ID
7107
Description
Acute Myeloid Leukemia (AML)/Myelodysplastic Syndrome (MDS) - On-Study Form - Relapse/Refractory Treatment Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1B24FD93-54A8-51C5-E044-0003BA3F9857
Link
Keywords
Versions (3)
- 4/19/12 4/19/12 -
- 4/20/12 4/20/12 -
- 1/9/15 1/9/15 - Martin Dugas
Uploaded on
January 9, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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Acute Myeloid Leukemia (AML)Myelodysplastic Syndrome (MDS) - On-Study Form - RelapseRefractory Treatment 2019378_v3_0
No Instruction available.
- StudyEvent: Acute Myeloid Leukemia (AML)/Myelodysplastic Syndrome (MDS) - On-Study Form - Relapse/Refractory Treatment
Description
Leukemia/mds: Form Administration
Description
Person Completing Form
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25191
- UMLS CUI-1
- C1550483
- NCI Thesaurus ObjectClass
- C25657
- NCI Thesaurus Property
- C25364
Description
Data amended
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS CUI-1
- C0680532
- NCI Thesaurus ObjectClass
- C25474
- NCI Thesaurus Property
- C25416
Description
Aml: Disease Description, Previously Untreated
Description
LeukemiaFrench-American-BritishClassificationCategory
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C3161
- UMLS 2011AA ObjectClass
- C0023418
- NCI Thesaurus Property
- C43854
- UMLS 2011AA Property
- C1556084
- NCI Thesaurus Property-2
- C25161
- UMLS 2011AA Property-2
- C0008902
- NCI Metathesaurus Property
- C0596227
- NCI Metathesaurus Property-2
- C0596070
- NCI Thesaurus ValueDomain
- C25372
- UMLS 2011AA ValueDomain
- C0683312
Description
LeukemiaFrench-American-BritishClassificationSpecify
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C3161
- UMLS 2011AA ObjectClass
- C0023418
- NCI Thesaurus Property
- C43854
- UMLS 2011AA Property
- C1556084
- NCI Thesaurus Property-2
- C25161
- UMLS 2011AA Property-2
- C0008902
- NCI Metathesaurus Property
- C0596227
- NCI Metathesaurus Property-2
- C0596070
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
Description
HematopoieticDiseaseStatusType
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus ObjectClass-2
- C13324
- UMLS 2011AA ObjectClass-2
- C0229601
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Description
DiseaseStatusSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ObjectClass
- C2991
- UMLS 2011AA ObjectClass
- C0012634
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Description
PriorResponseRelapseDuration
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25755
- UMLS 2011AA ObjectClass
- C0871261
- NCI Thesaurus Property
- C18265
- NCI Thesaurus ObjectClass-2
- C25629
- UMLS 2011AA ObjectClass-2
- C0332152
- NCI Thesaurus ValueDomain
- C25330
- UMLS 2011AA ValueDomain
- C0449238
Description
HematologySpecimenCollectedDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ObjectClass
- C16673
- UMLS 2011AA ObjectClass
- C0018943
- NCI Thesaurus ObjectClass-2
- C19157
- UMLS 2011AA ObjectClass-2
- C0370003
- NCI Thesaurus Property
- C25452
Description
LaboratoryProcedureLeukocyteResultSpecifiedValue
Data type
float
Measurement units
- 1000/uL
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C12529
- UMLS 2011AA Property
- C0023516
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus ValueDomain
- C25712
- UMLS 2011AA ValueDomain
- C1522609
- NCI Thesaurus ValueDomain-2
- C38024
- UMLS 2011AA ValueDomain-2
- C0205369
Description
LaboratoryProcedureNeutrophilResultPercentageValue
Data type
float
Measurement units
- %
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C12533
- UMLS 2011AA Property
- C0027950
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus ValueDomain
- C25613
- UMLS 2011AA ValueDomain
- C0439165
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS 2011AA ValueDomain-2
- C1522609
Description
LaboratoryProcedureBlastCellOutcomePercentageValue
Data type
float
Measurement units
- %
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C20200
- UMLS 2011AA Property
- C1274040
- NCI Thesaurus Property-2
- C12918
- UMLS 2011AA Property-2
- C0368761
- NCI Thesaurus ValueDomain
- C25613
- UMLS 2011AA ValueDomain
- C0439165
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS 2011AA ValueDomain-2
- C1522609
Description
BoneMarrowBiopsyDate
Data type
date
Alias
- NCI Thesaurus ValueDomain
- C25164
- UMLS 2011AA ValueDomain
- C0011008
- NCI Thesaurus ValueDomain-2
- C25367
- NCI Thesaurus Property
- C15189
- UMLS 2011AA Property
- C0005558
- NCI Thesaurus ObjectClass
- C12431
- UMLS 2011AA ObjectClass
- C0005953
Description
LaboratoryProcedureBoneMarrowCellularityOutcomePercentageValue
Data type
float
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C12431
- UMLS 2011AA Property
- C0005953
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus Property-3
- C37923
- UMLS 2011AA Property-3
- C1516377
- NCI Thesaurus ValueDomain
- C25613
- UMLS 2011AA ValueDomain
- C0439165
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS 2011AA ValueDomain-2
- C1522609
Description
LaboratoryProcedureBoneMarrowBlastCellOutcomePercentageValue
Data type
float
Measurement units
- %
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C12431
- UMLS 2011AA Property
- C0005953
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus Property-3
- C12918
- UMLS 2011AA Property-3
- C0368761
- NCI Thesaurus ValueDomain
- C25613
- UMLS 2011AA ValueDomain
- C0439165
- NCI Thesaurus ValueDomain-2
- C25712
- UMLS 2011AA ValueDomain-2
- C1522609
Description
LaboratoryProcedureBoneMarrowCellularityOutcomeStatus
Data type
text
Alias
- NCI Thesaurus ObjectClass
- C25294
- UMLS 2011AA ObjectClass
- C0022885
- NCI Thesaurus Property
- C12431
- UMLS 2011AA Property
- C0005953
- NCI Thesaurus Property-2
- C20200
- UMLS 2011AA Property-2
- C1274040
- NCI Thesaurus Property-3
- C37923
- UMLS 2011AA Property-3
- C1516377
- NCI Thesaurus ValueDomain
- C25688
- UMLS 2011AA ValueDomain
- C0449438
Description
PriorBMSCTAdministeredInd-3
Data type
boolean
Alias
- NCI Thesaurus ValueDomain
- C38148
- UMLS 2011AA ValueDomain
- C1512699
- NCI Thesaurus ObjectClass
- C25629
- UMLS 2011AA ObjectClass
- C0332152
- NCI Thesaurus ObjectClass-2
- C25437
- UMLS 2011AA ObjectClass-2
- C0842093
- NCI Thesaurus Property
- C25382
- UMLS 2011AA Property
- C1521801
Description
BMSCTType
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25284
- UMLS 2011AA ValueDomain
- C0332307
- NCI Thesaurus ObjectClass
- C25437
- UMLS 2011AA ObjectClass
- C0842093
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Description
BMSCTDescriptionOtherSpecify
Data type
text
Alias
- NCI Thesaurus ValueDomain
- C25685
- UMLS 2011AA ValueDomain
- C1521902
- NCI Thesaurus ValueDomain-2
- C17649
- UMLS 2011AA ValueDomain-2
- C0205394
- NCI Thesaurus ObjectClass
- C25437
- UMLS 2011AA ObjectClass
- C0842093
- NCI Thesaurus Property
- C25365
- UMLS 2011AA Property
- C0678257
Description
Allows Documentation Of Any Additional Comments
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