ID
6477
Description
E3A06 Treatment Form (Arm A) Lenalidomide or Observation in Treating Patients With Asymptomatic High-Risk Smoldering Multiple Myeloma NCT01169337 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=86D1B322-221A-3014-E040-BB89AD432E00
Lien
Mots-clés
Versions (2)
- 19/09/2012 19/09/2012 -
- 01/01/2015 01/01/2015 - Martin Dugas
Téléchargé le
1 janvier 2015
DOI
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Creative Commons BY-NC 3.0 Legacy
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Treatment Form Multiple Myeloma E3A06 Arm A
INSTRUCTIONS: Complete this form at the end of each cycle of Arm A Induction protocol treatment. Submit original to the ECOG Coordinating Center. Keep a copy for your files. Refer to forms packet for submission schedule
Description
On Treatment
Description
Cycle number
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C2045829
- NCI Thesaurus Property
- C25214
- NCI Thesaurus Property-2
- C25616
- NCI Thesaurus ObjectClass
- C15368
Description
Chemotherapy cycle
Type de données
text
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25214
- UMLS CUI-1
- C1302181
- NCI Thesaurus Property-2
- C25616
- NCI Thesaurus ValueDomain
- C25685
- NCI Thesaurus ValueDomain-2
- C25472
- NCI Thesaurus ValueDomain-3
- C25275
Description
Reporting Period Start Date
Type de données
date
Unités de mesure
- M D Y
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25616
- NCI Thesaurus Property-2
- C25651
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25431
- UMLS CUI-1
- C2361257
Description
Reporting Period End Date
Type de données
date
Unités de mesure
- M D Y
Alias
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus Property
- C25616
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property-2
- C25651
- UMLS CUI-1
- C2361259
Description
Vital Status
Description
Patient Status
Type de données
text
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C3846084
- NCI Thesaurus ValueDomain
- C18003
- NCI Thesaurus ValueDomain-2
- C25688
- NCI Thesaurus Property
- C25717
Description
Date last contact
Type de données
date
Alias
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-1
- C0805839
- NCI Thesaurus Property
- C25461
- NCI Thesaurus Property-2
- C25551
- NCI Thesaurus ValueDomain
- C25164
- NCI Thesaurus ValueDomain-2
- C25367
Description
Primary Cause of Death
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C0007465
- NCI Thesaurus ObjectClass
- C16960
- NCI Thesaurus Property
- C28554
- NCI Thesaurus ValueDomain-2
- C25251
Description
Cause of Death, specify
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C0007465
- NCI Thesaurus ObjectClass
- C16960
- UMLS CUI-2
- C1521902
- NCI Thesaurus Property
- C28554
Description
Patient Characteristics
Description
Therapy Administered
Alias
- UMLS CUI-1
- C0087111
Description
Agent
Type de données
text
Alias
- NCI Thesaurus Property
- C25364
- UMLS CUI-1
- C1521826
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus ValueDomain
- C1708
- NCI Thesaurus ValueDomain-2
- C42614
Description
Agent administered during reporting period
Type de données
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS CUI-1
- C0450442
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-2
- C1521801
- NCI Thesaurus Property
- C25382
Description
Patient Diary complete
Type de données
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C3259162
- NCI Thesaurus Property
- C25250
- NCI Metathesaurus ObjectClass
- C0030705
Description
Concomitant Medication Start Date
Type de données
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2826734
- NCI Thesaurus ValueDomain-2
- C25431
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus Property
- C25275
Description
Agent Total Dose
Type de données
float
Unités de mesure
- mg
Alias
- NCI Thesaurus ValueDomain
- C25304
- NCI Thesaurus Property
- C25379
- NCI Thesaurus ValueDomain-2
- C25488
- NCI Thesaurus ObjectClass
- C1708
- UMLS CUI-1
- C2986497
Description
Dose modification Lenalidomide
Type de données
boolean
Alias
- NCI Thesaurus ValueDomain
- C38147
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C2668
- UMLS CUI-2
- C1144149
- NCI Thesaurus ObjectClass-2
- C25488
- NCI Thesaurus Property
- C25572
Description
Dose modification Lenalidomide per protocol
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C2668
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass-2
- C25488
- UMLS CUI-2
- C1144149
- NCI Thesaurus Property
- C25320
- UMLS CUI-3
- C1698058
- NCI Thesaurus Property-2
- C25572
- NCI Thesaurus ValueDomain
- C38147
Description
Dose modification begin date
Type de données
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1707811
- NCI Thesaurus ValueDomain-2
- C25431
- UMLS CUI-2
- C0808070
- NCI Thesaurus ObjectClass
- C25488
- NCI Thesaurus Property
- C25572
Description
Dose modification end date
Type de données
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-2
- C0806020
- NCI Thesaurus Property
- C25572
Description
Total Modified Dose
Type de données
float
Unités de mesure
- mg
Alias
- NCI Thesaurus ValueDomain
- C25304
- NCI Thesaurus ValueDomain-2
- C25488
- NCI Thesaurus ObjectClass
- C1708
- NCI Thesaurus Property
- C25572
- UMLS CUI-1
- C2986497
- UMLS CUI-2
- C0392747
Description
Dose Modification Status
Type de données
text
Alias
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-1
- C1707811
- NCI Thesaurus ValueDomain
- C25688
- NCI Thesaurus Property
- C25572
Description
Dose Modification Reason
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25638
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-2
- C0392360
- NCI Thesaurus Property
- C25572
Description
Dose Modification Reason, other
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS CUI-1
- C1707811
- NCI Thesaurus ObjectClass
- C25488
- UMLS CUI-2
- C3840932
- NCI Thesaurus Property
- C25572
Description
Deep Vein Thrombosis prophylaxis
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C49343
- UMLS CUI-1
- C0853245
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C25639
- NCI Thesaurus ValueDomain
- C38147
Description
DVT prophylaxis daily dose
Type de données
text
Alias
- NCI Thesaurus ObjectClass
- C49343
- NCI Thesaurus ObjectClass-2
- C15405
- NCI Thesaurus Property
- C25473
- NCI Thesaurus Property-2
- C25256
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C0853245
- UMLS CUI-2
- C2348070
Description
Aspirin dose
Type de données
float
Unités de mesure
- mg
Alias
- NCI Thesaurus ObjectClass
- C49343
- NCI Thesaurus ObjectClass-2
- C15368
- NCI Thesaurus ObjectClass-3
- C15405
- NCI Thesaurus Property
- C17649
- NCI Thesaurus Property-2
- C25639
- NCI Thesaurus Property-3
- C287
- NCI Thesaurus Property-4
- C25256
- NCI Thesaurus ValueDomain
- C25488
- UMLS CUI-1
- C0004057
- UMLS CUI-2
- C0178602
Description
INR
Type de données
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS CUI-1
- C0525032
- NCI Thesaurus Property
- C20200
- NCI Thesaurus ObjectClass
- C25294
- NCI Thesaurus Property-2
- C25352
Description
Chemotherapy delayed
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C15368
- NCI Thesaurus Property
- C25477
- NCI Thesaurus Property-2
- C25472
- UMLS CUI-1
- C1299577
- NCI Thesaurus Property-3
- C53286
- NCI Thesaurus ValueDomain
- C38147
Description
Non-protocol Therapy
Description
Non-protocol therapy
Type de données
boolean
Alias
- NCI Thesaurus ObjectClass
- C25590
- UMLS CUI-1
- C1518384
- NCI Thesaurus ObjectClass-2
- C16212
- UMLS CUI-2
- C0087111
- NCI Thesaurus Property
- C25320
- NCI Thesaurus Property-2
- C49236
- NCI Thesaurus Property-3
- C25456
- NCI Thesaurus Property-4
- C25382
- NCI Thesaurus ValueDomain
- C38148
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