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Leukemia NCT00897767 Eligibility - E3903 Registration Worksheet (step 1) - 2952105v1.0 - E3903 Registration Worksheet (step 1)

- 2015-01-09 - 1 Formulär, 1 Item-grupp, 13 Dataelement, 1 Språk
Item-grupp: Eligibility
E3903 Registration Worksheet (step 1) Collecting Tissue Samples From Patients With Leukemia or Other Blood Disorders Planning to Enroll in an ECOG Leukemia Treatment Clinical Trial Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=7586FA81-F57E-351C-E040-BB89AD43544C

Leukemia NCT01041703 Eligibility - E2906 Registration Worksheet (step 2) - 3083300v1.0 - E2906 Registration Worksheet (step 2)

- 2015-01-09 - 1 Formulär, 1 Item-grupp, 3 Dataelement, 1 Språk
Item-grupp: Eligibility
E2906 Registration Worksheet (step 2) 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=8605B765-B230-3E8A-E040-BB89AD4310BC

Leukemia NCT00945815 Registration - Southwest Oncology Group S0910 Registration Worksheet Form - 3116464v1.0 - Southwest Oncology Group S0910 Registration Worksheet Form

- 2015-01-09 - 1 Formulär, 7 Item-grupper, 17 Dataelement, 1 Språk
Item-grupper: Protocol Information, SWOG PATIENT ID, DEMOGRAPHY, For SWOG Institutions:, Patient Information, Indicate how the patient answered the following questions on the consent form, Patient Eligibility
Southwest Oncology Group S0910 Registration Worksheet Form Epratuzumab, Cytarabine, and Clofarabine in Treating Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8A5A6B07-2599-04D8-E040-BB89AD435E5E

Leukemia NCT00558519 Registration - CALGB-10403 OPEN Registration Worksheet - 3057212v1.0 - CALGB-10403 OPEN Registration Worksheet

- 2015-01-09 - 1 Formulär, 7 Item-grupper, 19 Dataelement, 1 Språk
Item-grupper: Protocol Administration, Pre-Treatment Characteristics, Certification Of Eligibility, Protocol Design, CALGB Companion Studies, SWOG Companion Studies, Case Notes
CALGB-10403 OPEN Registration Worksheet Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Acute Lymphoblastic Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=83D35A37-D0A0-FE1A-E040-BB89AD435D90

Leukemia NCT01041703 Lab - E2906 Hematology/Chemistry Form - 2950751v1.0 - E2906 Hematology/Chemistry Form

- 2015-01-09 - 1 Formulär, 6 Item-grupper, 48 Dataelement, 1 Språk
Item-grupper: Header Module, ON TREATMENT, OFF TREATMENT, Header, Hematology/Chemistry, Footer Module
E2906 Hematology/Chemistry 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=755ADD70-A207-B92C-E040-BB89AD435B07

Leukemia NCT01041703 Treatment - E2906 Baseline Data Form - Maintenance - Arm E and Arm F - 2951934v1.0 - E2906 Baseline Data Form - Maintenance - Arm E and Arm F

- 2015-01-09 - 1 Formulär, 8 Item-grupper, 58 Dataelement, 1 Språk
Item-grupper: Header Module, Reporting Period, Header, Pre-registration Evaluation, Bone Marrow, Pre-registration Hematology/Chemistry, Baseline Abnormalities, Footer Module
E2906 Baseline Data Form - Maintenance - Arm E and Arm F 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-CA52-8BDD-E040-BB89AD430415

Leukemia NCT00492856 Treatment - SOUTHWEST ONCOLOGY GROUP APL Disease Assessment Form (S0521) - 2415460v1.0 - SOUTHWEST ONCOLOGY GROUP APL Disease Assessment Form (S0521)

- 2015-01-09 - 1 Formulär, 9 Item-grupper, 38 Dataelement, 1 Språk
Item-grupper: Header, Status, Unnamed 1, Response, Relapse, Laboratory Values and Extramedullary Disease: Peripheral Blood Examination, Laboratory Values and Extramedullary Disease: Bone Marrow Examination , Laboratory Values and Extramedullary Disease: Extramedullary Disease Involvement, Comments
SOUTHWEST ONCOLOGY GROUP APL Disease Assessment Form (S0521) Combination Chemotherapy With or Without Gemtuzumab Followed By Tretinoin, Mercaptopurine, and Methotrexate or Observation in Treating Patients With Acute Promyelocytic Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=02C9A3A8-9B14-5BA0-E044-0003BA3F9857

Leukemia NCT01041703 Treatment - E2906 Baseline Data Form - Step 3 - 3177877v1.0 - E2906 Baseline Data Form - Step 3

- 2015-01-09 - 1 Formulär, 8 Item-grupper, 61 Dataelement, 1 Språk
Item-grupper: Header Module, Reporting Period, Header, Pre-registration Evaluation, Bone Marrow, Pre-registration Hematology/Chemistry, Baseline Abnormalities, Footer Module
E2906 Baseline Data Form - Step 3 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=9805CBE8-D299-9B64-E040-BB89AD431E80

Leukemia NCT01041703 Treatment - E2906 Acute Graft vs. Host Disease Form - Arm G - 2951629v1.0 - E2906 Acute Graft vs. Host Disease Form - Arm G

- 2015-01-09 - 1 Formulär, 6 Item-grupper, 23 Dataelement, 1 Språk
Item-grupper: Header Module, Reporting Period, Header, GVHD Information, GVHD Prophylaxis, Footer Module
E2906 Acute Graft vs. Host Disease 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=758358AD-52B1-2ABE-E040-BB89AD430F03

Leukemia NCT01041703 Treatment - E2906 Baseline Data Form - Step 2 (Consolidation) - 3176444v1.0 - E2906 Baseline Data Form - Step 2 (Consolidation)

- 2015-01-09 - 1 Formulär, 9 Item-grupper, 64 Dataelement, 1 Språk
Item-grupper: Header Module, Reporting Period, Header, Pre-registration Evaluation, Bone Marrow, Pre-registration Hematology/Chemistry, HLA Typing, Baseline Abnormalities, Footer Module
E2906 Baseline Data Form - Step 2 (Consolidation) 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=97F3E4CB-9ED3-20B5-E040-BB89AD437950

Leukemia NCT00492856 Follow-Up - SOUTHWEST ONCOLOGY GROUP FOLLOW UP FORM - 2416676v1.0 - SOUTHWEST ONCOLOGY GROUP FOLLOW UP FORM

- 2015-01-09 - 1 Formulär, 3 Item-grupper, 25 Dataelement, 1 Språk
Item-grupper: Header, VITAL STATUS, Comments
SOUTHWEST ONCOLOGY GROUP FOLLOW UP FORM Combination Chemotherapy With or Without Gemtuzumab Followed By Tretinoin, Mercaptopurine, and Methotrexate or Observation in Treating Patients With Acute Promyelocytic Leukemia Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=02E11F79-8367-10DE-E044-0003BA3F9857

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

- 2015-01-09 - 1 Formulär, 3 Item-grupper, 24 Dataelement, 1 Språk
Item-grupper: 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

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