10-CMSMDS-1 Study Training Slides. SUM07\_1.ppt. Overview. Primary Study Objectives To prospectively examine outcomes of allogeneic HCT in adults > 65 years of age with MDS to determine whether their outcomes are similar to those in younger patients
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Primary Study Objectives
Complete and submit the Center Verification of Participation form
Maintain IRB approval of Research Database Protocol and Consent
Consent eligible patients using the Research Database consent form
Submit paper registration form for each patient to be enrolled.
Study participants will be assigned to the CRF track
Completion of Form 2400 ( Pre-TED)
This form can be either faxed or emailed to:
612-884-8660 (Fax) [email protected]
Is IRB approval required for the CMS-MDS study plan?
Under Recipient Identification-The RCI-BMT box must be checked, and the St ID# 10-CMSMDS-1 must entered in the specify field.
Consented to Research question should also be marked as Yes.
This will ensure that the patient is properly enrolled on to the CMS-MDS study and assigned to the CRF track.Form 2400 (Pre-TED) Completion
CIBMTR recipient ID#: ______________________________________
ID assigned by: CIBMTR EBMT Other __________________
BMT-CTN, St ID #:_______ RCI-BMT, St ID #:_______ NMDP SCTOD
Consented for Research? Yes No
Consented for CIBMTR Related Specimen Repository? Yes No
Gender: Male Female DOB:___ ___ ___ ___ - ___ ___ - ___ ___
Y Y Y Y M M
All study related materials can be found on the study web page at: