Description:

SOUTHWEST ONCOLOGY GROUP FOLLOW UP FORM 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=02E11F79-8367-10DE-E044-0003BA3F9857

Link:

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=02E11F79-8367-10DE-E044-0003BA3F9857

Keywords:
Versions (2) ▾
  1. 9/19/12
  2. 1/9/15
Uploaded on:

January 9, 2015

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License:
Creative Commons BY-NC 3.0 Legacy
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Leukemia NCT00492856 Follow-Up - SOUTHWEST ONCOLOGY GROUP FOLLOW UP FORM - 2416676v1.0

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  1. StudyEvent: SOUTHWEST ONCOLOGY GROUP FOLLOW UP FORM
    1. No Instruction available.
Header
Participating Group Name
Vital Status
Vital Status
Has the patient had a documented clinical assessment for this cancer (since submission of the previous follow-up form)
Has the patient developed a first relapse or progression that has not been previously reported
Has a new primary cancer or MDS been diagnosed that has not been previously reported? (myelodysplastic syndrome)
Has the patient received any non-protocol cancer therapy not previously reported? (prior to progression/relapse)
Has the patient experienced any severe long term toxicity that has not been previously reported? (prior to treatment for progression or relapse or a second primary, and prior to non-protocol treatment grade >=3)
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