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On-Study - Acute Promyelocytic Leukemia (APL) - On-Study Form - Relapse/Refractory Treatment - 2019357v3.0 - Acute Promyelocytic Leukemia (APL) - On-Study Form - Relapse/Refractory Treatment

- 09.01.15 - 1 Formular, 4 Itemgruppen, 35 Datenelemente, 1 Sprache

Itemgruppen: CRF Header, APL: Form Administration, APL: Disease Description, Comments

Acute Promyelocytic Leukemia (APL) - On-Study Form - Relapse/Refractory Treatment Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1B24F56C-41C2-5165-E044-0003BA3F9857

Pathology - Leukemia Pathology Form - Molecular Parameters - 2019352v3.0 - Leukemia Pathology Form - Molecular Parameters

- 09.01.15 - 1 Formular, 3 Itemgruppen, 24 Datenelemente, 1 Sprache

Itemgruppen: CRF Header, Pathology: Form Administration, Pathology: Assessment of Molecular Parameters

Leukemia Pathology Form - Molecular Parameters Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1B4D8DDB-73A4-6BBD-E044-0003BA3F9857

Pathology - Leukemia Pathology Form - Immunophenotype - 2019351v3.0 - Leukemia Pathology Form - Immunophenotype

- 09.01.15 - 1 Formular, 3 Itemgruppen, 36 Datenelemente, 1 Sprache

Itemgruppen: CRF Header, Pathology: Form Administration, Pathology: Immunophenotype

Leukemia Pathology Form - Immunophenotype Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1B4D88B8-2F2F-6AB9-E044-0003BA3F9857

On-Study - Chronic Lymphocytic Leukemia (CLL) - On-Study Form - Previously Untreated Patients - 2019400v3.0 - Chronic Lymphocytic Leukemia (CLL) - On-Study Form - Previously Untreated Patients

- 09.01.15 - 1 Formular, 4 Itemgruppen, 33 Datenelemente, 1 Sprache

Itemgruppen: CRF Header, CLL: Form Administration, CLL: Disease Description, Comments

Chronic Lymphocytic Leukemia (CLL) - On-Study Form - Previously Untreated Patients Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1B4E5764-C41B-6674-E044-0003BA3F9857

On-Study - Acute Promyelocytic Leukemia (APL) - On-Study Form - Previously Untreated Patients - 2019398v3.0 - Acute Promyelocytic Leukemia (APL) - On-Study Form - Previously Untreated Patients

- 09.01.15 - 1 Formular, 4 Itemgruppen, 30 Datenelemente, 1 Sprache

Itemgruppen: CRF Header, APL: Form Administration, APL: Disease Description, Comments

Acute Promyelocytic Leukemia (APL) - On-Study Form - Previously Untreated Patients Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1B24D4C1-D3EC-4E1F-E044-0003BA3F9857

Treatment - Leukemia/Myelodysplastic Syndrome (MDS) - Transplant Form - 2019362v3.0 - Leukemia/Myelodysplastic Syndrome (MDS) - Transplant Form

- 09.01.15 - 1 Formular, 4 Itemgruppen, 20 Datenelemente, 1 Sprache

Itemgruppen: CRF Header, BM/SCT: Form Administration, BM/SCT: Transplant Treatment Plan, Comments

Leukemia/Myelodysplastic Syndrome (MDS) - Transplant Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1A9B6612-EEBA-29DB-E044-0003BA3F9857

On-Study - Chronic Lymphocytic Leukemia (CLL) - On-Study Form - Relapse/Refractory Treatment - 2019359v3.0 - Chronic Lymphocytic Leukemia (CLL) - On-Study Form - Relapse/Refractory Treatment

- 09.01.15 - 1 Formular, 4 Itemgruppen, 34 Datenelemente, 1 Sprache

Itemgruppen: CRF Header, CLL: Form Administration, CLL: Disease Description, Comments

Chronic Lymphocytic Leukemia (CLL) - On-Study Form - Relapse/Refractory Treatment Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=1B4E5CE3-0004-66BF-E044-0003BA3F9857

NCT01041703 Response - E2906 Acute Leukemia Disease Assessment Form - 2951828v1.0 - E2906 Acute Leukemia Disease Assessment Form

- 08.01.15 - 1 Formular, 6 Itemgruppen, 36 Datenelemente, 1 Sprache

Itemgruppen: Header Module, On Treatment Report Period, OFF TREATMENT, Header, Disease Assessment, Footer Module

E2906 Acute Leukemia Disease Assessment Form Clofarabine or Daunorubicin Hydrochloride and Cytarabine Followed By Decitabine or Observation in Treating Older Patients With Newly Diagnosed Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7585B205-C98E-8BDD-E040-BB89AD430415

Leukemia NCT01041703 Quality of Life - E2906 Assessment Compliance Form - 2951978v1.0 - E2906 Assessment Compliance Form

- 08.01.15 - 1 Formular, 11 Itemgruppen, 49 Datenelemente, 1 Sprache

Itemgruppen: Header Module, Header, On Treatment Report Period, Section I, Section II - E2906 QOL Assessment Not Completed, Indicate reason(s) why form was not completed, Section III Assessment Completed, How was the patient assisted?, What was the reason for assistance?, Who assisted or completed assessment?, Footer Module

E2906 Assessment Compliance Form Clofarabine or Daunorubicin Hydrochloride and Cytarabine Followed By Decitabine or Observation in Treating Older Patients With Newly Diagnosed Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7585B205-CAA4-8BDD-E040-BB89AD430415

Leukemia NCT01041703 Quality of Life - E2906 Quality of Life Assessment Form - FACT - 2952035v1.0 - E2906 Quality of Life Assessment Form - FACT

- 08.01.15 - 1 Formular, 9 Itemgruppen, 68 Datenelemente, 1 Sprache

Itemgruppen: Header Module, On Treatment Report Period, Header, PHYSICAL WELL-BEING, FUNCTIONAL WELL-BEING, SOCIAL/FAMILY WELL-BEING, EMOTIONAL WELL-BEING, Additional Concerns, FACIT Fatigue Scale

E2906 Quality of Life Assessment Form - FACT Clofarabine or Daunorubicin Hydrochloride and Cytarabine Followed By Decitabine or Observation in Treating Older Patients With Newly Diagnosed Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7586A704-3004-A522-E040-BB89AD4359F8

Leukemia NCT01041703 Flow Sheet - E2906 Source Document Tracking Coversheet Form - 2947795v1.0 - E2906 Source Document Tracking Coversheet Form

- 08.01.15 - 1 Formular, 5 Itemgruppen, 14 Datenelemente, 1 Sprache

Itemgruppen: Header Module, Header, Reporting Period, Off Treatment Report Period, Document Information

E2906 Source Document Tracking Coversheet Form Clofarabine or Daunorubicin Hydrochloride and Cytarabine Followed By Decitabine or Observation in Treating Older Patients With Newly Diagnosed Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=74BCE806-5876-4D7A-E040-BB89AD437934

Leukemia NCT01041703 Treatment - E2906 Engraftment Form - Arm G - 2951586v1.0 - E2906 Engraftment Form - Arm G

- 08.01.15 - 1 Formular, 6 Itemgruppen, 28 Datenelemente, 1 Sprache

Itemgruppen: Header Module, Reporting Period, Header, Vital Status, Engraftment, Footer Module

E2906 Engraftment Form - Arm G Clofarabine or Daunorubicin Hydrochloride and Cytarabine Followed By Decitabine or Observation in Treating Older Patients With Newly Diagnosed Acute Myeloid Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7583518B-5574-8F0A-E040-BB89AD437B26

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