Resultados de la búsqueda - Portal de Modelos de Datos Médicos (MDM-Portal)

2. Induction AML-AZA elderly patients NCT00915252

- 20/9/21 - 1 formulario, 21 itemgroups, 88 items, 2 idiomas

Itemgroups: Patientendaten, Clinical finding, Differential blood count, Klinische Chemie, 5-Azacytidine, 5-Azacytidine - Dose no. 1, 5-Azacytidine - Dose no. 2, 5-Azacytidine - Dose no. 3, 5-Azacytidine - Dose no. 4, 5-Azacytidine - Dose no. 5, 5-Azacytidine dose reduction, Transfusions, Chemotherapy, Ara-C , Daunorubicin, G-CSF, Cytopenia duration, Leukopenia, Neutropenia, Thrombopenia, Unterschrift

2. Induktionstherapieblock EudraCT-Nr 2008-004583-40 Akute myeloische Leukmie(AML) AML alle auer FAB M3 (5-Azacytidin plus Standardtherapie bei älteren AML-Patienten Efficacy of 5-azacytidine Added to Standard Primary Therapy in Elderly Patients With Newly Diagnosed Acute Myeloid Leukemia (AML) (AML-AZA) NCT00915252

Follow Up Disease Evaluation Form (E2905 NCT00843882)

- 20/9/21 - 1 formulario, 6 itemgroups, 37 items, 1 idioma

Itemgroups: Header, ON TREATMENT, OFF TREATMENT, Section I, Section II, Response

E2905 Follow Up Disease Evaluation 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=0F12A9EE-8D74-6165-E044-0003BA3F9857

Leukemia NCT01041703 Treatment - E2906 Allogeneic Transplant Form - Arm G - 2951703v1.0 - E2906 Allogeneic Transplant Form - Arm G

- 20/9/21 - 1 formulario, 9 itemgroups, 43 items, 1 idioma

Itemgroups: Header Module, Reporting Period, Header, Vital Status, Preparative Conditioning Regimen, Preparative Conditioning Regimen1, Donor Information, Allogeneic Transplant, Footer Module

E2906 Allogeneic Transplant 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=758373C9-BE14-F79E-E040-BB89AD433D62

Registration Worksheet (step 1) AML (NCT00634244)

- 20/9/21 - 1 formulario, 3 itemgroups, 29 items, 1 idioma

Itemgroups: Eligibility, Demographics, Data correct

E1906 Registration Worksheet (step 1) Comparing Three Different Combination Chemotherapy Regimens in Treating Patients With Relapsed or Refractory Acute Myeloid Leukemia NCT00634244 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=580BE65D-2E90-52E8-E044-0003BA3F9857

AML Material Submission Form Pathology NCT00049517 - Material Submission Form Pathology AML E1900 NCT00049517

- 20/9/21 - 1 formulario, 3 itemgroups, 31 items, 1 idioma

Itemgroups: Header, Completed by submitting institutions, Completed by central lab

E1900 Material Submission Form Combination Chemotherapy With or Without Monoclonal Antibody Therapy Followed by Stem Cell Transplant in Treating Patients With Acute Myeloid Leukemia NCT00049517 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=A727E0B4-B257-2F80-E034-0003BA0B1A09

Leukemia NCT01041703 Treatment - E2906 Baseline Data Form - Step 1 (Induction) - 2951887v1.0 - E2906 Baseline Data Form - Step 1 (Induction)

- 20/9/21 - 1 formulario, 14 itemgroups, 100 items, 1 idioma

Itemgroups: Header Module, Reporting Period, Header, Patient Information, Leukemia Classification/Baseline Evaluation Data, Pre-registration Disease Assessment, Prior Treatment, Pre-registration Hematology/Chemistry, Pre-registration Evaluation, Comorbidities, Pre-registration Evaluation1, HLA Typing, Baseline Abnormalities, Footer Module

E2906 Baseline Data Form - Step 1 (Induction) 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-CA04-8BDD-E040-BB89AD430415

Anamnese und klinische Untersuchung OPAL-Studie DRKS00004421 NCT01619124 ALL - Anamnese und klinische Untersuchung OPAL-Studie

- 20/9/21 - 1 formulario, 13 itemgroups, 72 items, 2 idiomas

Itemgroups: Allgemeine Angaben, Tägliche Aktivitäten, Gehen, Gelenkinspektion, Bewegungsumfang (in °) Hüftgelenk, Bewegungsumfang (in °) Kniegelenk, Bewegungsumfang (in °) Sprunggelenk, Muskelbefund Oberschenkel, Muskelbefund Unterschenkel, Therapiekomplikationen, Begleitmedikation, Spez. Intervention gegen Osteonekrosen, Bemerkungen

Osteonekrosen bei pädiatrischen Patienten mit ALL

TX5

- 20/9/21 - 1 formulario, 19 itemgroups, 46 items, 1 idioma

Itemgroups: Header module, Record the highest grade of toxicity diagnosed since the previous evaluation. If this is the first evaluation, record the highest toxicity diagnosed since day 0. The toxicity grades are based on the NCI CTCAE Version 3.0., Allergy/Immunologic toxicity, GI toxicity, Renal toxicity, Hemorrhagic toxicity, Cardiovascular toxicity, Neurologic toxicity, Coagulation toxicity, Vascular toxicity, Pulmonary toxicity, Hepatic toxicity, Did the patient develop any of the following clinical sugns/symptoms of abnormal liver function during this assessment period, Indicated the etiology of the abnormal liver function, VOD, GVHD, Infection, Other, Unknown

TX5 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF1AAC43-4B80-4030-E034-0003BA3F9857

Leukemia NCT00085124 Registration - CALGB 10201 REGISTRATION WORKSHEET - 2076520v3.0 - CALGB 10201 REGISTRATION WORKSHEET

- 20/9/21 - 1 formulario, 7 itemgroups, 35 items, 1 idioma

Itemgroups: Protocol Administration, Patient Demographics/Pre-Treatment Characteristics, Certification Of Eligibility, Protocol Design, Initial Patient Consent For Specimen Use, Registration Information, CCRR MODULE

CALGB 10201 REGISTRATION WORKSHEET 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=B228B8A4-E2DC-4D1A-E034-0003BA12F5E7

1. Induktionstherapieblock EudraCT-Nr 2008-004583-40 Akute myeloische Leukämie(AML) AML alle außer FAB M3 - 1. Induktionstherapieblock

- 20/9/21 - 1 formulario, 17 itemgroups, 69 items, 2 idiomas

Itemgroups: Patientendaten, 5-Azacytidine - Dose no. 1, 5-Azacytidine - Dose no. 2, 5-Azacytidine - Dose no. 3, 5-Azacytidine - Dose no. 4, 5-Azacytidine - Dose no. 5, 5-Azacytidine dose reduction, Differentialblutbild, Chemotherapy, Ara-C , Daunorubicin, G-CSF, Cytopenia duration, leukopenia, neutropenia, thrombopenia, 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

1. Konsolidierungstherapieblock EudraCT-Nr 2008-004583-40 Akute myeloische Leukämie(AML) AML alle außer FAB M3 - 1. Konsolidierungstherapieblock

- 20/9/21 - 1 formulario, 15 itemgroups, 84 items, 2 idiomas

Itemgroups: Clinical finding, Differential blood count, Klinische Chemie, 5-Azacytidine, 5-Azacytidine - Dose, 5-Azacytidine dose reduction, Transfusions, Chemotherapy, Ara-C, G-CSF, Cytopenia duration, Leukopenia, Neutropenia, Thrombopenia, Signature

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

DEM

- 20/9/21 - 1 formulario, 1 itemgroup, 10 items, 1 idioma

Itemgroup: Patient demographics

DEM Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=FF1A18C7-58B3-19A7-E034-0003BA3F9857

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