ID
6861
Description
E2906 Engraftment Form - Arm G Clofarabine or Daunorubicin Hydrochloride and Cytarabine Followed By Decitabine or Observation in Treating Older Patients With Newly Diagnosed Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7583518B-5574-8F0A-E040-BB89AD437B26
Link
Keywords
Versions (2)
- 9/19/12 9/19/12 -
- 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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Leukemia NCT01041703 Treatment - E2906 Engraftment Form - Arm G - 2951586v1.0
INSTRUCTIONS: Complete this form after the allogeneic transplant (30 days post transplant and 100 days post transplant). Submit original to the ECOG Coordinating Center; keep a copy for your files
Description
On Treatment
Description
Unnamed2
Description
Data amended
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Description
Data amended date
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- UMLS CUI-2
- C0011008
- NCI Thesaurus Property
- C25416
- NCI Thesaurus ValueDomain-2
- C25367
Description
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
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
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
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
Description
Engraftment
Description
TransplantNeutrophilEngraftmentInd-3
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C12981
- UMLS 2011AA ObjectClass
- C0332835
- NCI Thesaurus Property
- C12533
- UMLS 2011AA Property
- C0027950
- NCI Thesaurus Property-2
- C37947
- UMLS 2011AA Property-2
- C0301944
Description
TransplantNeutrophilEngraftmentDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C12981
- UMLS 2011AA ObjectClass
- C0332835
- NCI Thesaurus Property
- C12533
- UMLS 2011AA Property
- C0027950
- NCI Thesaurus Property-2
- C37947
- UMLS 2011AA Property-2
- C0301944
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
Description
TransplantPlateletEngraftmentInd-3
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C12981
- UMLS 2011AA ObjectClass
- C0332835
- NCI Thesaurus Property
- C37947
- UMLS 2011AA Property
- C0301944
- NCI Thesaurus Property-2
- C12520
- UMLS 2011AA Property-2
- C0005821
Description
TransplantPlateletEngraftmentDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C12981
- UMLS 2011AA ObjectClass
- C0332835
- NCI Thesaurus Property
- C37947
- UMLS 2011AA Property
- C0301944
- NCI Thesaurus Property-2
- C12520
- UMLS 2011AA Property-2
- C0005821
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
Description
LaboratoryProcedurePost-OperativeElevatedPlateletResultInd-2
Data type
boolean
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C25493
- UMLS 2011AA Property
- C0205250
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus Property-3
- C12520
- UMLS 2011AA Property-3
- C0005821
- NCI Thesaurus Property-4
- C25623
- NCI Thesaurus ValueDomain
- C38147
- UMLS 2011AA ValueDomain
- C1512698
Description
MalignantNeoplasmAllogeneicHematopoieticStemCellTransplantationBestResponseDate
Data type
date
Alias
- NCI Thesaurus ObjectClass
- C9305
- UMLS 2011AA ObjectClass
- C0006826
- NCI Thesaurus Property
- C50995
- UMLS 2011AA Property
- C1704632
- NCI Thesaurus Property-2
- C46089
- UMLS 2011AA Property-2
- C1705576
- NCI Thesaurus Property-3
- C25432
- UMLS 2011AA Property-3
- C1522427
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
Description
LaboratoryProcedureCytogeneticAnalysisChimerismOutcomePercentageValue
Data type
float
Measurement units
- %
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C18280
- UMLS 2011AA Property
- C0752095
- NCI Thesaurus Property-2
- C62582
- UMLS 2011AA Property-2
- C0333678
- NCI Thesaurus Property-3
- C20200
- UMLS 2011AA Property-3
- C1274040
- NCI Thesaurus ValueDomain
- C25613
- UMLS 2011AA ValueDomain
- C0439165
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS 2011AA ValueDomain-2
- C1522609
Description
LaboratoryProcedureText
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS 2011AA ValueDomain
- C1527021
- NCI Thesaurus Property
- C25218
- UMLS 2011AA Property
- C1948041
- NCI Thesaurus ObjectClass
- C37984
- UMLS 2011AA ObjectClass
- C0022877
Description
SpecimenCollectedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C19157
- UMLS 2011AA ObjectClass
- C0370003
- NCI Thesaurus Property
- C25452
- NCI Thesaurus Property-2
- C25275
- UMLS 2011AA Property
- C2745955
Description
Comments
Description
Investigator Signature
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25704
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- NCI Thesaurus ObjectClass
- C17089
Description
Investigator Signature Date
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS CUI-1
- C2346576
- NCI Thesaurus Property
- C25678
- UMLS CUI-2
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus ObjectClass
- C17089
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INSTRUCTIONS: Complete this form after the allogeneic transplant (30 days post transplant and 100 days post transplant). Submit original to the ECOG Coordinating Center; keep a copy for your files
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C25164 (NCI Thesaurus ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0007465 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
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C16960 (NCI Thesaurus ObjectClass)
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C12981 (NCI Thesaurus ObjectClass)
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C0301944 (UMLS 2011AA Property)
C12520 (NCI Thesaurus Property-2)
C0005821 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C0022885 (UMLS 2011AA ObjectClass)
C25493 (NCI Thesaurus Property)
C0205250 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
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C0005821 (UMLS 2011AA Property-3)
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