL Item
Tumor registry (1)
CL Item
Contact with patient (2)
CL Item
Contact with MD (3)
CL Item
Contact with family (4)
Other way of contact
Item
Other way of contact
text
C1705415 (UMLS CUI [1,1])
C0337611 (UMLS CUI [1,2])
Response to lodine-131 Tositumomab
Item
Does the patient have an ongoing response to lodine-131 Tositumomab?
boolean
C0768182 (UMLS CUI [1,1])
C0521982 (UMLS CUI [1,2])
Additional Therapy
Item
Has any additional therapy for NHL been administered?
boolean
C1706712 (UMLS CUI [1])
Myelodysplasia
Item
Has the patient had a documented diagnosis of myelodysplasia?
boolean
C0026985 (UMLS CUI [1])
Myelodysplasia diagnosis date
Item
If yes, date of diagnosis:
date
C2316983 (UMLS CUI [1,1])
C0026985 (UMLS CUI [1,2])
AML
Item
Has the patient had a documented diagnosis of AML?
boolean
C0023467 (UMLS CUI [1])
AML diagnosis date
Item
If yes, date of diagnosis:
date
C2316983 (UMLS CUI [1,1])
C0023467 (UMLS CUI [1,2])
Other malignancy
Item
Has the patient had a diagnosis of another malignancy?
boolean
C0006826 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Other malignancy diagnosis date
Item
If yes, date of diagnosis:
date
C2316983 (UMLS CUI [1,1])
C0006826 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Type of malignancy
Item
Type of malignancy:
text
C0006826 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Subsequent NHL Therapy since last LTFU
Item
Subsequent NHL Therapy since last LTFU
text
C2734539 (UMLS CUI [1,1])
C0008972 (UMLS CUI [1,2])
Therapy Start date
Item
Therapy Start date
date
C3173309 (UMLS CUI [1])
Therapy Stop Date
Item
Therapy Stop Date
date
C1531784 (UMLS CUI [1])
Total # of Cycles
Item
Total # of Cycles
integer
C0449788 (UMLS CUI [1,1])
C1302181 (UMLS CUI [1,2])
TSH Date
Item
TSH Date
date
C0040160 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
TSH Result
Item
Result:
float
C0202230 (UMLS CUI [1,1])
C1274040 (UMLS CUI [1,2])
Thyroid replacement therapy
Item
Has the patient begun thyroid replacement therapy since the last LTFU?
boolean
C2242640 (UMLS CUI [1])
Therapy start date
Item
If yes, start date:
date
C3173309 (UMLS CUI [1])
Drug Name
Item
Drug Name:
text
C0013227 (UMLS CUI [1])
Item
Was a HAMA obtained since the last LTFU?
integer
C1291910 (UMLS CUI [1])
Code List
Was a HAMA obtained since the last LTFU?
CL Item
Not applicable (3)
Accession #
Item
If yes, enter accession #
integer
C1510755 (UMLS CUI [1,1])
C2826726 (UMLS CUI [1,2])
Investigator Signature
Item
Investigator Signature:
text
C2346576 (UMLS CUI [1])
Date
Item
Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Cause of death (check one)
integer
C0007465 (UMLS CUI [1])
Code List
Cause of death (check one)
CL Item
Progression of lymphoma (1)
CL Item
Complications related to drug (complete Adverse Experiences form) (2)
CL Item
Other (specify) (3)
Other Cause of Death
Item
Other Cause of Death:
text
C0007465 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
Item
Relationship of study drug to patient's death (check one)
integer
C0007465 (UMLS CUI [1,1])
C0304229 (UMLS CUI [1,2])
Code List
Relationship of study drug to patient's death (check one)
Item
Source of Information concerning death of patient
integer
C0030705 (UMLS CUI [1,1])
C0011065 (UMLS CUI [1,2])
C0449416 (UMLS CUI [1,3])
Code List
Source of Information concerning death of patient
CL Item
Hospital physician (1)
CL Item
Patient's physician (2)
CL Item
Newspaper (obituary) (4)
CL Item
Tumor registry (5)
CL Item
Other (specify) (6)
Other Source
Item
Other Source of Information concerning death of patient
text
C0683836 (UMLS CUI [1,1])
C0011065 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])