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ECOG Leukemia Cytogenetics Report Form 2053765v3.0

- 03.06.15 - 1 Formular, 4 Itemgruppen, 43 Datenelemente, 1 Sprache
Itemgruppen: ECOG clinical trial administrative data, Cytogenetics samples, Number of Metaphases, CCRR MODULE
ECOG Leukemia Cytogenetics Report Form 2053765v3.0 Combination Chemotherapy With or Without Monoclonal Antibody Therapy Followed by Stem Cell Transplant in Treating Patients With Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A727E3BC-7882-2F82-E034-0003BA0B1A09

S0100 OFF TREATMENT NOTICE

- 28.05.15 - 1 Formular, 4 Itemgruppen, 24 Datenelemente, 1 Sprache
Itemgruppen: SWOG clinical trial administrative data, Treatment information, Comments, CCRR MODULE
S0100 OFF TREATMENT NOTICE Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AEB544B0-C752-4414-E034-0003BA12F5E7

S0100 NOTICE OF DEATH

- 28.05.15 - 1 Formular, 4 Itemgruppen, 22 Datenelemente, 1 Sprache
Itemgruppen: SWOG clinical trial administrative data, Causes of Death, Comments, CCRR MODULE
S0100 NOTICE OF DEATH Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=AEB5527E-0137-441C-E034-0003BA12F5E7

AML AZA NCT00915252 - Remissionsstatus vor 1. Konsolidierung AML NCT00915252

- 20.05.15 - 1 Formular, 8 Itemgruppen, 44 Datenelemente, 2 Sprachen
Itemgruppen: Patientendaten, Differentialblutbild, Knochenmarkuntersuchung, Zytologie, Zytogenetik, Molekulargenetik, Remission status, Unterschrift
A randomized, multi-center phase II trial to assess the efficacy of 5-azacytidine added to standard primary therapy in elderly patients with newly diagnosed AML NCT00915252

Leukemia Registration SWOG S0805 NCT00792948 - Registration Worksheet Leukemia NCT00792948

- 27.04.15 - 1 Formular, 3 Itemgruppen, 14 Datenelemente, 1 Sprache
Itemgruppen: Header, Approved RT Facility, Patient Eligibility
Southwest Oncology Group S0805 Registration Worksheet Form (Step 3) Combination Chemotherapy With or Without Donor Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia NCT00792948 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8FBEF46D-B6C8-4571-E040-BB89AD4363A1

Leukemia Registration SWOG-9007 NCT00996047 - Registration Worksheet Leukemia NCT00996047

- 24.04.15 - 1 Formular, 2 Itemgruppen, 10 Datenelemente, 1 Sprache
Itemgruppen: Header, Patient Information
Southwest Oncology Group SWOG-9007 Registration Worksheet Form Study of Bone Marrow and Blood Samples From Patients With Leukemia or Other Hematopoietic Cancers NCT00996047 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8FB8D1FF-3D88-5871-E040-BB89AD432FD5

Leukemia Registration SWOG S0805 NCT00792948 - Registration Worksheet Leukemia NCT00792948

- 21.04.15 - 1 Formular, 3 Itemgruppen, 9 Datenelemente, 1 Sprache
Itemgruppen: Header, Patient Information, Patient Eligibility
Southwest Oncology Group S0805 Registration Worksheet Form (Step 2) Combination Chemotherapy With or Without Donor Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia NCT00792948 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8FBEF46D-B665-4571-E040-BB89AD4363A1

AML - AZA (5-Azacytidin plus Standardtherapie bei älteren AML-Patienten) - Knochenmark-Diagnostik Tag 15

- 15.04.15 - 1 Formular, 4 Itemgruppen, 11 Datenelemente, 2 Sprachen
Itemgruppen: Patientendaten, Knochenmarkuntersuchung, Zytologie, Unterschrift
A randomized, multi-center phase II trial to assess the efficacy of 5-azacytidine added to standard primary therapy in elderly patients with newly diagnosed AML Principal Investigator Prof. Dr. Müller-Tidow

MDS Hematology Form NCT00843882 - Hematology Form MDS NCT00843882 E2905

- 27.03.15 - 1 Formular, 3 Itemgruppen, 31 Datenelemente, 1 Sprache
Itemgruppen: Header, ON/Off TREATMENT, HEMATOLOGY and CHEMISTRY
E2905 Hematology Form Lenalidomide With or Without Epoetin Alfa in Treating Patients With Myelodysplastic Syndrome and Anemia NCT00843882 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=11427DB4-3795-240D-E044-0003BA3F9857

Comorbidity score Sorror Score before Transplant HCT AML - Comorbidity Score Sorror Score before Transplant HCT AML

- 20.03.15 - 1 Formular, 1 Itemgruppe, 18 Datenelemente, 1 Sprache
Itemgruppe: Comorbidity
Definitions of comorbidities included in the HCT-CI Original Paper can be found here: http://redbook.streamliners.co.nz/Sorror%20Comorbidity%20index%20in%20HCT.pdf

Leukemia NCT00843882 On-Study - E2905 Baseline Step 2 Disease Evaluation Form - 2774237v1.0 - Baseline Step 2 Disease Evaluation Form (E2905 NCT00843882)

- 13.03.15 - 1 Formular, 4 Itemgruppen, 40 Datenelemente, 1 Sprache
Itemgruppen: Header, Pre-registration Hematology/chemistry, Bone marrow biopsy, IPSS
Lenalidomide With or Without Epoetin Alfa in Treating Patients With Myelodysplastic Syndrome and Anemia NCT00843882 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=54590A88-E5FE-3BDA-E044-0003BA3F9857

Brain and Central Nervous System Tumors NCT00053963 Treatment - ADVL0212: Reporting Period Worksheet (Leukemia) - 2172521v3.0 - Reporting Period Worksheet (Leukemia ADVL0212)

- 12.03.15 - 1 Formular, 7 Itemgruppen, 66 Datenelemente, 1 Sprache
Itemgruppen: Header, Patient characteristics, Treatment, Concomitant Medication, New Cancer, Follow-Up, Adverse event
ADVL0212: Reporting Period Worksheet (Leukemia) FR901228 in Treating Children With Refractory or Recurrent Solid Tumors or Leukemia NCT00053963 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=C0F387DC-C9D3-5664-E034-0003BA12F5E7

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