Description:

SOUTHWEST ONCOLOGY GROUP Consolidation #1 And #2 Treatment Summary Form (S0521) Combination Chemotherapy With or Without Gemtuzumab Followed By Tretinoin, Mercaptopurine, and Methotrexate or Observation in Treating Patients With Acute Promyelocytic Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=02DB2B73-5A1C-5C81-E044-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=02DB2B73-5A1C-5C81-E044-0003BA3F9857

Keywords:
Versions (2) ▾
  1. 12/18/14
  2. 1/8/15
Uploaded on:

January 8, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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Leukemia NCT00492856 Treatment - SOUTHWEST ONCOLOGY GROUP Consolidation #1 And #2 Treatment Summary Form (S0521) - 2415788v1.0

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  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP Consolidation #1 And #2 Treatment Summary Form (S0521)
    1. No Instruction available.
Header
Cycle completed
Participating Group Name
Reporting Period
Patient And Disease Description
Vital Status
Physical
Kg
Treatment: Atra
Did the patient receive arsenic trioxide during this reporting period?
Treatment: Growth Factors
If yes,
Was growth factor permanently discontined during this reporting period?
Was growth factor permanently discontined during this reporting period?
Treatment: Other Therapy
Did the patient receive other therapy during this reporting period? (If yes, give start and end dates and describe the other therapy in the Comments section.)
Dose Modifications
Were there any dose modifications or additions/omissions to protocol treatment?
Plans For Consildation #3 And #4
Is this patient expected to receive consolidation #3 and #4? (see NOTE in protocol section 7.3)
Ejection fraction
%
Comments

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