Unnamed2
PatientInitialsName
text
ProtocolECOGIdentifierNumber
text
PatientECOGIdentifierNumber
text
ProtocolParticipatingIdentifierNumber
text
PatientParticipatingIdentifierNumber
text
CombinedInstitutionName
text
Unnamed3
DataAmendedText
text
DataAmendedDate
date
On Treatment
TreatmentEvaluationPeriodType
text
TreatmentEvaluationPeriodType
text
TreatmentEvaluationPeriodCycleSpecify
text
TreatmentEvaluationPeriodCycleSpecify
text
Off Treatment
PersonOff-TreatmentTimePeriodType
text
Unnamed5
MyelodysplasticSyndromeWorldHealthOrganizationClassificationCategory
text
BoneMarrowBiopsyInd
text
BoneMarrowBiopsyDate
date
LaboratoryProcedureBoneMarrowBlastCellOutcomePercentageValue
double
LaboratoryProcedureBoneMarrowCellularityOutcomePercentageValue
double
LaboratoryProcedureBoneMarrowCellularityNegationReportOutcomeReason
text
DysplasiaPresentInd-3
text
DysplasiaHistologyType
text
CytogeneticAbnormalityPresentIndicator
text
Section Ii
PackedRedBloodCellTransfusionRequirementInd-3
text
PackedRedBloodCellTransfusionReceivedUnitCount
double
PackedRedBloodCellTransfusionReceivedFirstDate
date
PackedRedBloodCellTransfusionReceivedMostRecentDate
date
Mds Response
MyelodysplasticSyndromeResponseType
text
MyelodysplasticSyndromeResponseFirstDate
date
MyelodysplasticSyndromeResponseDiagnosisDate
date
DiseaseRelapseInd-3
text
DiseaseRelapseDate
date
DiseaseMyelodysplasticSyndromeHematologyResponseType
text
DiseaseMyelodysplasticSyndromeHematologyResponseFirstDate
date
DiseaseMyelodysplasticSyndromeHematologyResponseDiagnosisDate
date
Cytogenetic Response
Comments
InvestigatorSignatureText
text
InvestigatorSignatureDate
date