ID
44676
Descrizione
CALGB: 10201On-Study Form Daunorubicin and Cytarabine With or Without Oblimersen in Treating Older Patients With Previously Untreated Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AD838530-D422-2F4D-E034-0003BA12F5E7
collegamento
Keywords
versioni (3)
- 19/09/12 19/09/12 -
- 09/01/15 09/01/15 - Martin Dugas
- 27/09/21 27/09/21 -
Caricato su
27 settembre 2021
DOI
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Licenza
Creative Commons BY-NC 3.0 Legacy
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Leukemia NCT00085124 On-Study - CALGB: 10201On-Study Form - 2057573v3.0
Instructions: Complete and submit thie form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice. Print text in capital letters. Avoid contact with the edges of the boxes. Cirlce amended items and check "Amended data" box to teh right. If submitting by mail, retain a copy for your records and send the original form for mazimum clarity in transmission and fax to 919-416-4990. If submistting electronically, click the Send button when you have completed the PDF version of the form.
Descrizione
Patient Description
Descrizione
InitialDiagnosisDate
Tipo di dati
date
Descrizione
FirstAbnormalBoneMarrowPriorMyelodysplasticSyndromeFindingDate
Tipo di dati
date
Alias
- NCI Thesaurus ObjectClass
- C25401
- UMLS 2011AA ObjectClass
- C0205161
- NCI Thesaurus ObjectClass-2
- C12431
- UMLS 2011AA ObjectClass-2
- C0005953
- NCI Thesaurus ObjectClass-3
- C25509
- UMLS 2011AA ObjectClass-3
- C1279901
- NCI Thesaurus Property
- C3247
- UMLS 2011AA Property
- C3463824
- NCI Thesaurus Property-2
- C25629
- UMLS 2011AA Property-2
- C0332152
- NCI Thesaurus Property-3
- C61036
- UMLS 2011AA Property-3
- C0243095
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Descrizione
Leukemia/MDSClassification
Tipo di dati
text
Alias
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
- NCI Thesaurus ObjectClass
- C3161
- UMLS 2011AA ObjectClass
- C0023418
- NCI Thesaurus Property
- C25161
- UMLS 2011AA Property
- C0008902
Descrizione
LeukemiaClassification,Other
Tipo di dati
text
Descrizione
Onset,AML
Tipo di dati
text
Descrizione
ExtramedullaryDisease
Tipo di dati
text
Descrizione
DiseaseInvolvementSite,Other
Tipo di dati
text
Descrizione
BoneMarrowAuerrods
Tipo di dati
boolean
Descrizione
Organ Involvement
Descrizione
Splenomegaly,Palpation
Tipo di dati
text
Alias
- NCI Thesaurus Property
- C16950
- UMLS 2011AA Property
- C0030247
- NCI Thesaurus ObjectClass
- C3384
- UMLS 2011AA ObjectClass
- C0038002
Descrizione
Splenomegaly,Imaging
Tipo di dati
text
Alias
- NCI Thesaurus ObjectClass
- C3384
- UMLS 2011AA ObjectClass
- C0038002
- NCI Thesaurus Property
- C19477
- UMLS 2011AA Property
- C1704254
Descrizione
Hepatomegaly,Palpation
Tipo di dati
text
Alias
- NCI Thesaurus Property
- C16950
- UMLS 2011AA Property
- C0030247
- NCI Thesaurus ObjectClass
- C3100
- UMLS 2011AA ObjectClass
- C0017924
Descrizione
Hepatomegaly,Imaging
Tipo di dati
text
Alias
- NCI Thesaurus ObjectClass
- C3100
- UMLS 2011AA ObjectClass
- C0017924
- NCI Thesaurus Property
- C19477
- UMLS 2011AA Property
- C1704254
Descrizione
Lymphadenopathy,Palpation
Tipo di dati
text
Alias
- NCI Thesaurus Property
- C16950
- UMLS 2011AA Property
- C0030247
- NCI Thesaurus ObjectClass
- C3206
- UMLS 2011AA ObjectClass
- C0024228
Descrizione
Lymphadenopathy,Imaging
Tipo di dati
text
Alias
- NCI Thesaurus ObjectClass
- C3206
- UMLS 2011AA ObjectClass
- C0024228
- NCI Thesaurus Property
- C19477
- UMLS 2011AA Property
- C1704254
Descrizione
Current Symptoms
Descrizione
CurrentInfection
Tipo di dati
text
Descrizione
AdverseEventHemorrhageSymptomStatus
Tipo di dati
text
Alias
- NCI Thesaurus Property
- C26791
- UMLS 2011AA Property
- C0019080
- NCI Thesaurus ObjectClass
- C41331
- UMLS 2011AA ObjectClass
- C0877248
- NCI Thesaurus Property-2
- C4876
- UMLS 2011AA Property-2
- C1457887
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Descrizione
Lab Data At Study Entry
Descrizione
Lab,Renal,Creatinine
Tipo di dati
float
Descrizione
Lab,Hepatic,Bilirubin
Tipo di dati
float
Descrizione
Lab,Chemistry,LactateDehydrogenase
Tipo di dati
float
Descrizione
Lab,Chemistry,LactateDehydrogenase,ULN
Tipo di dati
float
Descrizione
Lab,Hepatic,SGOT
Tipo di dati
float
Descrizione
SGOTLabUpperLimitNormalValue
Tipo di dati
float
Alias
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descrizione
Lab,Hepatic,SGPT
Tipo di dati
float
Descrizione
SGPTLabUpperLimitNormalValue
Tipo di dati
float
Alias
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C25706
- UMLS 2011AA ValueDomain-2
- C1519815
Descrizione
Lab,Hepatic,AlkalinePhosphatase
Tipo di dati
float
Descrizione
Alkaline Phosphatase ULN
Tipo di dati
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS CUI-1
- C0151420
- NCI Thesaurus Property
- C20200
- NCI Thesaurus Property-2
- C16276
- NCI Thesaurus ValueDomain
- C25712
- NCI Thesaurus ValueDomain-2
- C25706
Descrizione
%LVEFbyMUGA
Tipo di dati
text
Descrizione
CompletedBy
Tipo di dati
text
Descrizione
DateCompleted
Tipo di dati
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Descrizione
%LVEFbyECHO
Tipo di dati
text
Descrizione
Ccrr Module For Calgb: 10201on-study Form
Similar models
Instructions: Complete and submit thie form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice. Print text in capital letters. Avoid contact with the edges of the boxes. Cirlce amended items and check "Amended data" box to teh right. If submitting by mail, retain a copy for your records and send the original form for mazimum clarity in transmission and fax to 919-416-4990. If submistting electronically, click the Send button when you have completed the PDF version of the form.
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C0205161 (UMLS 2011AA ObjectClass)
C12431 (NCI Thesaurus ObjectClass-2)
C0005953 (UMLS 2011AA ObjectClass-2)
C25509 (NCI Thesaurus ObjectClass-3)
C1279901 (UMLS 2011AA ObjectClass-3)
C3247 (NCI Thesaurus Property)
C3463824 (UMLS 2011AA Property)
C25629 (NCI Thesaurus Property-2)
C0332152 (UMLS 2011AA Property-2)
C61036 (NCI Thesaurus Property-3)
C0243095 (UMLS 2011AA Property-3)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C0683312 (UMLS 2011AA ValueDomain)
C3161 (NCI Thesaurus ObjectClass)
C0023418 (UMLS 2011AA ObjectClass)
C25161 (NCI Thesaurus Property)
C0008902 (UMLS 2011AA Property)
C0030247 (UMLS 2011AA Property)
C3384 (NCI Thesaurus ObjectClass)
C0038002 (UMLS 2011AA ObjectClass)
C0038002 (UMLS 2011AA ObjectClass)
C19477 (NCI Thesaurus Property)
C1704254 (UMLS 2011AA Property)
C0030247 (UMLS 2011AA Property)
C3100 (NCI Thesaurus ObjectClass)
C0017924 (UMLS 2011AA ObjectClass)
C0017924 (UMLS 2011AA ObjectClass)
C19477 (NCI Thesaurus Property)
C1704254 (UMLS 2011AA Property)
C0030247 (UMLS 2011AA Property)
C3206 (NCI Thesaurus ObjectClass)
C0024228 (UMLS 2011AA ObjectClass)
C0024228 (UMLS 2011AA ObjectClass)
C19477 (NCI Thesaurus Property)
C1704254 (UMLS 2011AA Property)
C0549184 (UMLS 2011AA)
C2945599 (UMLS 2011AA)
C0019080 (UMLS 2011AA Property)
C41331 (NCI Thesaurus ObjectClass)
C0877248 (UMLS 2011AA ObjectClass)
C4876 (NCI Thesaurus Property-2)
C1457887 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C0549184 (UMLS 2011AA)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C1519815 (UMLS 2011AA ValueDomain-2)
C0151420 (UMLS CUI-1)
C20200 (NCI Thesaurus Property)
C16276 (NCI Thesaurus Property-2)
C25712 (NCI Thesaurus ValueDomain)
C25706 (NCI Thesaurus ValueDomain-2)
C0011008 (UMLS 2011AA ValueDomain)