ID

6716

Description

Chronic Myelogenous Leukemia (CML) - Follow-Up Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1AB0C43D-1393-07D0-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1AB0C43D-1393-07D0-E044-0003BA3F9857

Keywords

  1. 9/19/12 9/19/12 -
  2. 1/8/15 1/8/15 - Martin Dugas
Uploaded on

January 8, 2015

DOI

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License

Creative Commons BY-NC 3.0 Legacy

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Follow-Up - Chronic Myelogenous Leukemia (CML) - Follow-Up Form - 2019375v3.0

No Instruction available.

  1. StudyEvent: Chronic Myelogenous Leukemia (CML) - Follow-Up Form
    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
Reporting Period Start Date (mm dd yyyy)
Description

Reporting Period Start Date

Data type

date

Alias
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property
C25616
UMLS CUI-1
C2361257
NCI Thesaurus Property-2
C25651
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ValueDomain-2
C25431
Reporting Period End Date (mm dd yyyy)
Description

Reporting Period End Date

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS CUI-1
C2361259
NCI Thesaurus Property
C25616
NCI Thesaurus ObjectClass
C15368
NCI Thesaurus Property-2
C25651
Aml/all/apl: Vital Status
Description

Aml/all/apl: Vital Status

Patient's Vital Status
Description

Patient Status

Data type

text

Alias
NCI Thesaurus ObjectClass
C16960
UMLS CUI-1
C3846084
NCI Thesaurus ValueDomain
C18003
NCI Thesaurus ValueDomain-2
C25688
NCI Thesaurus Property
C25717
Primary Cause of Death (if dead check one)
Description

Primary Cause of Death

Data type

text

Alias
NCI Thesaurus ValueDomain
C25638
UMLS CUI-1
C0007465
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C28554
NCI Thesaurus ValueDomain-2
C25251
Describe cause of death
Description

Cause of Death, specify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS CUI-1
C0007465
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C1521902
NCI Thesaurus Property
C28554
Date of Last Contact or Death (mm dd yyyy)
Description

Date last contact

Data type

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
Aml/all/apl: Disease Follow-up Status
Description

Aml/all/apl: Disease Follow-up Status

Has the patient had a documented clinical assessment for this cancer? (during this reporting period)
Description

Documented clinical assessment for this cancer

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C1522577
NCI Thesaurus Property
C16033
UMLS CUI-2
C0006826
NCI Thesaurus ObjectClass
C9305
NCI Thesaurus Property-2
C25365
Date of Last Clinical Assessment (mm dd yyyy only provide date if assessment during this reporting period)
Description

Follow-Up Date

Data type

date

Alias
NCI Thesaurus ObjectClass
C9305
UMLS CUI-1
C3694716
NCI Thesaurus Property
C16033
NCI Thesaurus Property-2
C25365
NCI Thesaurus ValueDomain
C25164
NCI Thesaurus ValueDomain-2
C25367
Did the patient achieve a complete response according to clinical/ hematologic criteria (during this reporting period)
Description

HematologyCompleteResponseInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C16673
UMLS 2011AA ObjectClass
C0018943
NCI Metathesaurus Property
C0677874
Date of Complete Response (If yes, indicate mm dd yyyy only provide date if CR was achieved during this reporting period)
Description

CompleteResponseOccurrenceDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25755
UMLS 2011AA ObjectClass
C0871261
NCI Thesaurus ObjectClass-2
C25250
UMLS 2011AA ObjectClass-2
C0205197
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
Cml:disease Follow-up Status-cytogenetic/molecular
Description

Cml:disease Follow-up Status-cytogenetic/molecular

Has the patient had a documented cytogenetic or molecular assessment (including Philadelphia chromosome karotype or BCR-abl) (during this reporting period)
Description

CancerFollow-upStatusMolecularInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C9305
UMLS 2011AA ObjectClass
C0006826
NCI Thesaurus Property
C16033
UMLS 2011AA Property
C1522577
NCI Thesaurus Property-2
C25365
UMLS 2011AA Property-2
C0678257
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ValueDomain-2
C25574
UMLS 2011AA ValueDomain-2
C1521991
Date of Last Cytogenetic or Molecular Assessment (mm dd yyyy)
Description

LastMolecularAssessmentDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C25574
UMLS 2011AA ObjectClass
C1521991
NCI Thesaurus ObjectClass-2
C25551
UMLS 2011AA ObjectClass-2
C1517741
Did the patient achieve a complete response according to cytogenetic or molecular criteria (during this reporting period)
Description

CMLCompleteResponseMolecularInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C3174
UMLS 2011AA ObjectClass
C0023473
NCI Metathesaurus Property
C0677874
Date of Complete Response (If yes, indicate mm dd yyyy only provide date if CR was achieved during this reporting period)
Description

CompleteResponseOccurrenceDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25755
UMLS 2011AA ObjectClass
C0871261
NCI Thesaurus ObjectClass-2
C25250
UMLS 2011AA ObjectClass-2
C0205197
NCI Thesaurus Property
C25275
UMLS 2011AA Property
C2745955
Was cytogenetic analysis successful? (If yes, indicate the results of cytogenetic or molecular assessment.)
Description

CytogeneticsAnalysisSuccessInd-3

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25391
UMLS 2011AA ObjectClass
C0936012
NCI Thesaurus ObjectClass-2
C16487
UMLS 2011AA ObjectClass-2
C0010802
NCI Thesaurus Property
C25362
UMLS 2011AA Property
C0597535
Karyotypic Philadelphia Chromosome Positive
Description

PhiladelphiaChromosomeCytogeneticsKaryotypeResultStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C16487
UMLS 2011AA ObjectClass
C0010802
NCI Thesaurus ObjectClass-2
C28452
UMLS 2011AA ObjectClass-2
C0031526
NCI Thesaurus Property
C25215
UMLS 2011AA Property
C1261273
NCI Thesaurus Property-2
C20200
UMLS 2011AA Property-2
C1274040
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Were FISH studies performed
Description

FISHEvaluationPerformedInd-3

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C17563
UMLS 2011AA ObjectClass-2
C0162789
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
FISH probe(s) specify (If yes,)
Description

FISHAssessmentDNAProbeNameText

Data type

text

Alias
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus ObjectClass-2
C17563
UMLS 2011AA ObjectClass-2
C0162789
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property-2
C451
UMLS 2011AA Property-2
C0012893
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
Specific Abnormalities Detected by FISH
Description

CytogeneticsAbnormalityFISHType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C16487
UMLS 2011AA ObjectClass
C0010802
NCI Thesaurus Property
C9440
UMLS 2011AA Property
C1704258
Other specify
Description

CytogeneticsAbnormalityFISHSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C16487
UMLS 2011AA ObjectClass
C0010802
NCI Thesaurus Property
C9440
UMLS 2011AA Property
C1704258
Result of FISH
Description

FISHAssessmentResultStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus ObjectClass-2
C17563
UMLS 2011AA ObjectClass-2
C0162789
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property-2
C13212
UMLS 2011AA Property-2
C0008659
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
RT-PCR Marker Type
Description

ReverseTranscriptase-PolymeraseChainReactionGeneticMarkerAssessmentType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C18136
UMLS 2011AA ObjectClass
C0599161
NCI Thesaurus Property-2
C16622
UMLS 2011AA Property-2
C0017393
Other specify
Description

ReverseTranscriptase-PolymeraseChainReactionGeneticMarkerAssessmentSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C18136
UMLS 2011AA ObjectClass
C0599161
NCI Thesaurus Property-2
C16622
UMLS 2011AA Property-2
C0017393
Result of RT-PCR for Chimeric Genes (Polymerase Chain Reaction)
Description

ReverseTranscriptase-PolymeraseChainReactionGeneticMarkerAssessmentStatus

Data type

text

Alias
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C18136
UMLS 2011AA ObjectClass
C0599161
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
NCI Thesaurus Property-2
C16622
UMLS 2011AA Property-2
C0017393
Cml: Notice Of Progression - Clinical/hematologic
Description

Cml: Notice Of Progression - Clinical/hematologic

Has the patient developed clinical or hematologic evidence of progression or relapse (during this reporting period)
Description

ChronicMyelogenousLeukemiaClinicalHematologyProgressionInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C62780
UMLS 2011AA ObjectClass
C0205488
NCI Thesaurus ObjectClass-2
C3174
UMLS 2011AA ObjectClass-2
C0023473
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property-2
C25331
NCI Thesaurus Property-3
C16673
UMLS 2011AA Property-2
C0018943
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Date of Clinical/Hematologic Progression (mm dd yyyy only provide date if progression occurred during this reporting period)
Description

ChronicMyelogenousLeukemiaClinicalHematologyProgressionDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C62780
UMLS 2011AA ObjectClass
C0205488
NCI Thesaurus ObjectClass-2
C3174
UMLS 2011AA ObjectClass-2
C0023473
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property-2
C25331
NCI Thesaurus Property-3
C16673
UMLS 2011AA Property-2
C0018943
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
Indicate the CML classification at the time of clinical/ hematologic progression (If yes,)
Description

ChronicMyelogenousLeukemiaClinicalHematologyProgressionClassificationType

Data type

text

Alias
NCI Thesaurus ObjectClass
C3174
UMLS 2011AA ObjectClass
C0023473
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property-2
C25331
NCI Thesaurus Property-3
C16673
UMLS 2011AA Property-2
C0018943
NCI Thesaurus Property-4
C25161
UMLS 2011AA Property-3
C0008902
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other specify
Description

ChronicMyelogenousLeukemiaClinicalHematologyProgressionClassificationSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C3174
UMLS 2011AA ObjectClass
C0023473
NCI Thesaurus Property
C25398
UMLS 2011AA Property
C0205210
NCI Thesaurus Property-2
C25331
NCI Thesaurus Property-3
C16673
UMLS 2011AA Property-2
C0018943
NCI Thesaurus Property-4
C25161
UMLS 2011AA Property-3
C0008902
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Cml:disease Follow-up Status-cytogenetic/molecular
Description

Cml:disease Follow-up Status-cytogenetic/molecular

Has the patient developed cytogenetic or molecular evidence of progression or relapse (during this reporting period)
Description

CMLMolecularProgressionInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C25331
NCI Thesaurus ObjectClass
C3174
UMLS 2011AA ObjectClass
C0023473
NCI Thesaurus ObjectClass-2
C25574
UMLS 2011AA ObjectClass-2
C1521991
Date of Progression by Cytogenetic or Molecular Assessment (mm dd yyyy only provide date if progression occurred during this reporting period)
Description

ProgressionMolecularCytogeneticsDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ObjectClass
C25331
NCI Thesaurus Property
C16487
UMLS 2011AA Property
C0010802
NCI Thesaurus Property-2
C25574
UMLS 2011AA Property-2
C1521991
Was cytogenetic analysis successful? (If yes, indicate the results of cytogenetic or molecular assessment.)
Description

CytogeneticsAnalysisSuccessInd-3

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25391
UMLS 2011AA ObjectClass
C0936012
NCI Thesaurus ObjectClass-2
C16487
UMLS 2011AA ObjectClass-2
C0010802
NCI Thesaurus Property
C25362
UMLS 2011AA Property
C0597535
Karyotypic Philadelphia Chromosome Positive
Description

PhiladelphiaChromosomeCytogeneticsKaryotypeResultStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C16487
UMLS 2011AA ObjectClass
C0010802
NCI Thesaurus ObjectClass-2
C28452
UMLS 2011AA ObjectClass-2
C0031526
NCI Thesaurus Property
C25215
UMLS 2011AA Property
C1261273
NCI Thesaurus Property-2
C20200
UMLS 2011AA Property-2
C1274040
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Were FISH studies performed
Description

FISHEvaluationPerformedInd-3

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25214
UMLS 2011AA ObjectClass
C0220825
NCI Thesaurus ObjectClass-2
C17563
UMLS 2011AA ObjectClass-2
C0162789
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
FISH probe(s) specify (If yes,)
Description

FISHAssessmentDNAProbeNameText

Data type

text

Alias
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus ObjectClass-2
C17563
UMLS 2011AA ObjectClass-2
C0162789
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property-2
C451
UMLS 2011AA Property-2
C0012893
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
Specific Abnormalities Detected by FISH
Description

CytogeneticsAbnormalityFISHType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C16487
UMLS 2011AA ObjectClass
C0010802
NCI Thesaurus Property
C9440
UMLS 2011AA Property
C1704258
Other specify
Description

CytogeneticsAbnormalityFISHSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C16487
UMLS 2011AA ObjectClass
C0010802
NCI Thesaurus Property
C9440
UMLS 2011AA Property
C1704258
Result of FISH
Description

FISHAssessmentResultStatus

Data type

text

Alias
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus ObjectClass-2
C17563
UMLS 2011AA ObjectClass-2
C0162789
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property-2
C13212
UMLS 2011AA Property-2
C0008659
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
RT-PCR Marker Type
Description

ReverseTranscriptase-PolymeraseChainReactionGeneticMarkerAssessmentType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C18136
UMLS 2011AA ObjectClass
C0599161
NCI Thesaurus Property-2
C16622
UMLS 2011AA Property-2
C0017393
Other specify
Description

ReverseTranscriptase-PolymeraseChainReactionGeneticMarkerAssessmentSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C18136
UMLS 2011AA ObjectClass
C0599161
NCI Thesaurus Property-2
C16622
UMLS 2011AA Property-2
C0017393
Result of RT-PCR for Chimeric Genes (Polymerase Chain Reaction)
Description

ReverseTranscriptase-PolymeraseChainReactionGeneticMarkerAssessmentStatus

Data type

text

Alias
NCI Thesaurus Property
C20989
UMLS 2011AA Property
C0031809
NCI Thesaurus ObjectClass
C18136
UMLS 2011AA ObjectClass
C0599161
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
NCI Thesaurus Property-2
C16622
UMLS 2011AA Property-2
C0017393
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

Similar models

No Instruction available.

  1. StudyEvent: Chronic Myelogenous Leukemia (CML) - Follow-Up Form
    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)
Reporting Period Start Date
Item
Reporting Period Start Date (mm dd yyyy)
date
C15368 (NCI Thesaurus ObjectClass)
C25616 (NCI Thesaurus Property)
C2361257 (UMLS CUI-1)
C25651 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25431 (NCI Thesaurus ValueDomain-2)
Reporting Period End Date
Item
Reporting Period End Date (mm dd yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C2361259 (UMLS CUI-1)
C25616 (NCI Thesaurus Property)
C15368 (NCI Thesaurus ObjectClass)
C25651 (NCI Thesaurus Property-2)
Item Group
Aml/all/apl: Vital Status
Item
Patient's Vital Status
text
C16960 (NCI Thesaurus ObjectClass)
C3846084 (UMLS CUI-1)
C18003 (NCI Thesaurus ValueDomain)
C25688 (NCI Thesaurus ValueDomain-2)
C25717 (NCI Thesaurus Property)
Code List
Patient's Vital Status
CL Item
Alive (Alive)
CL Item
Dead (Dead)
Item
Primary Cause of Death (if dead check one)
text
C25638 (NCI Thesaurus ValueDomain)
C0007465 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C28554 (NCI Thesaurus Property)
C25251 (NCI Thesaurus ValueDomain-2)
Code List
Primary Cause of Death (if dead check one)
CL Item
Due To This Disease (Due to this disease)
CL Item
Due To Protocol Treatment (Due to protocol treatment)
CL Item
Due To Other Cause (Due to other cause)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Cause of Death, specify
Item
Describe cause of death
text
C25685 (NCI Thesaurus ValueDomain)
C0007465 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C1521902 (UMLS CUI-2)
C28554 (NCI Thesaurus Property)
Date last contact
Item
Date of Last Contact or Death (mm dd yyyy)
date
C16960 (NCI Thesaurus ObjectClass)
C0805839 (UMLS CUI-1)
C25461 (NCI Thesaurus Property)
C25551 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
Item Group
Aml/all/apl: Disease Follow-up Status
Item
Has the patient had a documented clinical assessment for this cancer? (during this reporting period)
text
C38148 (NCI Thesaurus ValueDomain)
C1522577 (UMLS CUI-1)
C16033 (NCI Thesaurus Property)
C0006826 (UMLS CUI-2)
C9305 (NCI Thesaurus ObjectClass)
C25365 (NCI Thesaurus Property-2)
Code List
Has the patient had a documented clinical assessment for this cancer? (during this reporting period)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Follow-Up Date
Item
Date of Last Clinical Assessment (mm dd yyyy only provide date if assessment during this reporting period)
date
C9305 (NCI Thesaurus ObjectClass)
C3694716 (UMLS CUI-1)
C16033 (NCI Thesaurus Property)
C25365 (NCI Thesaurus Property-2)
C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
Item
Did the patient achieve a complete response according to clinical/ hematologic criteria (during this reporting period)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C16673 (NCI Thesaurus ObjectClass)
C0018943 (UMLS 2011AA ObjectClass)
C0677874 (NCI Metathesaurus Property)
Code List
Did the patient achieve a complete response according to clinical/ hematologic criteria (during this reporting period)
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus-3)
C1705108 (UMLS 2011AA-4)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus-3)
C1298908 (UMLS 2011AA-4)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CompleteResponseOccurrenceDate
Item
Date of Complete Response (If yes, indicate mm dd yyyy only provide date if CR was achieved during this reporting period)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus ObjectClass)
C0871261 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus ObjectClass-2)
C0205197 (UMLS 2011AA ObjectClass-2)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
Item Group
Cml:disease Follow-up Status-cytogenetic/molecular
Item
Has the patient had a documented cytogenetic or molecular assessment (including Philadelphia chromosome karotype or BCR-abl) (during this reporting period)
text
C9305 (NCI Thesaurus ObjectClass)
C0006826 (UMLS 2011AA ObjectClass)
C16033 (NCI Thesaurus Property)
C1522577 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property-2)
C0678257 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25574 (NCI Thesaurus ValueDomain-2)
C1521991 (UMLS 2011AA ValueDomain-2)
Code List
Has the patient had a documented cytogenetic or molecular assessment (including Philadelphia chromosome karotype or BCR-abl) (during this reporting period)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
LastMolecularAssessmentDate
Item
Date of Last Cytogenetic or Molecular Assessment (mm dd yyyy)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C25574 (NCI Thesaurus ObjectClass)
C1521991 (UMLS 2011AA ObjectClass)
C25551 (NCI Thesaurus ObjectClass-2)
C1517741 (UMLS 2011AA ObjectClass-2)
Item
Did the patient achieve a complete response according to cytogenetic or molecular criteria (during this reporting period)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C3174 (NCI Thesaurus ObjectClass)
C0023473 (UMLS 2011AA ObjectClass)
C0677874 (NCI Metathesaurus Property)
Code List
Did the patient achieve a complete response according to cytogenetic or molecular criteria (during this reporting period)
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus-3)
C1705108 (UMLS 2011AA-4)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus-3)
C1298908 (UMLS 2011AA-4)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CompleteResponseOccurrenceDate
Item
Date of Complete Response (If yes, indicate mm dd yyyy only provide date if CR was achieved during this reporting period)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25755 (NCI Thesaurus ObjectClass)
C0871261 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus ObjectClass-2)
C0205197 (UMLS 2011AA ObjectClass-2)
C25275 (NCI Thesaurus Property)
C2745955 (UMLS 2011AA Property)
CytogeneticsAnalysisSuccessInd-3
Item
Was cytogenetic analysis successful? (If yes, indicate the results of cytogenetic or molecular assessment.)
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25391 (NCI Thesaurus ObjectClass)
C0936012 (UMLS 2011AA ObjectClass)
C16487 (NCI Thesaurus ObjectClass-2)
C0010802 (UMLS 2011AA ObjectClass-2)
C25362 (NCI Thesaurus Property)
C0597535 (UMLS 2011AA Property)
Item
Karyotypic Philadelphia Chromosome Positive
text
C16487 (NCI Thesaurus ObjectClass)
C0010802 (UMLS 2011AA ObjectClass)
C28452 (NCI Thesaurus ObjectClass-2)
C0031526 (UMLS 2011AA ObjectClass-2)
C25215 (NCI Thesaurus Property)
C1261273 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Karyotypic Philadelphia Chromosome Positive
CL Item
Yes, The Philadelphia Chromosome Karyotype Assessment Is Positive (Yes)
CL Item
No, The Philadelphia Chromosome Karyotype Assessment Is Not Positive (No)
CL Item
A Karyotype Assessment For The Philadelphia Chromosome Was Not Done (Not done)
CL Item
The Karyotype Assessment For The Philadelphia Chromosome Was Indeterminate (Indeterminate)
FISHEvaluationPerformedInd-3
Item
Were FISH studies performed
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C17563 (NCI Thesaurus ObjectClass-2)
C0162789 (UMLS 2011AA ObjectClass-2)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
FISHAssessmentDNAProbeNameText
Item
FISH probe(s) specify (If yes,)
text
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C17563 (NCI Thesaurus ObjectClass-2)
C0162789 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C451 (NCI Thesaurus Property-2)
C0012893 (UMLS 2011AA Property-2)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
Item
Specific Abnormalities Detected by FISH
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16487 (NCI Thesaurus ObjectClass)
C0010802 (UMLS 2011AA ObjectClass)
C9440 (NCI Thesaurus Property)
C1704258 (UMLS 2011AA Property)
Code List
Specific Abnormalities Detected by FISH
CL Item
T(9;22)(q34;q11.2); Bcr/abl (t(9;22)(q34;q11.2); BCR/ABL)
CL Item
Other Specify (Other)
CytogeneticsAbnormalityFISHSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16487 (NCI Thesaurus ObjectClass)
C0010802 (UMLS 2011AA ObjectClass)
C9440 (NCI Thesaurus Property)
C1704258 (UMLS 2011AA Property)
Item
Result of FISH
text
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C17563 (NCI Thesaurus ObjectClass-2)
C0162789 (UMLS 2011AA ObjectClass-2)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C13212 (NCI Thesaurus Property-2)
C0008659 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Result of FISH
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
Item
RT-PCR Marker Type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C18136 (NCI Thesaurus ObjectClass)
C0599161 (UMLS 2011AA ObjectClass)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
Code List
RT-PCR Marker Type
CL Item
Bcr-abl1 Fusion Protein Expression (BCR/ABL)
C36715 (NCI Thesaurus)
C1516132 (UMLS 2011AA)
CL Item
Other Specify (Other)
ReverseTranscriptase-PolymeraseChainReactionGeneticMarkerAssessmentSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C18136 (NCI Thesaurus ObjectClass)
C0599161 (UMLS 2011AA ObjectClass)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
Item
Result of RT-PCR for Chimeric Genes (Polymerase Chain Reaction)
text
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C18136 (NCI Thesaurus ObjectClass)
C0599161 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
Code List
Result of RT-PCR for Chimeric Genes (Polymerase Chain Reaction)
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
Item Group
Cml: Notice Of Progression - Clinical/hematologic
Item
Has the patient developed clinical or hematologic evidence of progression or relapse (during this reporting period)
text
C62780 (NCI Thesaurus ObjectClass)
C0205488 (UMLS 2011AA ObjectClass)
C3174 (NCI Thesaurus ObjectClass-2)
C0023473 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25331 (NCI Thesaurus Property-2)
C16673 (NCI Thesaurus Property-3)
C0018943 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
Code List
Has the patient developed clinical or hematologic evidence of progression or relapse (during this reporting period)
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus-3)
C1705108 (UMLS 2011AA-4)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus-3)
C1298908 (UMLS 2011AA-4)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
ChronicMyelogenousLeukemiaClinicalHematologyProgressionDate
Item
Date of Clinical/Hematologic Progression (mm dd yyyy only provide date if progression occurred during this reporting period)
date
C62780 (NCI Thesaurus ObjectClass)
C0205488 (UMLS 2011AA ObjectClass)
C3174 (NCI Thesaurus ObjectClass-2)
C0023473 (UMLS 2011AA ObjectClass-2)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25331 (NCI Thesaurus Property-2)
C16673 (NCI Thesaurus Property-3)
C0018943 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
Item
Indicate the CML classification at the time of clinical/ hematologic progression (If yes,)
text
C3174 (NCI Thesaurus ObjectClass)
C0023473 (UMLS 2011AA ObjectClass)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25331 (NCI Thesaurus Property-2)
C16673 (NCI Thesaurus Property-3)
C0018943 (UMLS 2011AA Property-2)
C25161 (NCI Thesaurus Property-4)
C0008902 (UMLS 2011AA Property-3)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
Code List
Indicate the CML classification at the time of clinical/ hematologic progression (If yes,)
CL Item
Blast Count In The Marrow Or Blood Steady Or Constant Level Less Than 30% Over Period Of Time (CML chronic phase)
CL Item
Blast Count In The Marrow Or Blood Increasing Over Period Of Time, But Currently Less Than 30% (CML accelerating phase)
CL Item
Blast Count In The Marrow Or Blood Greater Than 30% (CML blast crisis)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Other Specify (Other)
ChronicMyelogenousLeukemiaClinicalHematologyProgressionClassificationSpecify
Item
Other specify
text
C3174 (NCI Thesaurus ObjectClass)
C0023473 (UMLS 2011AA ObjectClass)
C25398 (NCI Thesaurus Property)
C0205210 (UMLS 2011AA Property)
C25331 (NCI Thesaurus Property-2)
C16673 (NCI Thesaurus Property-3)
C0018943 (UMLS 2011AA Property-2)
C25161 (NCI Thesaurus Property-4)
C0008902 (UMLS 2011AA Property-3)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
Item Group
Cml:disease Follow-up Status-cytogenetic/molecular
Item
Has the patient developed cytogenetic or molecular evidence of progression or relapse (during this reporting period)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25331 (NCI Thesaurus Property)
C3174 (NCI Thesaurus ObjectClass)
C0023473 (UMLS 2011AA ObjectClass)
C25574 (NCI Thesaurus ObjectClass-2)
C1521991 (UMLS 2011AA ObjectClass-2)
Code List
Has the patient developed cytogenetic or molecular evidence of progression or relapse (during this reporting period)
CL Item
Yes (YES)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
C49488 (NCI Thesaurus-3)
C1705108 (UMLS 2011AA-4)
CL Item
No (NO)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
C49487 (NCI Thesaurus-3)
C1298908 (UMLS 2011AA-4)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
ProgressionMolecularCytogeneticsDate
Item
Date of Progression by Cytogenetic or Molecular Assessment (mm dd yyyy only provide date if progression occurred during this reporting period)
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25331 (NCI Thesaurus ObjectClass)
C16487 (NCI Thesaurus Property)
C0010802 (UMLS 2011AA Property)
C25574 (NCI Thesaurus Property-2)
C1521991 (UMLS 2011AA Property-2)
CytogeneticsAnalysisSuccessInd-3
Item
Was cytogenetic analysis successful? (If yes, indicate the results of cytogenetic or molecular assessment.)
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25391 (NCI Thesaurus ObjectClass)
C0936012 (UMLS 2011AA ObjectClass)
C16487 (NCI Thesaurus ObjectClass-2)
C0010802 (UMLS 2011AA ObjectClass-2)
C25362 (NCI Thesaurus Property)
C0597535 (UMLS 2011AA Property)
Item
Karyotypic Philadelphia Chromosome Positive
text
C16487 (NCI Thesaurus ObjectClass)
C0010802 (UMLS 2011AA ObjectClass)
C28452 (NCI Thesaurus ObjectClass-2)
C0031526 (UMLS 2011AA ObjectClass-2)
C25215 (NCI Thesaurus Property)
C1261273 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Karyotypic Philadelphia Chromosome Positive
CL Item
Yes, The Philadelphia Chromosome Karyotype Assessment Is Positive (Yes)
CL Item
No, The Philadelphia Chromosome Karyotype Assessment Is Not Positive (No)
CL Item
A Karyotype Assessment For The Philadelphia Chromosome Was Not Done (Not done)
CL Item
The Karyotype Assessment For The Philadelphia Chromosome Was Indeterminate (Indeterminate)
FISHEvaluationPerformedInd-3
Item
Were FISH studies performed
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25214 (NCI Thesaurus ObjectClass)
C0220825 (UMLS 2011AA ObjectClass)
C17563 (NCI Thesaurus ObjectClass-2)
C0162789 (UMLS 2011AA ObjectClass-2)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
FISHAssessmentDNAProbeNameText
Item
FISH probe(s) specify (If yes,)
text
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C17563 (NCI Thesaurus ObjectClass-2)
C0162789 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C451 (NCI Thesaurus Property-2)
C0012893 (UMLS 2011AA Property-2)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
Item
Specific Abnormalities Detected by FISH
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16487 (NCI Thesaurus ObjectClass)
C0010802 (UMLS 2011AA ObjectClass)
C9440 (NCI Thesaurus Property)
C1704258 (UMLS 2011AA Property)
Code List
Specific Abnormalities Detected by FISH
CL Item
T(9;22)(q34;q11.2); Bcr/abl (t(9;22)(q34;q11.2); BCR/ABL)
CL Item
Other Specify (Other)
CytogeneticsAbnormalityFISHSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16487 (NCI Thesaurus ObjectClass)
C0010802 (UMLS 2011AA ObjectClass)
C9440 (NCI Thesaurus Property)
C1704258 (UMLS 2011AA Property)
Item
Result of FISH
text
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C17563 (NCI Thesaurus ObjectClass-2)
C0162789 (UMLS 2011AA ObjectClass-2)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C13212 (NCI Thesaurus Property-2)
C0008659 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
Code List
Result of FISH
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
Item
RT-PCR Marker Type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C18136 (NCI Thesaurus ObjectClass)
C0599161 (UMLS 2011AA ObjectClass)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
Code List
RT-PCR Marker Type
CL Item
Bcr-abl1 Fusion Protein Expression (BCR/ABL)
C36715 (NCI Thesaurus)
C1516132 (UMLS 2011AA)
CL Item
Other Specify (Other)
ReverseTranscriptase-PolymeraseChainReactionGeneticMarkerAssessmentSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C18136 (NCI Thesaurus ObjectClass)
C0599161 (UMLS 2011AA ObjectClass)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
Item
Result of RT-PCR for Chimeric Genes (Polymerase Chain Reaction)
text
C20989 (NCI Thesaurus Property)
C0031809 (UMLS 2011AA Property)
C18136 (NCI Thesaurus ObjectClass)
C0599161 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
C16622 (NCI Thesaurus Property-2)
C0017393 (UMLS 2011AA Property-2)
Code List
Result of RT-PCR for Chimeric Genes (Polymerase Chain Reaction)
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
CL Item
Indeterminate (Indeterminate)
C48658 (NCI Thesaurus)
C0205258 (UMLS 2011AA)
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)

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