ID

44111

Beschrijving

RATIONALE: Nilotinib and imatinib mesylate may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. PURPOSE: This phase II trial is studying how well giving nilotinib together with imatinib mesylate works in treating patients with early chronic phase chronic myelogenous leukemia. This is the visit 0 form.

Trefwoorden

  1. 28-11-17 28-11-17 -
  2. 20-09-21 20-09-21 -
Houder van rechten

Gruppo Italiano Malattie EMatologiche dell'Adulto

Geüploaded op

20 september 2021

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0

Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Visit 0 GIMEMA CML0408 NCT00769327

  1. StudyEvent: ODM
    1. Visit 0
Enrollment
Beschrijving

Enrollment

Alias
UMLS CUI-1
C2348568
UMLS CUI-2
C1516879
Acronym
Beschrijving

Acronym

Datatype

text

Alias
UMLS CUI [1]
C2986333
Patient (surname/name)
Beschrijving

Patient

Datatype

text

Alias
UMLS CUI [1]
C1299487
Gender
Beschrijving

Gender

Datatype

text

Alias
UMLS CUI [1]
C0079399
Date of Birth
Beschrijving

Date of Birth

Datatype

date

Alias
UMLS CUI [1]
C0421451
Place of Birth
Beschrijving

Place of Birth

Datatype

text

Alias
UMLS CUI [1]
C0032040
Country of Birth
Beschrijving

Country of Birth

Datatype

text

Alias
UMLS CUI [1]
C1300001
City of residence
Beschrijving

City of residence

Datatype

text

Alias
UMLS CUI [1,1]
C2316883
UMLS CUI [1,2]
C0421449
Country of Residence
Beschrijving

Country of Residence

Datatype

text

Alias
UMLS CUI [1]
C3258975
Residence address
Beschrijving

Residence address

Datatype

text

Alias
UMLS CUI [1]
C0421449
Cap
Beschrijving

Cap

Datatype

text

Date of Diagnosis
Beschrijving

Date of the first documented leukemia, performed before any cytotoxic therapy

Datatype

date

Alias
UMLS CUI [1]
C2316983
Informed Consent signed
Beschrijving

Informed Consent signed

Datatype

boolean

Alias
UMLS CUI [1]
C0021430
Informed Consent Date
Beschrijving

Informed Consent Date

Datatype

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0009797
Inclusion Criteria confirmed
Beschrijving

Inclusion Criteria confirmed

Datatype

boolean

Alias
UMLS CUI [1,1]
C1512693
UMLS CUI [1,2]
C1516637
Inclusion Criteria
Beschrijving

Inclusion Criteria

Datatype

text

Alias
UMLS CUI [1,1]
C1512693
UMLS CUI [1,2]
C1516637
Exclusion Criteria verified
Beschrijving

Exclusion Criteria verified

Datatype

boolean

Alias
UMLS CUI [1,1]
C0680251
UMLS CUI [1,2]
C1516637
Exclusion Criteria
Beschrijving

Exclusion Criteria

Datatype

text

Alias
UMLS CUI [1,1]
C0680251
UMLS CUI [1,2]
C1516637
Pregnancy Test negative
Beschrijving

Pregnancy Test negative

Datatype

integer

Alias
UMLS CUI [1]
C0032976
Symptoms
Beschrijving

Symptoms

Alias
UMLS CUI-1
C1457887
Acronym
Beschrijving

Acronym

Datatype

text

Alias
UMLS CUI [1]
C2986333
Visit
Beschrijving

Visit

Datatype

integer

Alias
UMLS CUI [1]
C0545082
Visit Date
Beschrijving

Visit Date

Datatype

date

Alias
UMLS CUI [1]
C1320303
Secondary Symptoms to LMC? If yes, indicate which symptoms:
Beschrijving

Secondary Symptoms to LMC

Datatype

boolean

Alias
UMLS CUI [1]
C0037088
Fatigue
Beschrijving

Fatigue

Datatype

boolean

Alias
UMLS CUI [1]
C0015672
Fever
Beschrijving

Fever

Datatype

boolean

Alias
UMLS CUI [1]
C0015967
Headache
Beschrijving

Headache

Datatype

boolean

Alias
UMLS CUI [1]
C0018681
Sweating
Beschrijving

Sweating

Datatype

boolean

Alias
UMLS CUI [1]
C0038990
Artralgia
Beschrijving

Artralgia

Datatype

boolean

Alias
UMLS CUI [1]
C0003862
Nausea
Beschrijving

Nausea

Datatype

boolean

Alias
UMLS CUI [1]
C0027497
Vomiting
Beschrijving

Vomiting

Datatype

boolean

Alias
UMLS CUI [1]
C0042963
Diarrhea
Beschrijving

Diarrhea

Datatype

boolean

Alias
UMLS CUI [1]
C0011991
Weight loss
Beschrijving

Weight loss

Datatype

boolean

Alias
UMLS CUI [1]
C1262477
Abdominal Pain
Beschrijving

Abdominal Pain

Datatype

boolean

Alias
UMLS CUI [1]
C0000737
Physical Examination
Beschrijving

Physical Examination

Alias
UMLS CUI-1
C0031809
Acronym
Beschrijving

Acronym

Datatype

text

Alias
UMLS CUI [1]
C2986333
Visit
Beschrijving

Visit

Datatype

integer

Alias
UMLS CUI [1]
C0545082
Physical Examination Date
Beschrijving

Physical Examination Date

Datatype

date

Alias
UMLS CUI [1]
C2826643
splenomegaly (cm from the costal bow)
Beschrijving

splenomegaly

Datatype

integer

Maateenheden
  • cm
Alias
UMLS CUI [1]
C0038002
cm
hepatomegaly (cm from the costal bow) - optinal
Beschrijving

hepatomegaly

Datatype

integer

Maateenheden
  • cm
Alias
UMLS CUI [1]
C0019209
cm
Weight
Beschrijving

Weight

Datatype

integer

Maateenheden
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Height
Beschrijving

Height

Datatype

integer

Maateenheden
  • cm
Alias
UMLS CUI [1]
C0005890
cm
Complete Blood Count
Beschrijving

Complete Blood Count

Alias
UMLS CUI-1
C0009555
Acronym
Beschrijving

Acronym

Datatype

text

Alias
UMLS CUI [1]
C2986333
Visit
Beschrijving

Visit

Datatype

integer

Alias
UMLS CUI [1]
C0545082
Date complete blood count
Beschrijving

Date complete blood count

Datatype

date

Alias
UMLS CUI [1,1]
C0009555
UMLS CUI [1,2]
C0011008
Hemoglobin
Beschrijving

Hemoglobin

Datatype

integer

Maateenheden
  • g/L
Alias
UMLS CUI [1]
C0019046
g/L
Leukocytes
Beschrijving

Leukocytes

Datatype

integer

Maateenheden
  • x103/mL
Alias
UMLS CUI [1]
C0023516
x103/mL
Platelets
Beschrijving

Platelets

Datatype

integer

Maateenheden
  • x109/L
Alias
UMLS CUI [1]
C0005821
x109/L
polymorphonuclear
Beschrijving

polymorphonuclear

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1]
C1168338
%
Lymphocytes
Beschrijving

Lymphocytes

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1]
C0024264
%
Monocytes
Beschrijving

Monocytes

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1]
C0026473
%
Eosinophils
Beschrijving

Eosinophils

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1]
C0200638
%
Basophils
Beschrijving

Basophils

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1]
C0200641
%
Metamyelocytes
Beschrijving

Metamyelocytes

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1]
C0229635
%
Myelocytes
Beschrijving

Myelocytes

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1]
C0369715
%
Promyelocytes
Beschrijving

Promyelocytes

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1]
C0455279
%
Blasts
Beschrijving

Blasts

Datatype

integer

Maateenheden
  • %
Alias
UMLS CUI [1]
C0368761
%
Answer hematology
Beschrijving

Answer hematology

Datatype

text

Alias
UMLS CUI [1]
C0474523

Similar models

  1. StudyEvent: ODM
    1. Visit 0
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Enrollment
C2348568 (UMLS CUI-1)
C1516879 (UMLS CUI-2)
Acronym
Item
Acronym
text
C2986333 (UMLS CUI [1])
Patient
Item
Patient (surname/name)
text
C1299487 (UMLS CUI [1])
Item
Gender
text
C0079399 (UMLS CUI [1])
Code List
Gender
CL Item
male  (M)
CL Item
female (F)
Date of Birth
Item
Date of Birth
date
C0421451 (UMLS CUI [1])
Place of Birth
Item
Place of Birth
text
C0032040 (UMLS CUI [1])
Country of Birth
Item
Country of Birth
text
C1300001 (UMLS CUI [1])
City of residence
Item
City of residence
text
C2316883 (UMLS CUI [1,1])
C0421449 (UMLS CUI [1,2])
Country of Residence
Item
Country of Residence
text
C3258975 (UMLS CUI [1])
Residence address
Item
Residence address
text
C0421449 (UMLS CUI [1])
Cap
Item
Cap
text
Date of Diagnosis
Item
Date of Diagnosis
date
C2316983 (UMLS CUI [1])
Informed Consent signed
Item
Informed Consent signed
boolean
C0021430 (UMLS CUI [1])
Informed Consent Date
Item
Informed Consent Date
date
C0011008 (UMLS CUI [1,1])
C0009797 (UMLS CUI [1,2])
Inclusion Criteria confirmed
Item
Inclusion Criteria confirmed
boolean
C1512693 (UMLS CUI [1,1])
C1516637 (UMLS CUI [1,2])
Inclusion Criteria
Item
Inclusion Criteria
text
C1512693 (UMLS CUI [1,1])
C1516637 (UMLS CUI [1,2])
Exclusion Criteria verified
Item
Exclusion Criteria verified
boolean
C0680251 (UMLS CUI [1,1])
C1516637 (UMLS CUI [1,2])
Exclusion Criteria
Item
Exclusion Criteria
text
C0680251 (UMLS CUI [1,1])
C1516637 (UMLS CUI [1,2])
Item
Pregnancy Test negative
integer
C0032976 (UMLS CUI [1])
Code List
Pregnancy Test negative
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not Applicable (3)
Item Group
Symptoms
C1457887 (UMLS CUI-1)
Acronym
Item
Acronym
text
C2986333 (UMLS CUI [1])
Visit
Item
Visit
integer
C0545082 (UMLS CUI [1])
Visit Date
Item
Visit Date
date
C1320303 (UMLS CUI [1])
Secondary Symptoms to LMC
Item
Secondary Symptoms to LMC? If yes, indicate which symptoms:
boolean
C0037088 (UMLS CUI [1])
Fatigue
Item
Fatigue
boolean
C0015672 (UMLS CUI [1])
Fever
Item
Fever
boolean
C0015967 (UMLS CUI [1])
Headache
Item
Headache
boolean
C0018681 (UMLS CUI [1])
Sweating
Item
Sweating
boolean
C0038990 (UMLS CUI [1])
Artralgia
Item
Artralgia
boolean
C0003862 (UMLS CUI [1])
Nausea
Item
Nausea
boolean
C0027497 (UMLS CUI [1])
Vomiting
Item
Vomiting
boolean
C0042963 (UMLS CUI [1])
Diarrhea
Item
Diarrhea
boolean
C0011991 (UMLS CUI [1])
Weight loss
Item
Weight loss
boolean
C1262477 (UMLS CUI [1])
Abdominal Pain
Item
Abdominal Pain
boolean
C0000737 (UMLS CUI [1])
Item Group
Physical Examination
C0031809 (UMLS CUI-1)
Acronym
Item
Acronym
text
C2986333 (UMLS CUI [1])
Visit
Item
Visit
integer
C0545082 (UMLS CUI [1])
Physical Examination Date
Item
Physical Examination Date
date
C2826643 (UMLS CUI [1])
splenomegaly
Item
splenomegaly (cm from the costal bow)
integer
C0038002 (UMLS CUI [1])
hepatomegaly
Item
hepatomegaly (cm from the costal bow) - optinal
integer
C0019209 (UMLS CUI [1])
Weight
Item
Weight
integer
C0005910 (UMLS CUI [1])
Height
Item
Height
integer
C0005890 (UMLS CUI [1])
Item Group
Complete Blood Count
C0009555 (UMLS CUI-1)
Acronym
Item
Acronym
text
C2986333 (UMLS CUI [1])
Visit
Item
Visit
integer
C0545082 (UMLS CUI [1])
Date complete blood count
Item
Date complete blood count
date
C0009555 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Hemoglobin
Item
Hemoglobin
integer
C0019046 (UMLS CUI [1])
Leukocytes
Item
Leukocytes
integer
C0023516 (UMLS CUI [1])
Platelets
Item
Platelets
integer
C0005821 (UMLS CUI [1])
polymorphonuclear
Item
polymorphonuclear
integer
C1168338 (UMLS CUI [1])
Lymphocytes
Item
Lymphocytes
integer
C0024264 (UMLS CUI [1])
Monocytes
Item
Monocytes
integer
C0026473 (UMLS CUI [1])
Eosinophils
Item
Eosinophils
integer
C0200638 (UMLS CUI [1])
Basophils
Item
Basophils
integer
C0200641 (UMLS CUI [1])
Metamyelocytes
Item
Metamyelocytes
integer
C0229635 (UMLS CUI [1])
Myelocytes
Item
Myelocytes
integer
C0369715 (UMLS CUI [1])
Promyelocytes
Item
Promyelocytes
integer
C0455279 (UMLS CUI [1])
Blasts
Item
Blasts
integer
C0368761 (UMLS CUI [1])
Answer hematology
Item
Answer hematology
text
C0474523 (UMLS CUI [1])

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial