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- 4/24/18 - 1 form, 26 itemgroups, 84 items, 1 language
Itemgroups: Identification Numbers, Demography, Vital Signs, 12-Lead Electrocardiogram, Echocardiogram or Multiple Gated Acquisition Scanning (MUGA), If Yes for the obtained Ejection Fraction, Chest X-Ray, History of Myelodysplastic Syndrome / Acute Myelogenous Leukemia, Previous Chemotherapy for MDS or AML, If Yes to Previous Chemotherapy for MDS or AML, Previous Biologic Therapy and/or Immunotherapy for MDS or AML, If Yes to Previous Biologic Therapy and/or Immunotherapy for MDS or AML, Toxicities Related to Previous Therapy for MDS or AML, If Yes to Toxicities Related to Previous Therapy for MDS or AML, Prior Transfusion Therapy (Including Erythropoietin), If Yes to Prior Transfusion Therapy (Including Erythropoietin), Prior Anti-Infective Therapy, If Yes to Prior Anti-Infective Therapy, Prior and Concominant Medication, If Yes to Prior and Concominant Medication, Ongoing Medical Conditions Associated with MDS or AML, If Yes to Ongoing Medical Conditions Associated with MDS or AML, Prior Malignancies, If Yes to Prior Malignancies, Significant Medical/Surgery History and Physical Examination, If Yes to Significant Medical/Surgery History and Physical Examination