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ECOG Second Primary Form NCT01169337

- 16.06.15 - 1 Formular, 4 Itemgruppen, 19 Datenelemente, 1 Sprache
Itemgruppen: Header, Patient demographics, Second primary cancer assessment, Comments
ECOG Second Primary Form NCT01169337 Lenalidomide or Observation in Treating Patients With Asymptomatic High-Risk Smoldering Multiple Myeloma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=8B34F8AB-6B35-638A-E040-BB89AD4311DF

Eligibility Thrombocytopenia NCT01484314

- 22.09.21 - 1 Formular, 2 Itemgruppen, 11 Datenelemente, 1 Sprache
Itemgruppen: Inclusion Criteria, Exclusion Criteria
Eltrombopag for Thrombocytopenia in Patients With Relapsed Multiple Myeloma; ODM derived from: https://clinicaltrials.gov/show/NCT01484314

Multiple Myeloma and Plasma Cell Neoplasm null Pre-Study - S0522 Prestudy Form - 2459879v1.0 - S0522 Prestudy Form

- 20.09.21 - 1 Formular, 6 Itemgruppen, 41 Datenelemente, 1 Sprache
Itemgruppen: Header, PATIENT AND DISEASE DESCRIPTION, Laboratory Values, DISEASE HISTORY AND DIAGNOSIS, PRIOR TREATMENT RELATED TO THIS CANCER, Comments
S0522 Prestudy Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=0F232910-2A2F-5CD7-E044-0003BA3F9857

EBMT Multiple Myeloma General Information - 16pp EBMT Multiple Myeloma 10PCD

- 29.06.16 - 1 Formular, 18 Itemgruppen, 283 Datenelemente, 1 Sprache
Itemgruppen: EBMT FORM GENERAL INFORMATION, PATIENT, DISEASE, PLASMA CELL DISORDERS (INCLUDING MULTIPLE MYELOMA), PRE-HSCT TREATMENT, HSCT, STATUS OF DISEASE AT COLLECTION, DISEASE STATUS AT HSCT, ADDITIONAL TREATMENT POST-HSCT, STATUS OF DISEASE AT 100 DAYS AFTER HSCT, FORMS TO BE FILLED IN, PLASMA CELL DISORDERS (INCLUDING MULTIPLE MYELOMA), PATIENT LAST SEEN, GRAFT VERSUS HOST DISEASE (GvHD) SINCE LAST REPORT, OTHER COMPLICATIONS SINCE LAST REPORT, ADDITIONAL THERAPIES SINCE LAST FOLLOW UP, FIRST EVIDENCE OF RELAPSE OR PROGRESSION SINCE LAST HSCT, LAST DISEASE AND PATIENT STATUS
DOCUMENTED PATHOGENS (Use this table for guidance on the pathogens of interest) Bacteria:S. pneumoniae,OHaemophilus influenzaether gram positive (i.e.: other streptococci, staphylococci, listeria …), Other gram negative (i.e.: E. coli klebsiella, proteus, serratia, pseudomonas …), Legionella sp,Mycobacteria sp, Other Fungi:Candida sp, Aspergillus sp, Pneumocystis carinii, Other Parasites: Toxoplasma gondii, Other Viruses: HSV, VZV, EBV,CMV,HHV-6, RSV,Other respiratory virus (influenza, parainfluenza, rhinovirus),Adenovirus, HBV, HCV, HIV,Papovavirus, Parvovirus, Other

Eligibility NCT00689936 Multiple Myeloma - Eligibility

- 20.09.21 - 1 Formular, 2 Itemgruppen, 47 Datenelemente, 2 Sprachen
Itemgruppen: Inclusion Criteria, Exclusion Criteria
ODM derived from http://clinicaltrials.gov/show/NCT00689936

Eligibility NCT00777998 Multiple Myeloma - Eligibility

- 16.04.14 - 1 Formular, 2 Itemgruppen, 10 Datenelemente, 2 Sprachen
Itemgruppen: Inclusion Criteria, Exclusion Criteria
ODM derived from http://clinicaltrials.gov/show/NCT00408746

Eligibility NCT00722566 Multiple Myeloma - Eligibility

- 15.04.14 - 1 Formular, 2 Itemgruppen, 11 Datenelemente, 2 Sprachen
Itemgruppen: Inclusion Criteria, Exclusion Criteria
ODM derived from http://clinicaltrials.gov/show/NCT00722566

German Myeloma Patient Outcome Scale (MyPOS) - MyPOS

- 15.03.22 - 1 Formular, 8 Itemgruppen, 40 Datenelemente, 1 Sprache
Itemgruppen: Administratative Angaben, Symptome und Nebenwirkungen - Beeinträchtigung in der letzten Woche, Beeinträchtigung durch weitere Symptome, Verlauf der letzten Woche (Teil 1), Verlauf der letzten Woche (Teil 2), Probleme und Sorgen, Sorgen und Ängste, Ausfüllen des Fragebogens
Die Nutzung des MyPOS ist kostenfrei, es wird aber eine (kostenfreie) Registrierung auf der POS-Website (www.pos-pal.org) gewünscht. Um eine Information über Nutzung und/oder Änderung wird seitens des POS-Team explizit gebeten. Affiliation: Dr. med. Christina Gerlach M.Sc. Oberärztin | Klinik für Palliativmedizin Fachärztin für Innere Medizin, Hämatologie & Onkologie; Notfallmedizin, Palliativmedizin Universitätsklinikum Heidelberg | Im Neuenheimer Feld 305 | 69120 Heidelberg Tel. +49 6221 56-310683 | Fax. +49 6221 56-7203 | E-Mail: christina.gerlach@med.uni-heidelberg.de http://www.klinikum.uni-heidelberg.de Gerlach, C., Taylor, K., Ferner, M. et al. Challenges in the cultural adaptation of the German Myeloma Patient Outcome Scale (MyPOS): an outcome measure to support routine symptom assessment in myeloma care. BMC Cancer 20, 245 (2020). https://doi.org/10.1186/s12885-020-06730-7

Staging after Consolidation LenaMain-Study - Staging after Consolidation

- 17.03.16 - 1 Formular, 8 Itemgruppen, 75 Datenelemente, 1 Sprache
Itemgruppen: Monthly control visit with response evaluation, Parameter of multiple myeloma, Vital signs, Laboratory:Protein electrophoresis, Laboratory:Hematology, Laboratory:serum chemistry, Laboratory:pregnancy test, Quality of life
A randomised comparison of daily 25 mg versus 5 mg lenalidomide as maintenance therapy after high-dose therapy and autologous stem cell transplantation in patients with multiple myeloma. Protocol-Code: RV-MM-PI-280 EudraCT-Number: 2007-003945-33 Author: Claus Schreiber Review: Gerd Felder Approval of CRF: Prof. Dr. med. G. Kobbe (LKP) Release for MDM: Prof. Gattermann, Düsseldorf (26.1.2016) Principal Investigator „LenaMain“-Studie: Prof. Roland Fenk, Düsseldorf Coordinating center for clinical trial Medical faculty of University Hospital Heinrich-Heine-University Scientific Director: Herr Dr. J. Grebe Moorenstrasse 5 40225 Düsseldorf Tel.: +49 (0) 211-81-19701 Fax: +49 (0) 211-81-19702

Multiple Myeloma and Plasma Cell Neoplasm NCT00644228 Pre-Study - Southwest Oncology Group S0777 Prestudy Form - 2656421v1.0 - Southwest Oncology Group S0777 Prestudy Form

- 20.09.21 - 1 Formular, 8 Itemgruppen, 58 Datenelemente, 1 Sprache
Itemgruppen: Header, Eligibility Verification:, Patient and Disease Description, Laboratory Values, Laboratory Values, continued, Disease History and Diagnosis, Prior Treatment Related To This Cancer, Comments
Southwest Oncology Group S0777 Prestudy Form Lenalidomide and Dexamethasone With or Without Bortezomib in Treating Patients With Previously Untreated Multiple Myeloma Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=33319F8E-13F8-4E7C-E044-0003BA3F9857

Eligibility Multiple Myeloma NCT00083538

- 24.01.16 - 1 Formular, 2 Itemgruppen, 14 Datenelemente, 1 Sprache
Itemgruppen: Inclusion Criteria, Exclusion Criteria
Study of Tumor Antigen-Pulsed Autologous Dendritic Cell Vaccination Administrated Subcutaneously or Intranodally; ODM derived from: https://clinicaltrials.gov/show/NCT00083538

Safety and Activity of SRT501 Alone or in Combination with Bortezomib in Patients with Multiple Myeloma NCT00920556 - Screening - Medical and Surgical History; Disease Stage at Study Entry; Classification of Disease at Study Entry; Cancer related Surgical History; Previous Anti-Neoplastic Therapy

- 27.02.19 - 1 Formular, 9 Itemgruppen, 26 Datenelemente, 1 Sprache
Itemgruppen: Adminstrative, Does the subject have any clinically significant medical or surgical history?, Medical and Surgical History, Disease Stage at Study Entry, Classification of Disease at Study Entry, Did the subject have previous cancer related surgical history?, Cancer related Surgical History, Previous Anti-Neoplastic Therapy, Previous Anti-Neoplastic Therapy
Study ID: 113222 Clinical Study ID: 113222 Study Title: A Phase II, Open Label, Clinical Study to Assess the Safety and Activity of SRT501 Alone or in Combination with Bortezomib in Patients with Multiple Myeloma Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00920556 Sponsor: GlaxoSmithKline Phase: Phase 2 Study Recruitment Status: Completed Generic Name:5.0g SRT501 Trade Name: Bortezomib Study Indication: Multiple Myeloma

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