ID
9194
Description
CALGB: 10201 Treatment FORM Daunorubicin and Cytarabine With or Without Oblimersen in Treating Older Patients With Previously Untreated Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AD83D624-B33F-3003-E034-0003BA12F5E7
Lien
Mots-clés
Versions (2)
- 19/09/2012 19/09/2012 -
- 09/01/2015 09/01/2015 - Martin Dugas
Téléchargé le
9 janvier 2015
DOI
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Licence
Creative Commons BY-NC 3.0 Legacy
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Leukemia NCT00085124 Treatment - CALGB: 10201 Treatment FORM - 2031608v3.0
Instructions: Complete and submit thie form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice. Print text in capital letters. Avoid contact with the edges of the boxes. Cirlce amended items and check "Amended data" box to teh right. If submitting by mail, retain a copy for your records and send the original form for mazimum clarity in transmission and fax to 919-416-4990. If submistting electronically, click the Send button when you have completed the PDF version of the form.
Description
Treatment Phase Information
Description
Leukemia Treatment Plan
Description
ProtocolTreatmentInd
Type de données
boolean
Description
TreatmentFirstDoseBeginDate
Type de données
date
Description
TotalCourseNumber
Type de données
float
Description
TreatmentLastDoseEndDate
Type de données
date
Description
AgentTotalDose
Type de données
float
Description
AgentTotalDose
Type de données
float
Description
AgentTotalDose
Type de données
float
Description
OffTreatmentReason
Type de données
text
Description
OffTreatmentReason,Other
Type de données
text
Description
DoseModification(Change)
Type de données
text
Description
DoseModificationReason
Type de données
text
Description
CompletedBy
Type de données
text
Description
Ccrr Module For Calgb: 10201 Treatment Form
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Instructions: Complete and submit thie form as required by the protocol. Information in the upper right box must be completed for this form to be accepted. For optimal accuracy use black ink. Mark an X in the appropriate box for fields with a choice. Print text in capital letters. Avoid contact with the edges of the boxes. Cirlce amended items and check "Amended data" box to teh right. If submitting by mail, retain a copy for your records and send the original form for mazimum clarity in transmission and fax to 919-416-4990. If submistting electronically, click the Send button when you have completed the PDF version of the form.
C1511726 (UMLS 2011AA ObjectClass)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
C1257890 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C0205394 (UMLS 2011AA)
C1298908 (UMLS 2011AA)
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