Description:

ANHL01P1: Reporting Period Rituximab, Rasburicase, and Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Advanced B-Cell Leukemia or Lymphoma NCT00057811 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BA568824-31F6-08D7-E034-0003BA12F5E7

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=BA568824-31F6-08D7-E034-0003BA12F5E7

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Versions (6) ▾
  1. 8/27/12
  2. 1/8/15
  3. 1/9/15
  4. 1/9/15
  5. 3/21/15
  6. 9/20/21
Uploaded on:

September 20, 2021

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License:
Creative Commons BY-NC 3.0 Legacy
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Advanced B-Cell Leukemia or Lymphoma (NCT00057811)

No Instruction available.

  1. StudyEvent: ANHL01P1: Reporting Period [reload]
    1. No Instruction available.
Header
Reporting Period (Institution will choose which course their patient is on.)
Patient characteristics
cm
Kg
Was the patient's disease status evaluated during this reporting period? (Required for reporting periods 1, 2, 3, 4)
COP Phase (Required only for Reduction Phase)
Did the patient have a bone marrow evaluation during this reporting period? (Required field)
does the patient have bone marrow involvement? (If yes,)
%
CNS involvement
Was patient's CNS status evaluated during this reporting period? (Required field)
Does patient have CNS involvement? (Required if above answer is 'yes')
Was cerebrospinal fluid cell count done? (Required if CNS involvement yes)
/ul
Diagnostics and treatment
was an Echocardiogram performed during this reporting period? (If Echocardiogram was not able to be performed prior to starting treatment,)
Imaging Studies Following Reporting Period (Required field)
results of imaging studies
Is the patient off protocol therapy at the end of this reporting period? (Required field)
reason off protocol therapy (If yes,)
was the patient switched to Sub-pilot Group C or pilot Group C, respectively? (If there was evidence of disease,)
treatment assignment (If the treatment assignment is Group B Sub-Pilot or Group B Pilot)
Was there evidence of residual disease on diagnostic tests?
was a biopsy performed? (If yes,)
what were the results? (If yes,)
Did renal dysfunction occur during the reduction phase? (Required for reduction phase only.)
Was there assisted renal support?
type of renal support
Was rasburicase utilized prior to Day 0 of the reduction phase? (Required only for Reduction Phase)
Did the patient receive rituximab in this cycle?
did the patient develop clinically significant Steven's Johnson syndrome? (If yes,)
Did a second malignant neoplasm (SMN) occur during this Reporting Period? (Required field)
Life status at end of this reporting period (Required field)
Was patient confirmed lost to follow-up at the end of this reporting period? (Required field)
Was patient enrolled on another COG therapeutic study at the end of the reporting period? (Required field)
Did the patient withdraw consent for follow-up at the end of the reporting period? (Note: Withdrawal of consent is to be coded only when the patient no longer wants to participate in the study and asks that data no longer be submitted.)
Did the patient relapse or experience disease progression during the reporting period? (Required field)
Lab values
mg/dL
mmol/L
mg/dL
mg/dL
mg/dL
mg/dL
U/L
U/L
1000/uL
1000/uL

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