ID

43189

Description

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

Keywords

  1. 9/20/12 9/20/12 -
  2. 9/20/21 9/20/21 -
Uploaded on

September 20, 2021

DOI

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License

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

    Complete this form at baseline only

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

    Unnamed1

    Visit Number
    Description

    HospitalAdmissionOrdinalNumber

    Data type

    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
    Description

    Unnamed2

    Modified Ann Arbor Stage
    Description

    LymphomaAnnArborLymphomaStagingSystemClassificationStage

    Data type

    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)
    Description

    LymphomaSweatingSymptomInd-3

    Data type

    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)
    Description

    LymphomaFeverSymptomInd-3

    Data type

    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)
    Description

    LymphomaWeightLossInd-3

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus Property
    C3445
    UMLS 2011AA Property
    C1262477
    NCI Thesaurus ObjectClass
    C3208
    UMLS 2011AA ObjectClass
    C0024299
    Hematopoietic Diagnosis
    Description

    HematopoieticDiseaseDiagnosisType

    Data type

    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
    Description

    DiffuseLargeB-CellLymphomaMorphologyType

    Data type

    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
    Description

    Burkitt'sLymphomaMorphologyType

    Data type

    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
    Description

    DiseaseDiagnosisHematopoieticSpecify

    Data type

    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
    Description

    DiseaseDiagnosisHematopoieticSpecify

    Data type

    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
    Description

    DiseaseDiagnosisHematopoieticSpecify

    Data type

    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
    Description

    Hodgkin'sLymphomaMorphologyType

    Data type

    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)
    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
    Method of Evaluation
    Description

    AssessmentMethodType

    Data type

    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
    Description

    AssessmentMethodSpecify

    Data type

    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)
    Description

    InternationalPrognosticIndexPatientAgeAssessmentInd-2

    Data type

    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)
    Description

    InternationalPrognosticIndexPatientStageAssessmentInd-2

    Data type

    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)
    Description

    InternationalPrognosticIndexPatientLactateDehydrogenaseAssessmentInd-2

    Data type

    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)
    Description

    InternationalPrognosticIndexPatientPerformanceStatus2-4AssessmentInd-2

    Data type

    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)
    Description

    InternationalPrognosticIndexPatientExtranodalDiseaseAssessmentInd-2

    Data type

    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
    Description

    PatientInternationalPrognosticIndexScore

    Data type

    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
    Description

    PatientInternationalPrognosticIndexRiskCategory

    Data type

    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
    Description

    Histogenetic Subtyping Markers

    Histogenetic Subtyping Markers
    Description

    TumorMarkerAvailableAssessmentType

    Data type

    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
    Description

    FindingResultStatus

    Data type

    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
    Description

    LaboratoryProcedureTumorMarkerKi-67AntigenResultType

    Data type

    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
    Description

    AntibodyEpstein-BarrVirusTestType

    Data type

    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
    Description

    LymphomaLymphNodeLargeDiameterIndicator

    Data type

    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
    Description

    Comments

    Comments
    Description

    ResearchCommentsText

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393
    UMLS 2011AA Property
    C0282411

    Similar models

    Complete this form at baseline only

    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)
    Data type
    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)
    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)
    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)
    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)
    C1262477 (UMLS 2011AA Property)
    C3208 (NCI Thesaurus ObjectClass)
    C0024299 (UMLS 2011AA ObjectClass)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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)
    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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