- 7/5/15 - 1 form, 6 itemgroups, 45 items, 1 language

Itemgroups: Patient demographics, Bone Marrow, Hemogram, Chemistries, Comments, CCRR MODULE

• Brain Neoplasms
• Clinical Trial
• Central Nervous System Neoplasms
• On-Study Form
• Leukemia

- 3/12/15 - 1 form, 7 itemgroups, 66 items, 1 language

Itemgroups: Header, Patient characteristics, Treatment, Concomitant Medication, New Cancer, Follow-Up, Adverse event

• Brain Neoplasms
• Clinical Trial
• Central Nervous System Neoplasms
• Treatment Form
• Leukemia

- 6/16/15 - 1 form, 5 itemgroups, 33 items, 1 language

Itemgroups: Header, Eligibility Assessment, Comments, Treatment Assignment, CCRR MODULE

• Brain Neoplasms
• Clinical Trial
• Central Nervous System Neoplasms
• Leukemia
• Eligibility Determination

- 6/21/15 - 1 form, 10 itemgroups, 60 items, 1 language

Itemgroups: Header, Patient demographics, Patient status assessment, RAI STAGE CLASSIFICATION, BLOOD OR PLATELET TRANSFUSIONS, ORGAN INVOLVEMENT, LYMPH NODE INVOLVEMENT, LAB DATA/VALUES, CHEST X-RAY OR THORACIC CT, Footer Module

• Leukemia
• Clinical Trial
• On-Study Form

- 9/20/21 - 1 form, 19 itemgroups, 46 items, 1 language

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

• Leukemia
• Clinical Trial
• Treatment Form
• Leukemia, Myeloid, Acute

- 6/26/15 - 1 form, 24 itemgroups, 84 items, 2 languages

Itemgroups: General Info, Influenza-like symptoms, Constitutional symptoms, Ocular/Visual, Dermatologic, Cardiac, Pulmonary, Gastrointestinal, Vascular, Neurologic, Hematological, Infection sites, For each of the sites listed below, indicate the severity of infection present, Pain sites, Severity of pain, Donor Pre-Apheresis vital signs, Donor Pre-Apheresis hematology, First apheresis, Specify therapy, Second apheresis, Specify therapy, Third apheresis, Specify therapy, Donor post-apheresis hematology

• Leukemia
• Treatment Form
• Clinical Trial
• AML