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43252

Descrizione

E2905 Follow Up Disease Evaluation Form Lenalidomide With or Without Epoetin Alfa in Treating Patients With Myelodysplastic Syndrome and Anemia NCT00843882 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0F12A9EE-8D74-6165-E044-0003BA3F9857

collegamento

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0F12A9EE-8D74-6165-E044-0003BA3F9857

Keywords

versioni (4)
  1. 18/12/14 18/12/14 - Martin Dugas
  2. 08/01/15 08/01/15 - Martin Dugas
  3. 23/01/15 23/01/15 - Martin Dugas
  4. 20/09/21 20/09/21 -
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20 settembre 2021

DOI

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Creative Commons BY-NC 3.0 Legacy
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    Follow Up Disease Evaluation Form (E2905 NCT00843882)

    Inglese

    INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files

    1 moduli  
    Header
    Descrizione

    Header

    ECOG Protocol Number
    Descrizione

    Protocol Number ECOG

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1512162
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25491
    ECOG Patient ID
    Descrizione

    Patient ID ECOG

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C1512162
    NCI Thesaurus Property
    C25364
    NCI Thesaurus Property-2
    C25491
    DCI Name
    Descrizione

    Generic drug form

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C3242750
    NCI Thesaurus Property
    C19464
    NCI Thesaurus ObjectClass
    C25474
    NCI Thesaurus ObjectClass-2
    C25452
    Registration Step
    Descrizione

    Registration Number

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C1514821
    NCI Thesaurus ObjectClass
    C25646
    UMLS CUI-2
    C0237753
    NCI Thesaurus Property
    C16154
    NCI Thesaurus ValueDomain-2
    C16154
    Patient Initials (Last, First)
    Descrizione

    Patient Initials

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    Participating Group Protocol Number
    Descrizione

    Study Number Participating Group

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Participating Group Patient ID
    Descrizione

    Trial subject ID Participating Group

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Institution/Affiliate
    Descrizione

    Institution Name

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C25454
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass-2
    C21541
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ValueDomain
    C25191
    NCI Thesaurus ValueDomain-2
    C21541
    Please mark an 'X' if data have been amended. (Please circle amended items in red)
    Descrizione

    Data amended

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C0680532
    NCI Thesaurus ObjectClass
    C25474
    NCI Thesaurus Property
    C25416
    Date data amended (MM/DD/YYYY)
    Descrizione

    Data amended date

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C0680532
    NCI Thesaurus ObjectClass
    C25474
    UMLS CUI-2
    C0011008
    NCI Thesaurus Property
    C25416
    NCI Thesaurus ValueDomain-2
    C25367
    Investigator Signature
    Descrizione

    Investigator Signature

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C2346576
    NCI Thesaurus Property
    C25678
    NCI Thesaurus ObjectClass
    C17089
    Investigator Signature Date
    Descrizione

    Investigator Signature Date

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS CUI-1
    C2346576
    NCI Thesaurus Property
    C25678
    UMLS CUI-2
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    NCI Thesaurus ObjectClass
    C17089
    On Treatment
    Descrizione

    On Treatment

    On Treatment Report Period (Step 2 - Choose one x)
    Descrizione

    Cycle number

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C2045829
    NCI Thesaurus Property
    C25214
    NCI Thesaurus Property-2
    C25616
    NCI Thesaurus ObjectClass
    C15368
    Specify Cycle
    Descrizione

    Chemotherapy cycle

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C15368
    NCI Thesaurus Property
    C25214
    UMLS CUI-1
    C1302181
    NCI Thesaurus Property-2
    C25616
    NCI Thesaurus ValueDomain
    C25685
    NCI Thesaurus ValueDomain-2
    C25472
    NCI Thesaurus ValueDomain-3
    C25275
    Off Treatment
    Descrizione

    Off Treatment

    Off Treatment Report Period (since registration - Choose one x)
    Descrizione

    PersonOff-TreatmentTimePeriodType

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25616
    UMLS 2011AA Property
    C1948053
    NCI Thesaurus Property-2
    C25601
    UMLS 2011AA Property-2
    C1518544
    NCI Thesaurus Property-3
    C25207
    UMLS 2011AA Property-3
    C0040223
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    Unnamed5
    Descrizione

    Unnamed5

    MDS classification
    Descrizione

    MyelodysplasticSyndromeWorldHealthOrganizationClassificationCategory

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25372
    NCI Thesaurus ObjectClass
    C3247
    NCI Thesaurus Property
    C25161
    NCI Thesaurus Property-2
    C75419
    UMLS CUI-1
    C3463824
    UMLS CUI-2
    C0008902
    Was bone marrow biopsy done
    Descrizione

    BoneMarrowBiopsyInd

    Tipo di dati

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C25180
    NCI Thesaurus Property
    C15189
    NCI Thesaurus ObjectClass
    C12431
    UMLS CUI-1
    C0005954
    Date of Bone Marrow Biopsy (Aspirate)
    Descrizione

    BoneMarrowBiopsyDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    NCI Thesaurus ValueDomain-2
    C25367
    NCI Thesaurus Property
    C15189
    NCI Thesaurus ObjectClass
    C12431
    UMLS CUI-1
    C0005954
    UMLS CUI-2
    C0011008
    Marrow Blasts
    Descrizione

    LaboratoryProcedureBoneMarrowBlastCellOutcomePercentageValue

    Tipo di dati

    float

    Unità di misura
    • %
    Alias
    NCI Thesaurus ObjectClass
    C25294
    NCI Thesaurus Property
    C12431
    NCI Thesaurus Property-2
    C20200
    NCI Thesaurus Property-3
    C12918
    NCI Thesaurus ValueDomain
    C25613
    NCI Thesaurus ValueDomain-2
    C25712
    UMLS CUI-1
    C1982687
    %
    Marrow Cellularity
    Descrizione

    LaboratoryProcedureBoneMarrowCellularityOutcomePercentageValue

    Tipo di dati

    float

    Unità di misura
    • %
    Alias
    NCI Thesaurus ObjectClass
    C25294
    NCI Thesaurus Property
    C12431
    NCI Thesaurus Property-2
    C20200
    NCI Thesaurus Property-3
    C37923
    NCI Thesaurus ValueDomain
    C25613
    NCI Thesaurus ValueDomain-2
    C25712
    UMLS CUI-1
    C1561532
    %
    Reason bone marrow cellularity was not recorded
    Descrizione

    LaboratoryProcedureBoneMarrowCellularityNegationReportOutcomeReason

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C25294
    NCI Thesaurus Property
    C25594
    NCI Thesaurus Property-2
    C12431
    NCI Thesaurus Property-3
    C25375
    NCI Thesaurus Property-4
    C20200
    NCI Thesaurus Property-5
    C37923
    NCI Thesaurus ValueDomain
    C25638
    UMLS CUI-1
    C1561532
    UMLS CUI-2
    C1546437
    Dysplasia
    Descrizione

    DysplasiaPresentInd-3

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    NCI Thesaurus Property
    C25626
    NCI Thesaurus ObjectClass
    C4086
    UMLS CUI-1
    C0334044
    Dysplasia type
    Descrizione

    DysplasiaHistologyType

    Tipo di dati

    integer

    Alias
    NCI Thesaurus ValueDomain
    C25284
    NCI Thesaurus Property
    C16681
    NCI Thesaurus ObjectClass
    C4086
    UMLS CUI-1
    C0334044
    UMLS CUI-2
    C0683312
    Is cytogenetic abnormality present now
    Descrizione

    CytogeneticAbnormalityPresentIndicator

    Tipo di dati

    text

    Alias
    NCI Thesaurus Property
    C25626
    NCI Thesaurus ObjectClass
    C2950
    NCI Metathesaurus ValueDomain
    C0021212
    UMLS CUI-1
    C0008625
    Section Ii
    Descrizione

    Section Ii

    Did the patient require packed red blood cell (PRBC) transfusions (in the last 8 weeks)
    Descrizione

    PackedRedBloodCellTransfusionRequirementInd-3

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS 2011AA ValueDomain
    C1512699
    NCI Thesaurus ObjectClass
    C15409
    UMLS 2011AA ObjectClass
    C0199962
    NCI Thesaurus Property
    C25382
    UMLS 2011AA Property
    C1521801
    Total number of units PRBC (transfused in the last 8 weeks)
    Descrizione

    PackedRedBloodCellTransfusionReceivedUnitCount

    Tipo di dati

    float

    Alias
    NCI Thesaurus ValueDomain
    C44278
    UMLS 2011AA ValueDomain
    C0439148
    NCI Thesaurus Property
    C25639
    UMLS 2011AA Property
    C1514756
    NCI Thesaurus ValueDomain-2
    C25463
    UMLS 2011AA ValueDomain-2
    C0750480
    NCI Thesaurus ObjectClass
    C15409
    UMLS 2011AA ObjectClass
    C0199962
    Date of First Transfusion (in the last 8 weeks)
    Descrizione

    PackedRedBloodCellTransfusionReceivedFirstDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus Property
    C25639
    UMLS 2011AA Property
    C1514756
    NCI Thesaurus ValueDomain-2
    C25509
    UMLS 2011AA ValueDomain-2
    C1279901
    NCI Thesaurus ObjectClass
    C15409
    UMLS 2011AA ObjectClass
    C0199962
    Date of most recent PRBC transfusion
    Descrizione

    PackedRedBloodCellTransfusionReceivedMostRecentDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus Property
    C25639
    UMLS 2011AA Property
    C1514756
    NCI Thesaurus ObjectClass
    C15409
    UMLS 2011AA ObjectClass
    C0199962
    NCI Thesaurus ValueDomain-2
    C25577
    UMLS 2011AA ValueDomain-2
    C1513491
    Mds Response
    Descrizione

    Mds Response

    Best response to date
    Descrizione

    MyelodysplasticSyndromeResponseType

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus Property
    C25755
    UMLS 2011AA Property
    C0871261
    NCI Thesaurus ObjectClass
    C3247
    UMLS 2011AA ObjectClass
    C3463824
    First observed date
    Descrizione

    MyelodysplasticSyndromeResponseFirstDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus Property
    C25755
    UMLS 2011AA Property
    C0871261
    NCI Thesaurus ObjectClass
    C3247
    UMLS 2011AA ObjectClass
    C3463824
    NCI Thesaurus ValueDomain-2
    C25509
    UMLS 2011AA ValueDomain-2
    C1279901
    First Confirmed Date
    Descrizione

    MyelodysplasticSyndromeResponseDiagnosisDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus Property
    C25755
    UMLS 2011AA Property
    C0871261
    NCI Thesaurus ObjectClass
    C3247
    UMLS 2011AA ObjectClass
    C3463824
    NCI Thesaurus ValueDomain-2
    C15220
    UMLS 2011AA ValueDomain-2
    C0011900
    Relapse
    Descrizione

    DiseaseRelapseInd-3

    Tipo di dati

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    NCI Thesaurus Property
    C18265
    NCI Thesaurus ObjectClass
    C2991
    UMLS CUI-1
    C0277556
    Date of relapse
    Descrizione

    DiseaseRelapseDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    NCI Thesaurus Property
    C18265
    NCI Thesaurus ObjectClass
    C2991
    UMLS CUI-1
    C0035020
    UMLS CUI-2
    C0011008
    If Hematologic improvement
    Descrizione

    DiseaseMyelodysplasticSyndromeHematologyResponseType

    Tipo di dati

    text

    Alias
    NCI Thesaurus ObjectClass
    C2991
    NCI Thesaurus Property
    C3247
    NCI Thesaurus Property-2
    C16673
    NCI Thesaurus Property-3
    C50995
    NCI Thesaurus ValueDomain
    C25284
    UMLS CUI-1
    C0012634
    UMLS CUI-2
    C3463824
    UMLS CUI-3
    C0018943
    UMLS CUI-4
    C1704632
    UMLS CUI-5
    C0332307
    First observed date (HI)
    Descrizione

    DiseaseMyelodysplasticSyndromeHematologyResponseFirstDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ObjectClass
    C2991
    NCI Thesaurus Property
    C3247
    NCI Thesaurus Property-2
    C16673
    NCI Thesaurus Property-3
    C50995
    NCI Thesaurus ValueDomain
    C25164
    NCI Thesaurus ValueDomain-2
    C25509
    UMLS CUI-1
    C0012634
    UMLS CUI-2
    C3463824
    UMLS CUI-3
    C0018943
    UMLS CUI-4
    C1704632
    UMLS CUI-5
    C0011008
    UMLS CUI-6
    C1279901
    First confirmed date (HI)
    Descrizione

    DiseaseMyelodysplasticSyndromeHematologyResponseDiagnosisDate

    Tipo di dati

    date

    Alias
    NCI Thesaurus ObjectClass
    C2991
    NCI Thesaurus Property
    C3247
    NCI Thesaurus Property-2
    C16673
    NCI Thesaurus Property-3
    C50995
    NCI Thesaurus ValueDomain
    C25164
    NCI Thesaurus ValueDomain-2
    C15220
    UMLS CUI-1
    C0012634
    UMLS CUI-2
    C3463824
    UMLS CUI-3
    C0018943
    UMLS CUI-4
    C1704632
    UMLS CUI-5
    C0011008
    UMLS CUI-6
    C0011900
    Cytogenetic Response
    Descrizione

    CytogeneticResponseType

    Tipo di dati

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus Property
    C50995
    UMLS 2011AA Property
    C1704632
    NCI Thesaurus ObjectClass
    C17938
    UMLS 2011AA ObjectClass
    C0314603
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    Similar models

    INSTRUCTIONS: Complete this form and submit original to the ECOG Coordinating Center within one week of registration. Keep a copy for your files

    1 moduli
    Name
    genere
    Description | Question | Decode (Coded Value)
    Tipo di dati
    Alias
    Item Group
    Header
    Protocol Number ECOG
    Item
    ECOG Protocol Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1512162 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25491 (NCI Thesaurus Property-2)
    Patient ID ECOG
    Item
    ECOG Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C1512162 (UMLS CUI-2)
    C25364 (NCI Thesaurus Property)
    C25491 (NCI Thesaurus Property-2)
    Generic drug form
    Item
    DCI Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C3242750 (UMLS CUI-1)
    C19464 (NCI Thesaurus Property)
    C25474 (NCI Thesaurus ObjectClass)
    C25452 (NCI Thesaurus ObjectClass-2)
    Registration Number
    Item
    Registration Step
    text
    C25337 (NCI Thesaurus ValueDomain)
    C1514821 (UMLS CUI-1)
    C25646 (NCI Thesaurus ObjectClass)
    C0237753 (UMLS CUI-2)
    C16154 (NCI Thesaurus Property)
    C16154 (NCI Thesaurus ValueDomain-2)
    Patient Initials
    Item
    Patient Initials (Last, First)
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    Study Number Participating Group
    Item
    Participating Group Protocol Number
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Trial subject ID Participating Group
    Item
    Participating Group Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Institution Name
    Item
    Institution/Affiliate
    text
    C25454 (NCI Thesaurus ObjectClass)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C25191 (NCI Thesaurus ValueDomain)
    C21541 (NCI Thesaurus ValueDomain-2)
    Data amended
    Item
    Please mark an 'X' if data have been amended. (Please circle amended items in red)
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C25416 (NCI Thesaurus Property)
    Data amended date
    Item
    Date data amended (MM/DD/YYYY)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C0011008 (UMLS CUI-2)
    C25416 (NCI Thesaurus Property)
    C25367 (NCI Thesaurus ValueDomain-2)
    Investigator Signature
    Item
    Investigator Signature
    text
    C25704 (NCI Thesaurus ValueDomain)
    C2346576 (UMLS CUI-1)
    C25678 (NCI Thesaurus Property)
    C17089 (NCI Thesaurus ObjectClass)
    Investigator Signature Date
    Item
    Investigator Signature Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C2346576 (UMLS CUI-1)
    C25678 (NCI Thesaurus Property)
    C0011008 (UMLS CUI-2)
    C25367 (NCI Thesaurus ValueDomain-2)
    C17089 (NCI Thesaurus ObjectClass)
    Item Group
    On Treatment
    Item
    On Treatment Report Period (Step 2 - Choose one x)
    text
    C25284 (NCI Thesaurus ValueDomain)
    C2045829 (UMLS CUI-1)
    C25214 (NCI Thesaurus Property)
    C25616 (NCI Thesaurus Property-2)
    C15368 (NCI Thesaurus ObjectClass)
    CL.2
    Code List
    On Treatment Report Period (Step 2 - Choose one x)
    CL Item
    Cycle 1 Step 2 (Cycle 1 Step 2)
    CL Item
    Cycle 2 Step 2 (Cycle 2 Step 2)
    CL Item
    Cycle 3 Step 2 (Cycle 3 Step 2)
    CL Item
    Cycle 4 Step 2 (Cycle 4 Step 2)
    CL Item
    Cycle 5 Step 2 (Cycle 5 Step 2)
    CL Item
    Cycle 6 Step 2 (Cycle 6 Step 2)
    CL Item
    Cycle 7 Step 2 (Cycle 7 Step 2)
    CL Item
    Cycle 8 Step 2 (Cycle 8 Step 2)
    CL Item
    Cycle 9 Step 2 (Cycle 9 Step 2)
    CL Item
    Cycle 10 Step 2 (Cycle 10 Step 2)
    CL Item
    Cycle 11 Step 2 (Cycle 11 Step 2)
    CL Item
    Cycle 12 Step 2 (Cycle 12 Step 2)
    CL Item
    Cycle 13-step 2 (Cycle 13-Step 2)
    CL Item
    >cycle 13-step 2 (>Cycle 13-Step 2)
    Chemotherapy cycle
    Item
    Specify Cycle
    text
    C15368 (NCI Thesaurus ObjectClass)
    C25214 (NCI Thesaurus Property)
    C1302181 (UMLS CUI-1)
    C25616 (NCI Thesaurus Property-2)
    C25685 (NCI Thesaurus ValueDomain)
    C25472 (NCI Thesaurus ValueDomain-2)
    C25275 (NCI Thesaurus ValueDomain-3)
    Item Group
    Off Treatment
    Item
    Off Treatment Report Period (since registration - Choose one x)
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25616 (NCI Thesaurus Property)
    C1948053 (UMLS 2011AA Property)
    C25601 (NCI Thesaurus Property-2)
    C1518544 (UMLS 2011AA Property-2)
    C25207 (NCI Thesaurus Property-3)
    C0040223 (UMLS 2011AA Property-3)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    CL.3
    Code List
    Off Treatment Report Period (since registration - Choose one x)
    CL Item
    3 Months Post End Of Treatment (3 months post end of treatment)
    CL Item
    6 Months Post End Of Treatment (6 months post end of treatment)
    Item Group
    Unnamed5
    Item
    MDS classification
    text
    C25372 (NCI Thesaurus ValueDomain)
    C3247 (NCI Thesaurus ObjectClass)
    C25161 (NCI Thesaurus Property)
    C75419 (NCI Thesaurus Property-2)
    C3463824 (UMLS CUI-1)
    C0008902 (UMLS CUI-2)
    CL.4
    Code List
    MDS classification
    CL Item
    Myelodysplastic Syndrome Associated With Isolated Del (5q) Chromosome Abnormality (MDS associated with isolated del(5q))
    C6867 (NCI Thesaurus)
    C1292779 (UMLS 2011AA)
    CL Item
    No Evidence Of Disease (No evidence of disease)
    CL Item
    Refractory Cytopenia With Multilineage Dysplasia (Refractory Cytopenia with Multilineage Dysplasia)
    C8574 (NCI Thesaurus)
    C0796466 (UMLS 2011AA)
    CL Item
    Refractory Cytopenia With Multilineage Dysplasia And Ringed Sideroblasts (Refractory Cytopenia with Multilineage Dysplasia and Ringed Sideroblasts)
    C27726 (NCI Thesaurus)
    C1301356 (UMLS 2011AA)
    CL Item
    Chronic Myelomonocytic Leukemia (CMML)
    CL Item
    Myelodysplastic Syndrome, Unclassifiable (MDS unclassified)
    CL Item
    Refractory Anemia (RA)
    CL Item
    Refractory anemia with excess blasts-1 (Raeb-1)
    CL Item
    Refractory anemia with excess blasts-2 (Raeb-2)
    CL Item
    Refractory Anemia With Ringed Sideroblasts (RA with Ringed Sideroblasts)
    Bone marrow biopsy
    Item
    Was bone marrow biopsy done
    boolean
    C25180 (NCI Thesaurus ValueDomain)
    C15189 (NCI Thesaurus Property)
    C12431 (NCI Thesaurus ObjectClass)
    C0005954 (UMLS CUI-1)
    Bone marrow biopsy date
    Item
    Date of Bone Marrow Biopsy (Aspirate)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    C15189 (NCI Thesaurus Property)
    C12431 (NCI Thesaurus ObjectClass)
    C0005954 (UMLS CUI-1)
    C0011008 (UMLS CUI-2)
    Bone Marrow Blasts
    Item
    Marrow Blasts
    float
    C25294 (NCI Thesaurus ObjectClass)
    C12431 (NCI Thesaurus Property)
    C20200 (NCI Thesaurus Property-2)
    C12918 (NCI Thesaurus Property-3)
    C25613 (NCI Thesaurus ValueDomain)
    C25712 (NCI Thesaurus ValueDomain-2)
    C1982687 (UMLS CUI-1)
    Bone Marrow Cellularity
    Item
    Marrow Cellularity
    float
    C25294 (NCI Thesaurus ObjectClass)
    C12431 (NCI Thesaurus Property)
    C20200 (NCI Thesaurus Property-2)
    C37923 (NCI Thesaurus Property-3)
    C25613 (NCI Thesaurus ValueDomain)
    C25712 (NCI Thesaurus ValueDomain-2)
    C1561532 (UMLS CUI-1)
    Item
    Reason bone marrow cellularity was not recorded
    text
    C25294 (NCI Thesaurus ObjectClass)
    C25594 (NCI Thesaurus Property)
    C12431 (NCI Thesaurus Property-2)
    C25375 (NCI Thesaurus Property-3)
    C20200 (NCI Thesaurus Property-4)
    C37923 (NCI Thesaurus Property-5)
    C25638 (NCI Thesaurus ValueDomain)
    C1561532 (UMLS CUI-1)
    C1546437 (UMLS CUI-2)
    CL.6
    Code List
    Reason bone marrow cellularity was not recorded
    CL Item
    Cellularity Status Of Bone Marrow Unknown, Procedure Resulted In No Material To Analyze (Dry Tap or inaspirable)
    CL Item
    Local Pathologist Did Not Quantify Cellularity (Local pathologist did not quantify cellularity)
    Item
    Dysplasia
    text
    C38148 (NCI Thesaurus ValueDomain)
    C25626 (NCI Thesaurus Property)
    C4086 (NCI Thesaurus ObjectClass)
    C0334044 (UMLS CUI-1)
    CL.7
    Code List
    Dysplasia
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    Item
    Dysplasia type
    integer
    C25284 (NCI Thesaurus ValueDomain)
    C16681 (NCI Thesaurus Property)
    C4086 (NCI Thesaurus ObjectClass)
    C0334044 (UMLS CUI-1)
    C0683312 (UMLS CUI-2)
    CL.8
    Code List
    Dysplasia type
    CL Item
    Erythroid (1)
    CL Item
    Megakaryocyte (2)
    CL Item
    Myeloid (3)
    Item
    Is cytogenetic abnormality present now
    text
    C25626 (NCI Thesaurus Property)
    C2950 (NCI Thesaurus ObjectClass)
    C0021212 (NCI Metathesaurus ValueDomain)
    C0008625 (UMLS CUI-1)
    CL.9
    Code List
    Is cytogenetic abnormality present now
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    Inevaluable (Inevaluable)
    Item Group
    Section Ii
    Item
    Did the patient require packed red blood cell (PRBC) transfusions (in the last 8 weeks)
    text
    C38148 (NCI Thesaurus ValueDomain)
    C1512699 (UMLS 2011AA ValueDomain)
    C15409 (NCI Thesaurus ObjectClass)
    C0199962 (UMLS 2011AA ObjectClass)
    C25382 (NCI Thesaurus Property)
    C1521801 (UMLS 2011AA Property)
    CL.10
    Code List
    Did the patient require packed red blood cell (PRBC) transfusions (in the last 8 weeks)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    PackedRedBloodCellTransfusionReceivedUnitCount
    Item
    Total number of units PRBC (transfused in the last 8 weeks)
    float
    C44278 (NCI Thesaurus ValueDomain)
    C0439148 (UMLS 2011AA ValueDomain)
    C25639 (NCI Thesaurus Property)
    C1514756 (UMLS 2011AA Property)
    C25463 (NCI Thesaurus ValueDomain-2)
    C0750480 (UMLS 2011AA ValueDomain-2)
    C15409 (NCI Thesaurus ObjectClass)
    C0199962 (UMLS 2011AA ObjectClass)
    PackedRedBloodCellTransfusionReceivedFirstDate
    Item
    Date of First Transfusion (in the last 8 weeks)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25639 (NCI Thesaurus Property)
    C1514756 (UMLS 2011AA Property)
    C25509 (NCI Thesaurus ValueDomain-2)
    C1279901 (UMLS 2011AA ValueDomain-2)
    C15409 (NCI Thesaurus ObjectClass)
    C0199962 (UMLS 2011AA ObjectClass)
    PackedRedBloodCellTransfusionReceivedMostRecentDate
    Item
    Date of most recent PRBC transfusion
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25639 (NCI Thesaurus Property)
    C1514756 (UMLS 2011AA Property)
    C15409 (NCI Thesaurus ObjectClass)
    C0199962 (UMLS 2011AA ObjectClass)
    C25577 (NCI Thesaurus ValueDomain-2)
    C1513491 (UMLS 2011AA ValueDomain-2)
    Item Group
    Mds Response
    Item
    Best response to date
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C25755 (NCI Thesaurus Property)
    C0871261 (UMLS 2011AA Property)
    C3247 (NCI Thesaurus ObjectClass)
    C3463824 (UMLS 2011AA ObjectClass)
    CL.11
    Code List
    Best response to date
    CL Item
    Complete Remission (CR)
    C4870 (NCI Thesaurus)
    C0677874 (UMLS 2011AA)
    CL Item
    Partial Remission (PR)
    C18058 (NCI Thesaurus)
    C1521726 (UMLS 2011AA)
    CL Item
    Stable Disease (SD)
    C18213 (NCI Thesaurus)
    C0677946 (UMLS 2011AA)
    CL Item
    Better Hematologic (HI)
    C62780 (NCI Thesaurus)
    C0205488 (UMLS 2011AA)
    C71685 (NCI Thesaurus-3)
    C0332272 (UMLS 2011AA-4)
    CL Item
    Progressive Disease (PD)
    C35571 (NCI Thesaurus)
    C1335499 (UMLS 2011AA)
    CL Item
    Transformation To Aml (Transformation to AML)
    MyelodysplasticSyndromeResponseFirstDate
    Item
    First observed date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25755 (NCI Thesaurus Property)
    C0871261 (UMLS 2011AA Property)
    C3247 (NCI Thesaurus ObjectClass)
    C3463824 (UMLS 2011AA ObjectClass)
    C25509 (NCI Thesaurus ValueDomain-2)
    C1279901 (UMLS 2011AA ValueDomain-2)
    MyelodysplasticSyndromeResponseDiagnosisDate
    Item
    First Confirmed Date
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25755 (NCI Thesaurus Property)
    C0871261 (UMLS 2011AA Property)
    C3247 (NCI Thesaurus ObjectClass)
    C3463824 (UMLS 2011AA ObjectClass)
    C15220 (NCI Thesaurus ValueDomain-2)
    C0011900 (UMLS 2011AA ValueDomain-2)
    Relapse
    Item
    Relapse
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C18265 (NCI Thesaurus Property)
    C2991 (NCI Thesaurus ObjectClass)
    C0277556 (UMLS CUI-1)
    Relapse date
    Item
    Date of relapse
    date
    C25164 (NCI Thesaurus ValueDomain)
    C18265 (NCI Thesaurus Property)
    C2991 (NCI Thesaurus ObjectClass)
    C0035020 (UMLS CUI-1)
    C0011008 (UMLS CUI-2)
    Item
    If Hematologic improvement
    text
    C2991 (NCI Thesaurus ObjectClass)
    C3247 (NCI Thesaurus Property)
    C16673 (NCI Thesaurus Property-2)
    C50995 (NCI Thesaurus Property-3)
    C25284 (NCI Thesaurus ValueDomain)
    C0012634 (UMLS CUI-1)
    C3463824 (UMLS CUI-2)
    C0018943 (UMLS CUI-3)
    C1704632 (UMLS CUI-4)
    C0332307 (UMLS CUI-5)
    CL.13
    Code List
    If Hematologic improvement
    CL Item
    Major Erythroid Response (Major erythroid response)
    CL Item
    Minor Erythroid Response (Minor erythroid response)
    CL Item
    Relapse Major Erythroid Response (Relaspe MER)
    First observed date HI
    Item
    First observed date (HI)
    date
    C2991 (NCI Thesaurus ObjectClass)
    C3247 (NCI Thesaurus Property)
    C16673 (NCI Thesaurus Property-2)
    C50995 (NCI Thesaurus Property-3)
    C25164 (NCI Thesaurus ValueDomain)
    C25509 (NCI Thesaurus ValueDomain-2)
    C0012634 (UMLS CUI-1)
    C3463824 (UMLS CUI-2)
    C0018943 (UMLS CUI-3)
    C1704632 (UMLS CUI-4)
    C0011008 (UMLS CUI-5)
    C1279901 (UMLS CUI-6)
    First confirmed date HI
    Item
    First confirmed date (HI)
    date
    C2991 (NCI Thesaurus ObjectClass)
    C3247 (NCI Thesaurus Property)
    C16673 (NCI Thesaurus Property-2)
    C50995 (NCI Thesaurus Property-3)
    C25164 (NCI Thesaurus ValueDomain)
    C15220 (NCI Thesaurus ValueDomain-2)
    C0012634 (UMLS CUI-1)
    C3463824 (UMLS CUI-2)
    C0018943 (UMLS CUI-3)
    C1704632 (UMLS CUI-4)
    C0011008 (UMLS CUI-5)
    C0011900 (UMLS CUI-6)
    Item
    Cytogenetic Response
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C50995 (NCI Thesaurus Property)
    C1704632 (UMLS 2011AA Property)
    C17938 (NCI Thesaurus ObjectClass)
    C0314603 (UMLS 2011AA ObjectClass)
    CL.14
    Code List
    Cytogenetic Response
    CL Item
    Complete Cytogenetic Response (Complete Cytogenetic Response)
    CL Item
    Partial Cytogenetic Response (Partial Cytogenetic Response)
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