If this file opens in Compatibility Mode using Microsoft Word, convert to the latest document format to avoid potential formatting issues.	

OP RSH PRO00042634 PINGALI 90014496LYM1001 SCREENING	

Types:      Research Oncology Treatment
Synonyms:  SCREENING

Screening (-28 to 0)	Repeat 1 time	Cycle length: 1 day	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: Until discontinued	Occurrences: --	Comments:	Nursing Communication: Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    90014496LYM1001_Pingali
		  	ONC NURSING COMMUNICATION 5	Interval: Until discontinued	Occurrences: --	Comments:	Nursing Communication: Dose Modifications and Management for study is NOT APPLICABLE Treatment: Refer to Section 6.6 (DOSE MODIFICATION) 
Protocol Access Hyperlink:  [CG1] 90014496LYM1001_Pingali
			Nursing Orders
  	ONC NURSING COMMUNICATION 68	Interval: --	Occurrences: --	Comments:	Informed Consent
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	Eligibility criteria
		  	ONC NURSING COMMUNICATION 35	Interval: --	Occurrences: --	Comments:	International Prognostic Index (IPI)
		  	ONC NURSING COMMUNICATION 36	Interval: --	Occurrences: --	Comments:	Staging
		  	ONC NURSING COMMUNICATION 37	Interval: --	Occurrences: --	Comments:	ECOG performance status score
		  	ONC NURSING COMMUNICATION 38	Interval: --	Occurrences: --	Comments:	Demographics, diagnosis and medical history, prior anti-lymphoma therapies. Prior therapies include surgical procedures, radiation, medications, stem cell transplants, etc
		  	ONC NURSING COMMUNICATION 47	Interval: --	Occurrences: --	Comments:	Physical Examination and neurological evaluation, including height and weight
		  	HEIGHT AND WEIGHT	Interval: --	Occurrences: --		  	ONC NURSING COMMUNICATION 52	Interval: --	Occurrences: --	Comments:	Neurological assessment (ICE Score). Neurological evaluation will be conducted using the ICANS grading tool and ICE score
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Vital signs, including oxygen saturation
			Labs
  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --	Comments:	For participants with Gilbert's syndrome
		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	FERRITIN LEVEL	Interval: --	Occurrences: --		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	as clinically indicated.
		  	PARTIAL THROMBOPLASTIN TIME (PTT)	Interval: --	Occurrences: --	Comments:	as clinically indicated.
		  	FIBRINOGEN	Interval: --	Occurrences: --		  	IMMUNOGLOBULIN G	Interval: --	Occurrences: --			Labs
  	HIV 1/2 ANTIGEN/ANTIBODY, FOURTH GENERATION, WITH REFLEXES	Interval: --	Occurrences: --	Comments:	At screening within 60 days of apheresis
		  	HEPATITIS C VIRUS (HCV) ANTIBODY WITH REFLEX TO PCR	Interval: --	Occurrences: --	Comments:	At screening within 60 days of apheresis
		  	HEPATITIS C VIRUS (HCV) RNA, DIAGNOSIS	Interval: --	Occurrences: --	Comments:	At screening within 60 days of apheresis
		  	HEPATITIS B SURFACE AB, QUANTITATIVE	Interval: --	Occurrences: --	Comments:	At screening within 60 days of apheresis
		  	HEPATITIS B SURFACE ANTIGEN	Interval: --	Occurrences: --	Comments:	At screening within 60 days of apheresis
		  	HEPATITIS B CORE ANTIBODY TOTAL	Interval: --	Occurrences: --	Comments:	At screening within 60 days of apheresis
		  	HEPATITIS B VIRUS (HBV), QUANTITATIVE, DNA (ABBOTT REALTIME)	Interval: --	Occurrences: --	Comments:	At screening within 60 days of apheresis
			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	For women of child-bearing potential.
			Imaging
  	ECG 12-LEAD	Interval: --	Occurrences: --			Imaging
  	CV ECHOCARDIOGRAM RESEARCH ONLY	Interval: --	Occurrences: --			Imaging
☑	CD19	Interval: --	Occurrences: --	Comments:	CD19 and/or CD20 tumor expression. Positive test result from last relapse prior to screening is acceptable based on local testing
		☐	CD20 ENUMERATION	Interval: --	Occurrences: --	Comments:	CD19 and/or CD20 tumor expression. Positive test result from last relapse prior to screening is acceptable based on local testing
			Imaging
☐	CT CHEST W CONTRAST ABDOMEN W CONTRAST PELVIS W CONTRAST	Interval: --	Occurrences: --	Comments:	Non-FDG-avid indolent lymphomas
		☐	CT CHEST WO CONTRAST ABDOMEN WO CONTRAST PELVIS WO CONTRAST	Interval: --	Occurrences: --	Comments:	Non-FDG-avid indolent lymphomasNon-FDG-avid indolent lymphomas
		☑	CT CHEST W CONTRAST ABDOMEN W WO CONTRAST PELVIS W WO CONTRAST	Interval: --	Occurrences: --	Comments:	Non-FDG-avid indolent lymphomas
		☐	CT CHEST W WO CONTRAST ABDOMEN W CONTRAST PELVIS W CONTRAST	Interval: --	Occurrences: --	Comments:	Non-FDG-avid indolent lymphomas
		☑	CTA NECK W WO CONTRAST	Interval: --	Occurrences: --		☐	MRA NECK WO CONTRAST	Interval: --	Occurrences: --			Imaging
  	PET CT WHOLE BODY	Interval: --	Occurrences: --	Comments:	FDG-avid lymphoma
			Imaging
☑	MRI BRAIN W WO CONTRAST	Interval: --	Occurrences: --	Comments:	Obtain for participants with prior history of CNS lymphoma or who exhibit symptoms of CNS lymphoma
		☑	CT HEAD W WO CONTRAST	Interval: --	Occurrences: --	Comments:	Obtain for participants with prior history of CNS lymphoma or who exhibit symptoms of CNS lymphoma
		☑	LUMBAR PUNCTURE	Interval: --	Occurrences: --	Comments:	Obtain for participants with prior history of CNS lymphoma or who exhibit symptoms of CNS
lymphoma
			Labs
☑	CYTOLOGY (NON-GYNECOLOGICAL) REQUEST	Interval: --	Occurrences: --	Comments:	Obtain for participants with prior history of CNS lymphoma or who exhibit symptoms of CNS lymphoma
			Procedures
  	BIOPSY BONE MARROW	Interval: --	Occurrences: --	Comments:	Bone marrow biopsy and/or aspirate.Obtain if known involvement.
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	ctDNA analysis
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Tumor biopsy (archival or fresh)