Unnamed2
Data amended
text
Data amended date
date
On Treatment
Cycle number
text
Off Treatment
PersonOff-TreatmentTimePeriodType
text
Unnamed4
AdverseEventCurrentAssessmentInd
text
CTCAdverseEventReportBeginDate
date
CTCAdverseEventReportEndDate
date
Unnamed5
CommonTerminologyCriteriaforAdverseEventsVersion4.0LowLevelTermName
text
AdverseEventSeverityGrade
text
CTC Adverse Event Attribution Category
text
AdverseEventInvestigationalClinicalStudyTherapyAttributionind-2
boolean
AdverseDrugExperienceReportText
text
ImmuneSystemAdverseEventPresentText
text
Unnamed6
CommonTerminologyCriteriaforAdverseEventsVersion4.0LowLevelTermName
text
AdverseEventSeverityGrade
text
CTC Adverse Event Attribution Category
text
AdverseEventInvestigationalClinicalStudyTherapyAttributionind-2
boolean
AdverseDrugExperienceReportText
text
ImmuneSystemAdverseEventPresentText
text
Other Adverse Events
CommonTerminologyCriteriaforAdverseEventsVersion4.0LowLevelTermName
text
CommonTerminologyCriteriaforAdverseEventsVersion4.0LowLevelTermOtherSpecifyText
text
AdverseEventSeverityGrade
text
CTC Adverse Event Attribution Category
text
AdverseEventInvestigationalClinicalStudyTherapyAttributionind-2
boolean
AdverseDrugExperienceReportText
text
ImmuneSystemAdverseEventPresentText
text
Comments
Investigator Signature
text
Investigator Signature Date
date