Descrição:

AMC-061 Baseline Evaluation Form (B61) Sunitinib Malate in Treating HIV-Positive Patients With Cancer Undergoing Highly Active Antiretroviral Therapy NCT00890747 Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=715BD918-9168-2975-E040-BB89AD434610

Link:
https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=715BD918-9168-2975-E040-BB89AD434610
Palavras-chave:
  1. 26/08/2012 26/08/2012 -
  2. 20/05/2015 20/05/2015 - Martin Dugas
Transferido a:

20 de maio de 2015

DOI:
Para um pedido faça login.
Licença :
Creative Commons BY-NC 3.0 Legacy
Comentários do modelo :

Aqui pode comentar o modelo. Pode comentá-lo especificamente através dos balões de texto nos grupos de itens e itens.

Comentários do grupo de itens para :

Comentários do item para :

Para descarregar formulários, precisa de ter uma sessão iniciada. Por favor faça login ou registe-se gratuitamente.

HIV with Cancer Baseline AMC-061 NCT00890747

Complete this form at baseline only

  1. StudyEvent: AMC-061 Baseline Evaluation Form (B61)
    1. Complete this form at baseline only
Visit Number
SOLID TUMOR/LYMPHOMA ASSESSMENT
Disease status
Hematopoietic Diagnosis
If diffuse large B-cell lymphoma, specify morphologic type
If Burkitt lymphoma/leukemia, specify morphologic type
Kaposi's Sarcoma Assessment
Does the patient have >=50 cutaneous lesions
Are there any oral cavity lesions present
Is there visceral disease
Hematologic Malignancy Assessment
Hematologic diagnosis
Acute Lymphoblastic Leukemia
Acute Myeloid Leukemia
Chronic Lymphoid Leukemia
Chronic Myeloproliferative Disease
Leukemia Miscellaneous

Similar models

Use este formulário para feedback, perguntas e sugestões de aperfeiçoamento.

Campos marcados com * são obrigatórios.

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial