ID

43608

Beschreibung

Randomized study with a run-in dose-selection phase to assess the added value of Lenalidomide in combination with standard remission-induction chemotherapy and post-remission treatment in patients aged 18-65 years with previously untreated acute myeloid leukemia (AML) or high risk myelodysplasia (MDS) (IPSS-R risk score> 4.5) With friendly permission of HOVON-Group - Prof. G. Ossenkoppele

Stichworte

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Hochgeladen am

20. September 2021

DOI

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Registration and Randomization Form (HOVON 132 AML/SAKK 30/13 EudraCT 2013-002843-26)

Englisch

Registration and Randomization Form (HOVON 132 AML/SAKK 30/13 EudraCT 2013-002843-26)

1 Formulare  
Patient data
Beschreibung

Patient data

Alias
UMLS CUI-1
C2707520
Caller
Beschreibung

Caller

Datentyp

text

Alias
UMLS CUI [1]
C0557514
Responsible physician
Beschreibung

Responsible physician

Datentyp

text

Alias
UMLS CUI [1]
C0031831
Date of birth
Beschreibung

Date of birth

Datentyp

date

Alias
UMLS CUI [1]
C0421451
Sex
Beschreibung

Sex

Datentyp

text

Alias
UMLS CUI [1]
C0079399
Date of written Informed Consent
Beschreibung

Date of written Informed Consent

Datentyp

date

Alias
UMLS CUI [1]
C2985782
Date of diagnosis of AML or MDS
Beschreibung

Date of diagnosis of AML or MDS

Datentyp

date

Alias
UMLS CUI [1,1]
C2316983
UMLS CUI [1,2]
C0023467
UMLS CUI [2,1]
C2316983
UMLS CUI [2,2]
C3463824
Patient consent
Beschreibung

Patient consent

Approach for future research
Beschreibung

Approach for future research

Datentyp

boolean

Keeping body material up to 15 years after trial for additional future research
Beschreibung

Keeping body material up to 15 years after trial for additional future research

Datentyp

boolean

Alias
UMLS CUI [1,1]
C1292533
UMLS CUI [1,2]
C0021430
Taking extra bone marrow, blood and saliva for additional research
Beschreibung

Taking extra bone marrow, blood and saliva for additional research

Datentyp

boolean

Alias
UMLS CUI [1,1]
C1292533
UMLS CUI [1,2]
C0021430
Eligibility
Beschreibung

Eligibility

Alias
UMLS CUI-1
C0013893
AML or MDS diagnosis (see protocol appendix A1-3)
Beschreibung

AML or MDS diagnosis (see protocol appendix A1-3)

Datentyp

text

Alias
UMLS CUI [1]
C0011900
IPSS-R risk score
Beschreibung

IPSS-R risk score

Datentyp

integer

Alias
UMLS CUI [1]
C2827405
WHO performance status
Beschreibung

WHO performance status

Datentyp

integer

Alias
UMLS CUI [1]
C1298650
Sampled BM/PB samples for analysis and MRD evaluation
Beschreibung

Sampled BM/PB samples for analysis and MRD evaluation

Datentyp

integer

Alias
UMLS CUI [1]
C0005953
UMLS CUI [2]
C0032105
UMLS CUI [3]
C2238270
Blood sampling
Beschreibung

Blood sampling

Datentyp

date

Alias
UMLS CUI [1]
C0005834
Serum creatinine
Beschreibung

Creatinine, Serum

Datentyp

float

Maßeinheiten
  • mg/dL
Alias
UMLS CUI [1]
C0201976
mg/dL
GFR
Beschreibung

GFR

Datentyp

float

Maßeinheiten
  • mL/min
Alias
UMLS CUI [1]
C0017654
mL/min
Bilirubin
Beschreibung

Bilirubin

Datentyp

float

Maßeinheiten
  • mg/dL
Alias
UMLS CUI [1]
C0005437
mg/dL
Bilirubin ULN
Beschreibung

Bilirubin ULN

Datentyp

float

Maßeinheiten
  • mg/dL
Alias
UMLS CUI [1,1]
C0201913
UMLS CUI [1,2]
C1519815
mg/dL
AST (SGOT)
Beschreibung

AST

Datentyp

float

Maßeinheiten
  • U/L
Alias
UMLS CUI [1]
C0201899
U/L
AST (SGOT) ULN
Beschreibung

AST ULN

Datentyp

float

Maßeinheiten
  • U/L
Alias
UMLS CUI [1,1]
C0201899
UMLS CUI [1,2]
C1519815
U/L
ALT (SGPT)
Beschreibung

ALT

Datentyp

float

Maßeinheiten
  • U/L
Alias
UMLS CUI [1]
C0201836
U/L
ALT (SGPT) ULN
Beschreibung

ALT ULN

Datentyp

float

Maßeinheiten
  • U/L
Alias
UMLS CUI [1,1]
C0201836
UMLS CUI [1,2]
C1519815
U/L
Alkaline Phosphatase
Beschreibung

Alkaline Phosphatase

Datentyp

float

Maßeinheiten
  • U/L
Alias
UMLS CUI [1]
C0201850
U/L
Alkaline Phosphatase ULN
Beschreibung

Alkaline Phosphatase ULN

Datentyp

float

Maßeinheiten
  • U/L
Alias
UMLS CUI [1,1]
C0201850
UMLS CUI [1,2]
C1519815
U/L
Ability and willingness to adhere to lenalidomide pregnancy prevention program
Beschreibung

Ability and willingness to adhere to lenalidomide pregnancy prevention program

Datentyp

boolean

Alias
UMLS CUI [1]
C0009862
Previous therapy with lenalidomide
Beschreibung

Previous therapy with lenalidomide

Datentyp

boolean

Alias
UMLS CUI [1,1]
C2114510
UMLS CUI [1,2]
C1144149
Acute promyelocytic leukemia
Beschreibung

Acute promyelocytic leukemia

Datentyp

boolean

Alias
UMLS CUI [1]
C0023487
Myeloproliferative neoplasia
Beschreibung

Myeloproliferative neoplasia

Datentyp

boolean

Alias
UMLS CUI [1]
C0027022
Previous treatment for AML or high risk MDS, except hydroxyurea
Beschreibung

Previous treatment for AML or high risk MDS, except hydroxyurea

Datentyp

boolean

Alias
UMLS CUI [1]
C2114510
Concurrent history of active malignancy in two past years prior to diagnosis (except for basal and squamous cell carcinoma of the skin and in situ carcinoma of the cervix)
Beschreibung

Concurrent history of active malignancy in two past years prior to diagnosis (except for basal and squamous cell carcinoma of the skin and in situ carcinoma of the cervix)

Datentyp

boolean

Alias
UMLS CUI [1]
C0006826
Concurrent severe and/or uncontrolled medical condition (e.g. uncontrolled diabetes, infection, hypertension, pulmonary disease etcetera)
Beschreibung

Concurrent severe and/or uncontrolled medical condition (e.g. uncontrolled diabetes, infection, hypertension, pulmonary disease etcetera)

Datentyp

boolean

Alias
UMLS CUI [1]
C0009488
Cardiac dysfunction (see protocol section 8.1.2)
Beschreibung

Cardiac dysfunction (see protocol section 8.1.2)

Datentyp

boolean

Alias
UMLS CUI [1]
C0018801
Hypersensitivity to the active substance or to any of the excipients of the drug product
Beschreibung

Hypersensitivity to the active substance or to any of the excipients of the drug product

Datentyp

boolean

Alias
UMLS CUI [1]
C0020517
Pregnant or lactating females
Beschreibung

Pregnant or lactating females

Datentyp

boolean

Alias
UMLS CUI [1]
C2828358
UMLS CUI [2]
C0032961
Unwilling or not capable to use effective means of birth control
Beschreibung

Unwilling or not capable to use effective means of birth control

Datentyp

boolean

Alias
UMLS CUI [1]
C0009862
Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule
Beschreibung

Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule

Datentyp

boolean

Alias
UMLS CUI [1]
C0525058
Data from HOVON data center
Beschreibung

Data from HOVON data center

Date of Randomization
Beschreibung

Date of Randomization

Datentyp

date

Patient study number
Beschreibung

Patient study number

Datentyp

integer

Alias
UMLS CUI [1]
C1830427
Lenalidomide treatment arm allocated
Beschreibung

Lenalidomide treatment arm allocated

Datentyp

text

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Ähnliche Modelle

Registration and Randomization Form (HOVON 132 AML/SAKK 30/13 EudraCT 2013-002843-26)

1 Formulare
Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Patient data
C2707520 (UMLS CUI-1)
Caller
Item
Caller
text
C0557514 (UMLS CUI [1])
Responsible physician
Item
Responsible physician
text
C0031831 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Sex
Code List
Sex
CL Item
Male (1)
C0086582 (UMLS CUI-1)
CL Item
Female (2)
C0086287 (UMLS CUI-1)
Date of written Informed Consent
Item
Date of written Informed Consent
date
C2985782 (UMLS CUI [1])
Date of diagnosis of AML or MDS
Item
Date of diagnosis of AML or MDS
date
C2316983 (UMLS CUI [1,1])
C0023467 (UMLS CUI [1,2])
C2316983 (UMLS CUI [2,1])
C3463824 (UMLS CUI [2,2])
Item Group
Patient consent
Approach for future research
Item
Approach for future research
boolean
Keeping body material up to 15 years after trial for additional future research
Item
Keeping body material up to 15 years after trial for additional future research
boolean
C1292533 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
Taking extra bone marrow, blood and saliva for additional research
Item
Taking extra bone marrow, blood and saliva for additional research
boolean
C1292533 (UMLS CUI [1,1])
C0021430 (UMLS CUI [1,2])
Item Group
C0013893 (UMLS CUI-1)
Item
AML or MDS diagnosis (see protocol appendix A1-3)
text
C0011900 (UMLS CUI [1])
AML or MDS diagnosis (see protocol appendix A1-3)
Code List
AML or MDS diagnosis (see protocol appendix A1-3)
CL Item
AML (1)
C0023467 (UMLS CUI-1)
CL Item
RAEB (2)
C0002894 (UMLS CUI-1)
CL Item
Leukemia with ambiguous lineage (3)
C1301357 (UMLS CUI-1)
IPSS-R risk score
Item
integer
C2827405 (UMLS CUI [1])
Item
WHO performance status
integer
C1298650 (UMLS CUI [1])
WHO performance status
Code List
WHO performance status
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
Sampled BM/PB samples for analysis and MRD evaluation
integer
C0005953 (UMLS CUI [1])
C0032105 (UMLS CUI [2])
C2238270 (UMLS CUI [3])
Sampled BM/PB samples for analysis and MRD evaluation
Code List
Sampled BM/PB samples for analysis and MRD evaluation
CL Item
no (0)
CL Item
yes (1)
CL Item
dry tap (2)
Blood sampling
Item
Blood sampling
date
C0005834 (UMLS CUI [1])
Creatinine, Serum
Item
Serum creatinine
float
C0201976 (UMLS CUI [1])
GFR
Item
GFR
float
C0017654 (UMLS CUI [1])
Bilirubin
Item
Bilirubin
float
C0005437 (UMLS CUI [1])
Bilirubin ULN
Item
Bilirubin ULN
float
C0201913 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
AST
Item
AST (SGOT)
float
C0201899 (UMLS CUI [1])
AST ULN
Item
AST (SGOT) ULN
float
C0201899 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
ALT
Item
ALT (SGPT)
float
C0201836 (UMLS CUI [1])
ALT ULN
Item
ALT (SGPT) ULN
float
C0201836 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
Alkaline Phosphatase
Item
Alkaline Phosphatase
float
C0201850 (UMLS CUI [1])
Alkaline Phosphatase ULN
Item
Alkaline Phosphatase ULN
float
C0201850 (UMLS CUI [1,1])
C1519815 (UMLS CUI [1,2])
Ability and willingness to adhere to lenalidomide pregnancy prevention program
Item
Ability and willingness to adhere to lenalidomide pregnancy prevention program
boolean
C0009862 (UMLS CUI [1])
Previous therapy with lenalidomide
Item
Previous therapy with lenalidomide
boolean
C2114510 (UMLS CUI [1,1])
C1144149 (UMLS CUI [1,2])
Acute promyelocytic leukemia
Item
Acute promyelocytic leukemia
boolean
C0023487 (UMLS CUI [1])
Myeloproliferative neoplasia
Item
Myeloproliferative neoplasia
boolean
C0027022 (UMLS CUI [1])
Previous treatment for AML or high risk MDS, except hydroxyurea
Item
Previous treatment for AML or high risk MDS, except hydroxyurea
boolean
C2114510 (UMLS CUI [1])
Concurrent history of active malignancy in two past years prior to diagnosis (except for basal and squamous cell carcinoma of the skin and in situ carcinoma of the cervix)
Item
Concurrent history of active malignancy in two past years prior to diagnosis (except for basal and squamous cell carcinoma of the skin and in situ carcinoma of the cervix)
boolean
C0006826 (UMLS CUI [1])
Concurrent severe and/or uncontrolled medical condition (e.g. uncontrolled diabetes, infection, hypertension, pulmonary disease etcetera)
Item
Concurrent severe and/or uncontrolled medical condition (e.g. uncontrolled diabetes, infection, hypertension, pulmonary disease etcetera)
boolean
C0009488 (UMLS CUI [1])
Cardiac dysfunction (see protocol section 8.1.2)
Item
Cardiac dysfunction (see protocol section 8.1.2)
boolean
C0018801 (UMLS CUI [1])
Hypersensitivity to the active substance or to any of the excipients of the drug product
Item
Hypersensitivity to the active substance or to any of the excipients of the drug product
boolean
C0020517 (UMLS CUI [1])
Pregnant or lactating females
Item
Pregnant or lactating females
boolean
C2828358 (UMLS CUI [1])
C0032961 (UMLS CUI [2])
Unwilling or not capable to use effective means of birth control
Item
Unwilling or not capable to use effective means of birth control
boolean
C0009862 (UMLS CUI [1])
Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule
Item
Any psychological, familial, sociological and geographical condition potentially hampering compliance with the study protocol and follow-up schedule
boolean
C0525058 (UMLS CUI [1])
Date of Randomization
Item
Date of Randomization
date
Patient study number
Item
integer
C1830427 (UMLS CUI [1])
Lenalidomide treatment arm allocated
Code List
Lenalidomide treatment arm allocated
CL Item
Arm A: induction chemotherapy without Lenalidomide (1)
CL Item
Arm B: induction chemotherapy with Lenalidomide 20mg (2)
CL Item
Arm B: induction chemotherapy with Lenalidomide 15mg (5)
CL Item
Arm B: induction chemotherapy with Lenalidomide 10mg (6)
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