0 Ratings
ID

44711

Description

Acute Myeloid Leukemia (AML) - On-Study Form - Previously Untreated Patients Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8D071CA6-C045-F391-E040-BB89AD4376C0

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8D071CA6-C045-F391-E040-BB89AD4376C0

Keywords

Versions (3)
  1. 9/19/12 9/19/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 9/27/21 9/27/21 -
Uploaded on

September 27, 2021

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0 Legacy
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

  • Newest
  • Oldest
  • Popular
  • Newest
    • Newest
    • Oldest
    • Popular

    No comments

    In order to download data models you must be logged in. Please log in or register for free.

    On-Study - Acute Myeloid Leukemia (AML) - On-Study Form - Previously Untreated Patients - 2019404v4.0

    English

    No Instruction available.

    1 forms  
    1. StudyEvent: Acute Myeloid Leukemia (AML) - On-Study Form - Previously Untreated Patients
      1. No Instruction available.
    Crf Header
    Description

    Crf Header

    Coordinating Group Protocol No.
    Description

    Protocol ID Coordinating Group

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C3274381
    NCI Thesaurus ObjectClass
    C25320
    UMLS CUI-2
    C1711341
    NCI Thesaurus Property
    C25462
    NCI Thesaurus Property-2
    C25364
    Coordinating Group Code
    Description

    Coordinating Group Code

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS CUI-1
    C1711341
    NCI Thesaurus ObjectClass
    C17005
    UMLS CUI-2
    C0805701
    NCI Thesaurus ObjectClass-2
    C25462
    NCI Thesaurus Property
    C25364
    Protocol Title
    Description

    Protocol Title

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986303
    NCI Thesaurus ObjectClass
    C25320
    NCI Thesaurus Property
    C42774
    Patient Study ID
    Description

    Patient Study ID

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25462
    NCI Thesaurus Property-2
    C25364
    Institution/Affiliate
    Description

    Institution Name

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25454
    UMLS CUI-1
    C1301943
    NCI Thesaurus ObjectClass-2
    C21541
    NCI Thesaurus Property
    C25364
    NCI Thesaurus ValueDomain
    C25191
    NCI Thesaurus ValueDomain-2
    C21541
    Other Patient ID
    Description

    Trial subject ID Participating Group

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS CUI-1
    C2348585
    NCI Thesaurus ObjectClass
    C16960
    UMLS CUI-2
    C2347449
    NCI Thesaurus Property
    C25608
    NCI Thesaurus Property-2
    C25364
    Participating Group Code
    Description

    ParticipatingGroupIdentifierCode

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25162
    UMLS 2011AA ValueDomain
    C0805701
    NCI Thesaurus ObjectClass
    C25608
    UMLS 2011AA ObjectClass
    C0679823
    NCI Thesaurus ObjectClass-2
    C17005
    UMLS 2011AA ObjectClass-2
    C1257890
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    Patient Initials
    Description

    Patient Initials

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C2986440
    NCI Thesaurus ObjectClass
    C16960
    NCI Thesaurus Property
    C25536
    Registration Type
    Description

    RegistrationSequenceType

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ObjectClass
    C25646
    UMLS 2011AA ObjectClass
    C1514821
    NCI Thesaurus Property
    C25673
    UMLS 2011AA Property
    C1519249
    Leukemia/mds: Form Administration
    Description

    Leukemia/mds: Form Administration

    Person Completing Form
    Description

    Person Completing Form

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS CUI-1
    C1550483
    NCI Thesaurus ObjectClass
    C25657
    NCI Thesaurus Property
    C25364
    Are data amended (If data are amended, please circle in red when using paper form)
    Description

    Data amended

    Data type

    boolean

    Alias
    NCI Thesaurus ValueDomain
    C38148
    UMLS CUI-1
    C0680532
    NCI Thesaurus ObjectClass
    C25474
    NCI Thesaurus Property
    C25416
    Aml: Disease Description, Previously Untreated
    Description

    Aml: Disease Description, Previously Untreated

    Date of Initial Pathologic Diagnosis (mm dd yyyy enter test date for first diagnosis of leukemia)
    Description

    CancerInitialDiagnosisDate

    Data type

    date

    Alias
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus Property
    C25509
    UMLS 2011AA Property
    C1279901
    NCI Thesaurus Property-2
    C15220
    UMLS 2011AA Property-2
    C0011900
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    Leukemia/MDS Classification (*Alternately, the CDE WHO Diagnosis can be used.)
    Description

    LeukemiaFrench-American-BritishClassificationCategory

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C3161
    UMLS 2011AA ObjectClass
    C0023418
    NCI Thesaurus Property
    C43854
    UMLS 2011AA Property
    C1556084
    NCI Thesaurus Property-2
    C25161
    UMLS 2011AA Property-2
    C0008902
    NCI Metathesaurus Property
    C0596227
    NCI Metathesaurus Property-2
    C0596070
    NCI Thesaurus ValueDomain
    C25372
    UMLS 2011AA ValueDomain
    C0683312
    Other specify
    Description

    LeukemiaFrench-American-BritishClassificationSpecify

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C3161
    UMLS 2011AA ObjectClass
    C0023418
    NCI Thesaurus Property
    C43854
    UMLS 2011AA Property
    C1556084
    NCI Thesaurus Property-2
    C25161
    UMLS 2011AA Property-2
    C0008902
    NCI Metathesaurus Property
    C0596227
    NCI Metathesaurus Property-2
    C0596070
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    Date Hematology (Blood) Sample Obtained (Peripheral Blood mm dd yyyy)
    Description

    HematologySpecimenCollectedDate

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C16673
    UMLS 2011AA ObjectClass
    C0018943
    NCI Thesaurus ObjectClass-2
    C19157
    UMLS 2011AA ObjectClass-2
    C0370003
    NCI Thesaurus Property
    C25452
    White Blood Cell Count (x 10^3/mcL)
    Description

    LaboratoryProcedureLeukocyteResultSpecifiedValue

    Data type

    float

    Measurement units
    • 1000/uL
    Alias
    NCI Thesaurus ObjectClass
    C25294
    UMLS 2011AA ObjectClass
    C0022885
    NCI Thesaurus Property
    C12529
    UMLS 2011AA Property
    C0023516
    NCI Thesaurus Property-2
    C20200
    UMLS 2011AA Property-2
    C1274040
    NCI Thesaurus ValueDomain
    C25712
    UMLS 2011AA ValueDomain
    C1522609
    NCI Thesaurus ValueDomain-2
    C38024
    UMLS 2011AA ValueDomain-2
    C0205369
    1000/uL
    Peripheral Neutrophils/Bands (%)
    Description

    LaboratoryProcedureNeutrophilResultPercentageValue

    Data type

    float

    Measurement units
    • %
    Alias
    NCI Thesaurus ObjectClass
    C25294
    UMLS 2011AA ObjectClass
    C0022885
    NCI Thesaurus Property
    C12533
    UMLS 2011AA Property
    C0027950
    NCI Thesaurus Property-2
    C20200
    UMLS 2011AA Property-2
    C1274040
    NCI Thesaurus ValueDomain
    C25613
    UMLS 2011AA ValueDomain
    C0439165
    NCI Thesaurus ValueDomain-2
    C25712
    UMLS 2011AA ValueDomain-2
    C1522609
    %
    Peripheral Blasts (%)
    Description

    LaboratoryProcedureBlastCellOutcomePercentageValue

    Data type

    float

    Measurement units
    • %
    Alias
    NCI Thesaurus ObjectClass
    C25294
    UMLS 2011AA ObjectClass
    C0022885
    NCI Thesaurus Property
    C20200
    UMLS 2011AA Property
    C1274040
    NCI Thesaurus Property-2
    C12918
    UMLS 2011AA Property-2
    C0368761
    NCI Thesaurus ValueDomain
    C25613
    UMLS 2011AA ValueDomain
    C0439165
    NCI Thesaurus ValueDomain-2
    C25712
    UMLS 2011AA ValueDomain-2
    C1522609
    %
    Date of Bone Marrow Biopsy (Bone Marrow Biopsy/Aspirate mm dd yyyy)
    Description

    BoneMarrowBiopsyDate

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain-2
    C25367
    NCI Thesaurus Property
    C15189
    UMLS 2011AA Property
    C0005558
    NCI Thesaurus ObjectClass
    C12431
    UMLS 2011AA ObjectClass
    C0005953
    Marrow Cellularity (%)
    Description

    LaboratoryProcedureBoneMarrowCellularityOutcomePercentageValue

    Data type

    float

    Alias
    NCI Thesaurus ObjectClass
    C25294
    UMLS 2011AA ObjectClass
    C0022885
    NCI Thesaurus Property
    C12431
    UMLS 2011AA Property
    C0005953
    NCI Thesaurus Property-2
    C20200
    UMLS 2011AA Property-2
    C1274040
    NCI Thesaurus Property-3
    C37923
    UMLS 2011AA Property-3
    C1516377
    NCI Thesaurus ValueDomain
    C25613
    UMLS 2011AA ValueDomain
    C0439165
    NCI Thesaurus ValueDomain-2
    C25712
    UMLS 2011AA ValueDomain-2
    C1522609
    Marrow Blasts (%)
    Description

    LaboratoryProcedureBoneMarrowBlastCellOutcomePercentageValue

    Data type

    float

    Measurement units
    • %
    Alias
    NCI Thesaurus ObjectClass
    C25294
    UMLS 2011AA ObjectClass
    C0022885
    NCI Thesaurus Property
    C12431
    UMLS 2011AA Property
    C0005953
    NCI Thesaurus Property-2
    C20200
    UMLS 2011AA Property-2
    C1274040
    NCI Thesaurus Property-3
    C12918
    UMLS 2011AA Property-3
    C0368761
    NCI Thesaurus ValueDomain
    C25613
    UMLS 2011AA ValueDomain
    C0439165
    NCI Thesaurus ValueDomain-2
    C25712
    UMLS 2011AA ValueDomain-2
    C1522609
    %
    Marrow Cellularity Status
    Description

    LaboratoryProcedureBoneMarrowCellularityOutcomeStatus

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25294
    UMLS 2011AA ObjectClass
    C0022885
    NCI Thesaurus Property
    C12431
    UMLS 2011AA Property
    C0005953
    NCI Thesaurus Property-2
    C20200
    UMLS 2011AA Property-2
    C1274040
    NCI Thesaurus Property-3
    C37923
    UMLS 2011AA Property-3
    C1516377
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    Extramedullary Disease Involvement (check all that apply)
    Description

    DiseaseExtramedullaryInvolvementSite

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717
    UMLS 2011AA ValueDomain
    C1515974
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    NCI Thesaurus Property-2
    C25503
    UMLS 2011AA Property-2
    C1517060
    Other specify
    Description

    DiseaseExtramedullaryInvolvementOtherSite

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C13717
    UMLS 2011AA ValueDomain
    C1515974
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus Property
    C25548
    UMLS 2011AA Property
    C1314939
    NCI Thesaurus Property-2
    C25503
    UMLS 2011AA Property-2
    C1517060
    Palpable splenomegaly (Organ Involvement)
    Description

    SplenomegalyPalpationDocumentedInd

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus Property
    C16950
    UMLS 2011AA Property
    C0030247
    NCI Thesaurus ObjectClass
    C3384
    UMLS 2011AA ObjectClass
    C0038002
    NCI Thesaurus ValueDomain-2
    C25356
    UMLS 2011AA ValueDomain-2
    C1301725
    Splenomegaly by scan (or x-ray)
    Description

    SplenomegalyImageDocumentedInd

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ObjectClass
    C3384
    UMLS 2011AA ObjectClass
    C0038002
    NCI Thesaurus Property
    C19477
    UMLS 2011AA Property
    C1704254
    NCI Thesaurus ValueDomain-2
    C25356
    UMLS 2011AA ValueDomain-2
    C1301725
    Palpable hepatomegaly
    Description

    HepatomegalyPalpationDocumentedInd

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus Property
    C16950
    UMLS 2011AA Property
    C0030247
    NCI Thesaurus ObjectClass
    C3100
    UMLS 2011AA ObjectClass
    C0017924
    NCI Thesaurus ValueDomain-2
    C25356
    UMLS 2011AA ValueDomain-2
    C1301725
    Hepatomegaly by scan (or x-ray)
    Description

    HepatomegalyImageDocumentedInd

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ObjectClass
    C3100
    UMLS 2011AA ObjectClass
    C0017924
    NCI Thesaurus Property
    C19477
    UMLS 2011AA Property
    C1704254
    NCI Thesaurus ValueDomain-2
    C25356
    UMLS 2011AA ValueDomain-2
    C1301725
    Palpable lymphadenopathy
    Description

    LymphadenopathyPalpationDocumentedInd

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus Property
    C16950
    UMLS 2011AA Property
    C0030247
    NCI Thesaurus ObjectClass
    C3206
    UMLS 2011AA ObjectClass
    C0024228
    NCI Thesaurus ValueDomain-2
    C25356
    UMLS 2011AA ValueDomain-2
    C1301725
    Lymphadenopathy by scan (or x-ray)
    Description

    LymphadenopathyImageDocumentedInd

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ObjectClass
    C3206
    UMLS 2011AA ObjectClass
    C0024228
    NCI Thesaurus Property
    C19477
    UMLS 2011AA Property
    C1704254
    NCI Thesaurus ValueDomain-2
    C25356
    UMLS 2011AA ValueDomain-2
    C1301725
    Clinical Onset of AML
    Description

    ClinicalEtiologyAcuteMyeloidLeukemiaDiagnosisType

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25398
    UMLS 2011AA ObjectClass
    C0205210
    NCI Thesaurus ObjectClass-2
    C16390
    UMLS 2011AA ObjectClass-2
    C1524003
    NCI Thesaurus Property
    C3171
    UMLS 2011AA Property
    C0023467
    NCI Thesaurus Property-2
    C15220
    UMLS 2011AA Property-2
    C0011900
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    Allows Documentation Of Any Additional Cooments
    Description

    Allows Documentation Of Any Additional Cooments

    Comments
    Description

    Research Comments

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS CUI-1
    C0947611
    NCI Thesaurus ObjectClass
    C15319
    NCI Thesaurus Property
    C25393
    Back to the top of the page

    Similar models

    No Instruction available.

    1 forms
    1. StudyEvent: Acute Myeloid Leukemia (AML) - On-Study Form - Previously Untreated Patients
      1. No Instruction available.
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Crf Header
    Protocol ID Coordinating Group
    Item
    Coordinating Group Protocol No.
    text
    C25337 (NCI Thesaurus ValueDomain)
    C3274381 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C1711341 (UMLS CUI-2)
    C25462 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Coordinating Group Code
    Item
    Coordinating Group Code
    text
    C25162 (NCI Thesaurus ValueDomain)
    C1711341 (UMLS CUI-1)
    C17005 (NCI Thesaurus ObjectClass)
    C0805701 (UMLS CUI-2)
    C25462 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    Protocol Title
    Item
    Protocol Title
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986303 (UMLS CUI-1)
    C25320 (NCI Thesaurus ObjectClass)
    C42774 (NCI Thesaurus Property)
    Patient Study ID
    Item
    Patient Study ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25462 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    Institution Name
    Item
    Institution/Affiliate
    text
    C25454 (NCI Thesaurus ObjectClass)
    C1301943 (UMLS CUI-1)
    C21541 (NCI Thesaurus ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C25191 (NCI Thesaurus ValueDomain)
    C21541 (NCI Thesaurus ValueDomain-2)
    Trial subject ID Participating Group
    Item
    Other Patient ID
    text
    C25337 (NCI Thesaurus ValueDomain)
    C2348585 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C2347449 (UMLS CUI-2)
    C25608 (NCI Thesaurus Property)
    C25364 (NCI Thesaurus Property-2)
    ParticipatingGroupIdentifierCode
    Item
    Participating Group Code
    text
    C25162 (NCI Thesaurus ValueDomain)
    C0805701 (UMLS 2011AA ValueDomain)
    C25608 (NCI Thesaurus ObjectClass)
    C0679823 (UMLS 2011AA ObjectClass)
    C17005 (NCI Thesaurus ObjectClass-2)
    C1257890 (UMLS 2011AA ObjectClass-2)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    Patient Initials
    Item
    Patient Initials
    text
    C25191 (NCI Thesaurus ValueDomain)
    C2986440 (UMLS CUI-1)
    C16960 (NCI Thesaurus ObjectClass)
    C25536 (NCI Thesaurus Property)
    RegistrationSequenceType
    Item
    Registration Type
    text
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C25646 (NCI Thesaurus ObjectClass)
    C1514821 (UMLS 2011AA ObjectClass)
    C25673 (NCI Thesaurus Property)
    C1519249 (UMLS 2011AA Property)
    Item Group
    Leukemia/mds: Form Administration
    Person Completing Form
    Item
    Person Completing Form
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1550483 (UMLS CUI-1)
    C25657 (NCI Thesaurus ObjectClass)
    C25364 (NCI Thesaurus Property)
    Data amended
    Item
    Are data amended (If data are amended, please circle in red when using paper form)
    boolean
    C38148 (NCI Thesaurus ValueDomain)
    C0680532 (UMLS CUI-1)
    C25474 (NCI Thesaurus ObjectClass)
    C25416 (NCI Thesaurus Property)
    Item Group
    Aml: Disease Description, Previously Untreated
    CancerInitialDiagnosisDate
    Item
    Date of Initial Pathologic Diagnosis (mm dd yyyy enter test date for first diagnosis of leukemia)
    date
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C25509 (NCI Thesaurus Property)
    C1279901 (UMLS 2011AA Property)
    C15220 (NCI Thesaurus Property-2)
    C0011900 (UMLS 2011AA Property-2)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    Item
    Leukemia/MDS Classification (*Alternately, the CDE WHO Diagnosis can be used.)
    text
    C3161 (NCI Thesaurus ObjectClass)
    C0023418 (UMLS 2011AA ObjectClass)
    C43854 (NCI Thesaurus Property)
    C1556084 (UMLS 2011AA Property)
    C25161 (NCI Thesaurus Property-2)
    C0008902 (UMLS 2011AA Property-2)
    C0596227 (NCI Metathesaurus Property)
    C0596070 (NCI Metathesaurus Property-2)
    C25372 (NCI Thesaurus ValueDomain)
    C0683312 (UMLS 2011AA ValueDomain)
    CL.2
    Code List
    Leukemia/MDS Classification (*Alternately, the CDE WHO Diagnosis can be used.)
    CL Item
    Disease Classified As Undifferentiated Acute Myeloid Leukemia (fab M0) (Undifferentiated acute myeloid leukemia (FAB M0))
    CL Item
    Disease Classified As Acute Myeloid Leukemia W/o Maturation (fab M1) (Acute myeloid leukemia w/o maturation (FAB M1))
    CL Item
    Disease Classified As Acute Myeloid Leukemia W/ Maturation (fab M2) (Acute myeloid leukemia w/ maturation (FAB M2))
    CL Item
    Disease Classified As Acute Promyelocytic Leukemia (fab M3) (Acute promyelocytic leukemia (FAB M3))
    CL Item
    Disease Classified As Acute Myelomonocytic Leukemia (fab M4) (Acute myelomonocytic leukemia (FAB M4))
    CL Item
    Disease Classified As Acute Monocytic Leukemia (fab M5) (Acute monocytic leukemia (FAB M5))
    CL Item
    Disease Classified As Acute Erythroblastic Leukemia (fab M6) (Acute erythroblastic leukemia (FAB M6))
    CL Item
    Disease Classified As Acute Megakaryoblastic Leukemia (fab M7) (Acute megakaryoblastic leukemia (FAB M7))
    CL Item
    Disease Classified As Aml, Not Otherwise Specified (nos) (AML, not otherwise specified (NOS))
    CL Item
    Disease Is An Unclassifiable Acute Leukemia (Unclassifiable acute leukemia)
    CL Item
    Disease Classified As Acute Undifferentiated Leukemia (aul) (Acute undifferentiated leukemia (AUL))
    CL Item
    Disease Is A Mixed Lineage Acute Leukemia (Mixed lineage acute leukemia)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    LeukemiaFrench-American-BritishClassificationSpecify
    Item
    Other specify
    text
    C3161 (NCI Thesaurus ObjectClass)
    C0023418 (UMLS 2011AA ObjectClass)
    C43854 (NCI Thesaurus Property)
    C1556084 (UMLS 2011AA Property)
    C25161 (NCI Thesaurus Property-2)
    C0008902 (UMLS 2011AA Property-2)
    C0596227 (NCI Metathesaurus Property)
    C0596070 (NCI Metathesaurus Property-2)
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    HematologySpecimenCollectedDate
    Item
    Date Hematology (Blood) Sample Obtained (Peripheral Blood mm dd yyyy)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C16673 (NCI Thesaurus ObjectClass)
    C0018943 (UMLS 2011AA ObjectClass)
    C19157 (NCI Thesaurus ObjectClass-2)
    C0370003 (UMLS 2011AA ObjectClass-2)
    C25452 (NCI Thesaurus Property)
    LaboratoryProcedureLeukocyteResultSpecifiedValue
    Item
    White Blood Cell Count (x 10^3/mcL)
    float
    C25294 (NCI Thesaurus ObjectClass)
    C0022885 (UMLS 2011AA ObjectClass)
    C12529 (NCI Thesaurus Property)
    C0023516 (UMLS 2011AA Property)
    C20200 (NCI Thesaurus Property-2)
    C1274040 (UMLS 2011AA Property-2)
    C25712 (NCI Thesaurus ValueDomain)
    C1522609 (UMLS 2011AA ValueDomain)
    C38024 (NCI Thesaurus ValueDomain-2)
    C0205369 (UMLS 2011AA ValueDomain-2)
    LaboratoryProcedureNeutrophilResultPercentageValue
    Item
    Peripheral Neutrophils/Bands (%)
    float
    C25294 (NCI Thesaurus ObjectClass)
    C0022885 (UMLS 2011AA ObjectClass)
    C12533 (NCI Thesaurus Property)
    C0027950 (UMLS 2011AA Property)
    C20200 (NCI Thesaurus Property-2)
    C1274040 (UMLS 2011AA Property-2)
    C25613 (NCI Thesaurus ValueDomain)
    C0439165 (UMLS 2011AA ValueDomain)
    C25712 (NCI Thesaurus ValueDomain-2)
    C1522609 (UMLS 2011AA ValueDomain-2)
    LaboratoryProcedureBlastCellOutcomePercentageValue
    Item
    Peripheral Blasts (%)
    float
    C25294 (NCI Thesaurus ObjectClass)
    C0022885 (UMLS 2011AA ObjectClass)
    C20200 (NCI Thesaurus Property)
    C1274040 (UMLS 2011AA Property)
    C12918 (NCI Thesaurus Property-2)
    C0368761 (UMLS 2011AA Property-2)
    C25613 (NCI Thesaurus ValueDomain)
    C0439165 (UMLS 2011AA ValueDomain)
    C25712 (NCI Thesaurus ValueDomain-2)
    C1522609 (UMLS 2011AA ValueDomain-2)
    BoneMarrowBiopsyDate
    Item
    Date of Bone Marrow Biopsy (Bone Marrow Biopsy/Aspirate mm dd yyyy)
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25367 (NCI Thesaurus ValueDomain-2)
    C15189 (NCI Thesaurus Property)
    C0005558 (UMLS 2011AA Property)
    C12431 (NCI Thesaurus ObjectClass)
    C0005953 (UMLS 2011AA ObjectClass)
    LaboratoryProcedureBoneMarrowCellularityOutcomePercentageValue
    Item
    Marrow Cellularity (%)
    float
    C25294 (NCI Thesaurus ObjectClass)
    C0022885 (UMLS 2011AA ObjectClass)
    C12431 (NCI Thesaurus Property)
    C0005953 (UMLS 2011AA Property)
    C20200 (NCI Thesaurus Property-2)
    C1274040 (UMLS 2011AA Property-2)
    C37923 (NCI Thesaurus Property-3)
    C1516377 (UMLS 2011AA Property-3)
    C25613 (NCI Thesaurus ValueDomain)
    C0439165 (UMLS 2011AA ValueDomain)
    C25712 (NCI Thesaurus ValueDomain-2)
    C1522609 (UMLS 2011AA ValueDomain-2)
    LaboratoryProcedureBoneMarrowBlastCellOutcomePercentageValue
    Item
    Marrow Blasts (%)
    float
    C25294 (NCI Thesaurus ObjectClass)
    C0022885 (UMLS 2011AA ObjectClass)
    C12431 (NCI Thesaurus Property)
    C0005953 (UMLS 2011AA Property)
    C20200 (NCI Thesaurus Property-2)
    C1274040 (UMLS 2011AA Property-2)
    C12918 (NCI Thesaurus Property-3)
    C0368761 (UMLS 2011AA Property-3)
    C25613 (NCI Thesaurus ValueDomain)
    C0439165 (UMLS 2011AA ValueDomain)
    C25712 (NCI Thesaurus ValueDomain-2)
    C1522609 (UMLS 2011AA ValueDomain-2)
    Item
    Marrow Cellularity Status
    text
    C25294 (NCI Thesaurus ObjectClass)
    C0022885 (UMLS 2011AA ObjectClass)
    C12431 (NCI Thesaurus Property)
    C0005953 (UMLS 2011AA Property)
    C20200 (NCI Thesaurus Property-2)
    C1274040 (UMLS 2011AA Property-2)
    C37923 (NCI Thesaurus Property-3)
    C1516377 (UMLS 2011AA Property-3)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    CL.3
    Code List
    Marrow Cellularity Status
    CL Item
    Cellularity Status Of Bone Marrow Is Aplasitc (severely Hypocellular) (Aplastic (severely hypocellular))
    CL Item
    Cellularity Status Of Bone Marrow Is Hypocellular (Hypocellular)
    CL Item
    Cellularity Status Of Bone Marrow Is Normocellular (Normocellular)
    CL Item
    Cellularity Status Of Bone Marrow Is Hypercellular (Hypercellular)
    CL Item
    Cellularity Status Of Bone Marrow Is Packed (intensely Hypercellular) (Packed (intensely hypercellular))
    CL Item
    Cellularity Status Of Bone Marrow Unknown, Procedure Resulted In No Material To Analyze (Dry tap or inaspirable)
    Item
    Extramedullary Disease Involvement (check all that apply)
    text
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    C25503 (NCI Thesaurus Property-2)
    C1517060 (UMLS 2011AA Property-2)
    CL.4
    Code List
    Extramedullary Disease Involvement (check all that apply)
    CL Item
    Central Nervous System (Central nervous system)
    C12438 (NCI Thesaurus)
    C3714787 (UMLS 2011AA)
    CL Item
    Gingival Hypertrophy (Gingival hypertrophy)
    CL Item
    Leukaemia Cutis (Skin (leukemia cutis))
    CL049753 (NCI Metathesaurus)
    CL Item
    Granulocytic Sarcoma (Chloroma)
    C35815 (NCI Thesaurus)
    C0152276 (UMLS 2011AA)
    CL Item
    Other Specify (Other)
    DiseaseExtramedullaryInvolvementOtherSite
    Item
    Other specify
    text
    C13717 (NCI Thesaurus ValueDomain)
    C1515974 (UMLS 2011AA ValueDomain)
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C25548 (NCI Thesaurus Property)
    C1314939 (UMLS 2011AA Property)
    C25503 (NCI Thesaurus Property-2)
    C1517060 (UMLS 2011AA Property-2)
    Item
    Palpable splenomegaly (Organ Involvement)
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C16950 (NCI Thesaurus Property)
    C0030247 (UMLS 2011AA Property)
    C3384 (NCI Thesaurus ObjectClass)
    C0038002 (UMLS 2011AA ObjectClass)
    C25356 (NCI Thesaurus ValueDomain-2)
    C1301725 (UMLS 2011AA ValueDomain-2)
    CL.5
    Code List
    Palpable splenomegaly (Organ Involvement)
    CL Item
    Examination Performed And Splenomegaly Present (Yes)
    CL Item
    Examination Performed And Splenomegaly Absent (No)
    CL Item
    Examination Of Spleen Not Performed (Not examined)
    CL Item
    Spleen Removed Via Prior Surgery (Surgically absent)
    Item
    Splenomegaly by scan (or x-ray)
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C3384 (NCI Thesaurus ObjectClass)
    C0038002 (UMLS 2011AA ObjectClass)
    C19477 (NCI Thesaurus Property)
    C1704254 (UMLS 2011AA Property)
    C25356 (NCI Thesaurus ValueDomain-2)
    C1301725 (UMLS 2011AA ValueDomain-2)
    CL.6
    Code List
    Splenomegaly by scan (or x-ray)
    CL Item
    Examination Performed And Splenomegaly Present (Yes)
    CL Item
    Examination Performed And Splenomegaly Absent (No)
    CL Item
    Examination Of Spleen Not Performed (Not examined)
    CL Item
    Spleen Removed Via Prior Surgery (Surgically absent)
    Item
    Palpable hepatomegaly
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C16950 (NCI Thesaurus Property)
    C0030247 (UMLS 2011AA Property)
    C3100 (NCI Thesaurus ObjectClass)
    C0017924 (UMLS 2011AA ObjectClass)
    C25356 (NCI Thesaurus ValueDomain-2)
    C1301725 (UMLS 2011AA ValueDomain-2)
    CL.7
    Code List
    Palpable hepatomegaly
    CL Item
    Examination Performed And Hepatomegaly Present (Yes)
    CL Item
    Examination Performed And Hepatomegaly Absent (No)
    CL Item
    Examination Of Liver Not Performed (Not examined)
    Item
    Hepatomegaly by scan (or x-ray)
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C3100 (NCI Thesaurus ObjectClass)
    C0017924 (UMLS 2011AA ObjectClass)
    C19477 (NCI Thesaurus Property)
    C1704254 (UMLS 2011AA Property)
    C25356 (NCI Thesaurus ValueDomain-2)
    C1301725 (UMLS 2011AA ValueDomain-2)
    CL.8
    Code List
    Hepatomegaly by scan (or x-ray)
    CL Item
    Examination Performed And Hepatomegaly Present (Yes)
    CL Item
    Examination Performed And Hepatomegaly Absent (No)
    CL Item
    Examination Of Liver Not Performed (Not examined)
    Item
    Palpable lymphadenopathy
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C16950 (NCI Thesaurus Property)
    C0030247 (UMLS 2011AA Property)
    C3206 (NCI Thesaurus ObjectClass)
    C0024228 (UMLS 2011AA ObjectClass)
    C25356 (NCI Thesaurus ValueDomain-2)
    C1301725 (UMLS 2011AA ValueDomain-2)
    CL.9
    Code List
    Palpable lymphadenopathy
    CL Item
    Examination Performed And Lymphadenopathy Present (Yes)
    CL Item
    Examination Performed And Lymphadenopathy Absent (No)
    CL Item
    Examination Of Lymph Nodes Not Performed (Not examined)
    Item
    Lymphadenopathy by scan (or x-ray)
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C3206 (NCI Thesaurus ObjectClass)
    C0024228 (UMLS 2011AA ObjectClass)
    C19477 (NCI Thesaurus Property)
    C1704254 (UMLS 2011AA Property)
    C25356 (NCI Thesaurus ValueDomain-2)
    C1301725 (UMLS 2011AA ValueDomain-2)
    CL.10
    Code List
    Lymphadenopathy by scan (or x-ray)
    CL Item
    Examination Performed And Lymphadenopathy Present (Yes)
    CL Item
    Examination Performed And Lymphadenopathy Absent (No)
    CL Item
    Examination Of Lymph Nodes Not Performed (Not examined)
    Item
    Clinical Onset of AML
    text
    C25398 (NCI Thesaurus ObjectClass)
    C0205210 (UMLS 2011AA ObjectClass)
    C16390 (NCI Thesaurus ObjectClass-2)
    C1524003 (UMLS 2011AA ObjectClass-2)
    C3171 (NCI Thesaurus Property)
    C0023467 (UMLS 2011AA Property)
    C15220 (NCI Thesaurus Property-2)
    C0011900 (UMLS 2011AA Property-2)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    CL.11
    Code List
    Clinical Onset of AML
    CL Item
    Aml Without Prior Clinical History Of Mds Or Potentially Leukemogenic Treatment (de novo)
    CL Item
    Aml Related To/associated With Prior Clinical History Of Potentially Leukemogenic Treatment (Treatment related)
    CL Item
    Aml Related To/associated With Prior Clinical History Of Mds (MDS-related)
    Item Group
    Allows Documentation Of Any Additional Cooments
    Research Comments
    Item
    Comments
    text
    C25704 (NCI Thesaurus ValueDomain)
    C0947611 (UMLS CUI-1)
    C15319 (NCI Thesaurus ObjectClass)
    C25393 (NCI Thesaurus Property)
    Back to the top of the page 

    Help

    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