CALGB: 10603 On-Study Form Daunorubicin, Cytarabine, and Midostaurin in Treating Patients With Newly Diagnosed Acute Myeloid Leukemia Source Form: NCI FormBuilder:

  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 9/20/21 9/20/21 -
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September 20, 2021

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Creative Commons BY-NC 3.0 Legacy
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Leukemia DRKS00003845 NCT00651261 On-Study - CALGB: 10603 On-Study Form - 2719613v1.0

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  1. StudyEvent: CALGB: 10603 On-Study Form
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Ccrr Module For Calgb 90202: Prostate Specific Antigen Form
Patient Description
Leukemia Classification (who/fab)
WHO Diagnosis
Leukemia Classification (FAB)
Clinical Onset Of Aml
Clinical Onset of AML
Prior treatment for leukemia or myelodysplasia
Did the patient receive cytotoxic treatment for the MDS (If the patient had antecedent MDS,)
Extramedullary Disease Involvement
Extramedullary Disease Involvement
Are auer rods present?
Organ Involvement
Palpable splenomegaly
Splenomegaly by scan (or X-ray)
Palpable hepatomegaly
Hepatomegaly by scan (or X-ray)
Palpable lymphadenopathy
Lymphadenopathy by scan
Current Symptoms
Current Infection
Lab Data At Study Entry
Chest X-Ray Result
EKG result
Method to determine ejection fraction
Overall Response

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