ID
17016
Description
ODM form derived from EBMT Allograft. please refer to: http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx
Link
Keywords
Versions (4)
- 7/14/16 7/14/16 -
- 8/21/16 8/21/16 -
- 4/13/21 4/13/21 - Dr. rer. medic Philipp Neuhaus
- 9/20/21 9/20/21 -
Uploaded on
August 21, 2016
DOI
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License
Creative Commons BY-NC 3.0
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EBMT Allograft
EBMT Allograft
- StudyEvent: ODM
Description
PRE-TRANSPLANT HISTORY OF DOCUMENTED INVASIVE FUNGAL INFECTION SINCE INITIAL DIAGNOSIS
Description
FUNGAL INFECTION
Data type
integer
Alias
- UMLS CUI [1]
- C0026946
Description
Candida
Data type
integer
Alias
- UMLS CUI [1]
- C0006837
Description
Aspergillus
Data type
integer
Alias
- UMLS CUI [1]
- C0004034
Description
Pneumocystis carinii
Data type
integer
Alias
- UMLS CUI [1]
- C0032276
Description
Other
Data type
boolean
Alias
- UMLS CUI [1]
- C0205394
Description
Other
Data type
integer
Alias
- UMLS CUI [1]
- C0205394
Description
PERFORMANCE SCORE
Description
score
Data type
integer
Alias
- UMLS CUI [1]
- C1518965
Description
Performance score
Data type
integer
Alias
- UMLS CUI [1]
- C1518965
Description
Weight
Data type
float
Measurement units
- kg
Alias
- UMLS CUI [1]
- C0005910
Description
Height
Data type
float
Measurement units
- cm
Alias
- UMLS CUI [1]
- C0005890
Description
DONOR AND STEM CELL SOURCE
Description
Multiple donors
Data type
boolean
Alias
- UMLS CUI [1]
- C0013018
Description
Make as many copies of the DONOR and HISTOCOMPATIBILITY sections as there are donors. Complete all of them and include them all in your report. For each donor Indicate in all pages their number in the infusion order and their Donor ID if known
Data type
float
Alias
- UMLS CUI [1]
- C0038250
Description
Tick only one. If same donor has donated stem cells from more than one source, fill the information under a separate donor form
Data type
integer
Alias
- UMLS CUI [1,1]
- C0038250
- UMLS CUI [1,2]
- C0449416
Description
given by the centre (can be the family relation if a related donor; if unrelated donor use the ID provided by the Donor Registry)
Data type
integer
Alias
- UMLS CUI [1]
- C1550613
Description
(if multiple donors or stem cell products)
Data type
integer
Alias
- UMLS CUI [1]
- C0574032
Description
(DONOR RELATION WITH PATIENT)
Data type
text
Alias
- UMLS CUI [1]
- C0242318
Description
Name of the Donor registry
Data type
integer
Alias
- UMLS CUI [1]
- C1549696
Description
(This information can be found in http://www.bmdw.org under “Participating Registries”)
Data type
integer
Alias
- UMLS CUI [1]
- C2987198
Description
Name of the Cord blood bank
Data type
integer
Alias
- UMLS CUI [1]
- C0005770
Description
Eurocord code for the cord blood bank
Data type
integer
Alias
- UMLS CUI [1,1]
- C0005770
- UMLS CUI [1,2]
- C0805701
Description
HLA MISMATCHES BETWEEN DONOR AND PATIENT
Description
Serology A
Data type
integer
Alias
- UMLS CUI [1]
- C0019728
Description
Serology B
Data type
integer
Alias
- UMLS CUI [1]
- C0019737
Description
Serology C
Data type
integer
Alias
- UMLS CUI [1]
- C0019751
Description
Serology DRB1
Data type
integer
Alias
- UMLS CUI [1]
- C0122040
Description
Serology DQB1
Data type
integer
Alias
- UMLS CUI [1]
- C0122020
Description
Serology DPB1
Data type
integer
Alias
- UMLS CUI [1]
- C0555918
Description
DNA A
Data type
text
Alias
- UMLS CUI [1]
- C0019729
Description
DNA B
Data type
integer
Alias
- UMLS CUI [1]
- C0019738
Description
DNA C
Data type
integer
Alias
- UMLS CUI [1]
- C0019752
Description
DNA DRB1
Data type
integer
Alias
- UMLS CUI [1]
- C1705258
Description
DNA DQB1
Data type
integer
Alias
- UMLS CUI [1]
- C0122020
Description
DNA DPB1
Data type
integer
Alias
- UMLS CUI [1]
- C0555918
Description
BLOOD GROUP, DATE OF BIRTH AND SEX OF DONOR
Description
STATUS OF THE DONOR OR CORD BLOOD UNIT BEFORE HSCT
Description
HIV
Data type
integer
Alias
- UMLS CUI [1]
- C0019682
Description
HIV ANTIGENS
Data type
integer
Alias
- UMLS CUI [1]
- C0019686
Description
CMV
Data type
integer
Alias
- UMLS CUI [1]
- C0582172
Description
EBV
Data type
integer
Alias
- UMLS CUI [1]
- C0014644
Description
HBV
Data type
integer
Alias
- UMLS CUI [1]
- C0019163
Description
HBVs
Data type
integer
Alias
- UMLS CUI [1]
- C0019165
Description
HBVc
Data type
integer
Alias
- UMLS CUI [1]
- C1440681
Description
HBVe
Data type
integer
Alias
- UMLS CUI [1]
- C0019167
Description
HCV
Data type
integer
Alias
- UMLS CUI [1]
- C0220847
Description
HCV ANTIGENS
Data type
integer
Alias
- UMLS CUI [1]
- C0121459
Description
HTLV
Data type
integer
Alias
- UMLS CUI [1]
- C0086427
Description
Toxoplasmosis
Data type
integer
Alias
- UMLS CUI [1]
- C0040558
Description
if other Antibodies in the patient
Data type
integer
Alias
- UMLS CUI [1]
- C0205394
Description
Date of harvest or cord blood collection
Data type
date
Alias
- UMLS CUI [1,1]
- C1512335
- UMLS CUI [1,2]
- C0011008
Description
GROWTH FACTORS
Data type
integer
Alias
- UMLS CUI [1]
- C0018284
Description
HISTOCOMPATIBILITY RESULTS
Description
Laboratory / Hospital
Data type
integer
Alias
- UMLS CUI [1,1]
- C0022877
- UMLS CUI [1,2]
- |C0019994
Description
Unit
Data type
integer
Alias
- UMLS CUI [1]
- C1519795
Description
telephone number
Data type
integer
Alias
- UMLS CUI [1]
- C1515258
Description
Technique
Data type
integer
Alias
- UMLS CUI [1,1]
- C0034925
- UMLS CUI [1,2]
- C0449851
Description
Serology (antigenic) HLA typing
Data type
boolean
Alias
- UMLS CUI [1]
- C0242318
Description
DNA (Allelic/molecular) HLA typing done
Description
DNA (Allelic/molecular) HLA typing done
Data type
boolean
Alias
- UMLS CUI [1]
- C0242318
Description
DNA (Allelic/molecular) HLA typing done: Locus
Data type
integer
Alias
- UMLS CUI [1]
- C1321760
Description
HLA string
Data type
integer
Alias
- UMLS CUI [1,1]
- C1547402
- UMLS CUI [1,2]
- C0019721
Description
NMDP code
Data type
integer
Alias
- UMLS CUI [1,1]
- C1882036
- UMLS CUI [1,2]
- C1827636
Description
Serology (antigenic) HLA typing done
Description
GRAFT MANIPULATION
Description
IF MULTIPLE DONORS (please, use same ID as in the preceding sheets)
Data type
integer
Alias
- UMLS CUI [1]
- C1827636
Description
Number in the infusion order
Data type
text
Alias
- UMLS CUI [1]
- C0237753
Description
GRAFT MANIPULATION EX-VIVO (INCLUDING T-CELL DEPLETION)
Data type
boolean
Alias
- UMLS CUI [1]
- C0677960
Description
GRAFT MANIPULATION EX-VIVO (INCLUDING T-CELL DEPLETION)
Data type
integer
Alias
- UMLS CUI [1]
- C2347338
Description
GRAFT MANIPULATION EX-VIVO (INCLUDING T-CELL DEPLETION)
Data type
integer
Alias
- UMLS CUI [1,1]
- C2347338
- UMLS CUI [1,2]
- C1521902
Description
GRAFT MANIPULATION EX-VIVO (INCLUDING T-CELL DEPLETION)
Data type
integer
Alias
- UMLS CUI [1,1]
- C2347644
- UMLS CUI [1,2]
- C1521902
Description
Monoclonal antibodies
Data type
integer
Alias
- UMLS CUI [1]
- C3542957
Description
Monoclonal antibodies: if yes
Data type
integer
Alias
- UMLS CUI [1]
- C0003250
Description
EXPANSION
Data type
integer
Alias
- UMLS CUI [1]
- C0040290
Description
GENE MANIPULATION
Data type
integer
Alias
- UMLS CUI [1]
- C0947647
Description
CELL INFUSION
Description
Identification of donor or Cord Blood Unit given by the centre
Data type
text
Description
Number in the infusion order
Data type
text
Alias
- UMLS CUI [1]
- C0237753
Description
Route of infusion
Data type
text
Description
Route of infusion: If other, please specify:
Data type
integer
Alias
- UMLS CUI [1]
- C1827465
Description
Infusion method
Data type
integer
Alias
- UMLS CUI [1]
- C0574032
Description
Infusion method: if other, please specify
Data type
integer
Alias
- UMLS CUI [1,1]
- C0574032
- UMLS CUI [1,2]
- C1521902
Description
CELL VIABILITY RESULTS AT HSCT CENTRE
Description
Tests performed after thawing of an aliquot on
Data type
integer
Alias
- UMLS CUI [1]
- C1521902
Description
Method used
Data type
integer
Alias
- UMLS CUI [1]
- C0871511
Description
Viability of all cells
Data type
float
Alias
- UMLS CUI [1]
- C1516362
Description
Viability of CD34+ cells
Data type
float
Alias
- UMLS CUI [1,1]
- C1516362
- UMLS CUI [1,2]
- C0882849
Description
CELLS INFUSED FROM THIS DONOR AND STEM CELL SOURCE COMBINATION
Description
Bone Marrow: Total number of cells actually infused
Data type
integer
Alias
- UMLS CUI [1,1]
- C2145394
- UMLS CUI [1,2]
- C0005953
Description
Bone Marrow: Total number of cells actually infused, specify:
Data type
integer
Alias
- UMLS CUI [1,1]
- C2145394
- UMLS CUI [1,2]
- C0005953
Description
Peripheral Blood: Total number of cells actually infused
Data type
integer
Alias
- UMLS CUI [1,1]
- C0229664
- UMLS CUI [1,2]
- C2145394
Description
Peripheral Blood: Total number of cells actually infused
Data type
integer
Alias
- UMLS CUI [1,1]
- C0229664
- UMLS CUI [1,2]
- C2145394
Description
Cord Blood: Total number of cellsactually infused
Data type
integer
Alias
- UMLS CUI [1,1]
- C0162371
- UMLS CUI [1,2]
- C2145394
Description
Cord Blood: Total number of cellsa ctually infused
Data type
integer
Alias
- UMLS CUI [1,1]
- C0162371
- UMLS CUI [1,2]
- C2145394
Description
HSC TRANSPLANTATION
Description
Chronological number
Data type
integer
Alias
- UMLS CUI [1,1]
- C1318453
- UMLS CUI [1,2]
- C0449788
Description
Donor the same as for previous HSCT?
Data type
integer
Alias
- UMLS CUI [1,1]
- C0013018
- UMLS CUI [1,2]
- C0472699
Description
Date of previous HSCT
Data type
date
Alias
- UMLS CUI [1,1]
- C0018956
- UMLS CUI [1,2]
- C0011008
Description
Type of HSCT
Data type
integer
Alias
- UMLS CUI [1]
- C0472699
Description
Reason for this transplant
Data type
integer
Alias
- UMLS CUI [1]
- C1718260
Description
HSCT part of a multiple sequential graft protocol
Data type
integer
Alias
- UMLS CUI [1]
- C0442711
Description
Type of multiple graft protocol
Data type
integer
Alias
- UMLS CUI [1]
- C0442711
Description
Graft number in the protocol
Data type
integer
Alias
- UMLS CUI [1]
- C1961139
Description
total number of HSCTs in the program
Data type
integer
Alias
- UMLS CUI [1,1]
- C0449788
- UMLS CUI [1,2]
- C0472699
Description
PREPARATIVE TREATMENT (conditioning)
Description
PREPARATIVE (CONDITIONING) REGIMEN GIVEN
Data type
boolean
Alias
- UMLS CUI [1]
- C1882454
Description
Was regimen intended to be myeloablative
Data type
integer
Alias
- UMLS CUI [1,1]
- C1882454
- UMLS CUI [1,2]
- C1513784
Description
Main reason (tick only one)
Data type
integer
Alias
- UMLS CUI [1]
- C1831742
Description
(include any active agent be it chemo, monoclonal antibody, polyclonal antibody, serotherapy, etc.) NOTE: ONLY AGENTS GIVEN BEFORE THE DATE OF THE 1ST CELL INFUSION (DAY 0) SHOULD BE LISTED HERE
Data type
integer
Alias
- UMLS CUI [1]
- C0013227
Description
Drugs
Description
NAME OF DRUG
Data type
text
Alias
- UMLS CUI [1]
- C3273235
Description
AS PER PROTOCOL (DAILY DOSE BY NUMBER OF DAYS)
Data type
integer
Alias
- UMLS CUI [1]
- C2986497
Description
MONOCLONAL ANTIBODY
Data type
integer
Alias
- UMLS CUI [1]
- C0003250
Description
UNITS IF RADIO LABELLED
Data type
integer
Alias
- UMLS CUI [1]
- C0041697
Description
Route of administration
Data type
integer
Alias
- UMLS CUI [1]
- C0013153
Description
For ALG, ATG (ALS, ATS):
Data type
integer
Alias
- UMLS CUI [1]
- C3494749
Description
(If yes, complete TBI Form)
Data type
integer
Alias
- UMLS CUI [1]
- C1456496
Description
Total dose
Data type
float
Alias
- UMLS CUI [1]
- C2919490
Description
Number of fractions
Data type
float
Alias
- UMLS CUI [1]
- C0454266
Description
radiation days
Data type
integer
Alias
- UMLS CUI [1]
- C3693616
Description
TLI / TNI / TAI
Data type
integer
Alias
- UMLS CUI [1]
- C3670574
- UMLS CUI [2]
- C0077401
Description
Local radiotherapy
Data type
integer
Alias
- UMLS CUI [1]
- C1522449
Description
TREATMENT DURING THE IMMEDIATE POST-TRANSPLANT PERIOD
Description
(excluding growth factors administered for engraftment failure)
Data type
integer
Alias
- UMLS CUI [1]
- C0018284
Description
GROWTH FACTORS: If yes, please specify
Data type
text
Alias
- UMLS CUI [1,1]
- C0018284
- UMLS CUI [1,2]
- C4035158
Description
Date started
Data type
date
Alias
- UMLS CUI [1]
- C3173309
Description
CELLULAR THERAPY
Data type
integer
Alias
- UMLS CUI [1]
- C0302189
Description
(can be the same as HSCT date)
Data type
date
Alias
- UMLS CUI [1,1]
- C0574032
- UMLS CUI [1,2]
- C0011008
Description
CELLULAR THERAPY
Data type
integer
Alias
- UMLS CUI [1,1]
- C0302189
- UMLS CUI [1,2]
- C1521902
Description
Number of cells infused by type
Description
Nucleated cells
Data type
float
Measurement units
- /kg*
Alias
- UMLS CUI [1]
- C1180059
Description
Nucleated cells
Data type
integer
Measurement units
- (/kg*
Alias
- UMLS CUI [1]
- C1180059
Description
CD 34+
Data type
integer
Measurement units
- cells/kg*
Alias
- UMLS CUI [1]
- C3538723
Description
CD 34+ (cells/kg*)
Data type
integer
Measurement units
- cells/kg*
Alias
- UMLS CUI [1]
- C3538723
Description
CD 3+
Data type
float
Measurement units
- cells/kg*
Alias
- UMLS CUI [1]
- C0483189
Description
CD 3+ (cells/kg*)
Data type
integer
Measurement units
- cells/kg*
Alias
- UMLS CUI [1]
- C0483189
Description
Total number of cells infused
Description
All cells
Data type
float
Measurement units
- cells/kg*
Alias
- UMLS CUI [1]
- C2322965
Description
Chronological number of this cell therapy for this patient
Data type
integer
Alias
- UMLS CUI [1,1]
- C0302189
- UMLS CUI [1,2]
- C0449788
Description
(check all that apply)
Data type
text
Alias
- UMLS CUI [1]
- C3146298
Description
Number of infusions within 10 weeks
Data type
integer
Alias
- UMLS CUI [1,1]
- C0449788
- UMLS CUI [1,2]
- C0574032
Description
GVHD PREVENTION IN THE RECIPIENT (THERAPEUTIC IMMUNOSUPPRESSION)
Data type
integer
Alias
- UMLS CUI [1,1]
- C0018133
- UMLS CUI [1,2]
- C0199176
Description
chemotherapy
Data type
integer
Alias
- UMLS CUI [1]
- C0392920
Description
Monoclonal antibodies
Data type
integer
Alias
- UMLS CUI [1]
- C3542957
Description
Drugs: If Other, please specify
Data type
integer
Alias
- UMLS CUI [1,1]
- C0013227
- UMLS CUI [1,2]
- C4035158
Description
GRAFT PERFORMANCE
Description
Haemopoietic reconstitution (Engraftment)
Data type
integer
Alias
- UMLS CUI [1]
- C0301944
Description
Neutrophils
Data type
integer
Alias
- UMLS CUI [1]
- C0948762
Description
Platelets
Data type
integer
Alias
- UMLS CUI [1]
- C0005821
Description
Date last assessment
Data type
date
Alias
- UMLS CUI [1]
- C2985720
Description
Date of graft failure
Data type
date
Alias
- UMLS CUI [1,1]
- C1262018
- UMLS CUI [1,2]
- C0011008
Description
HAEMOPOIETIC CHIMAERISM
Data type
integer
Alias
- UMLS CUI [1]
- C0333678
Description
DATE(S) AND RESULTS OF ALL TESTS DONE FOR ALL DONORS
Description
undefined item
Data type
text
Description
Date of test
Data type
date
Description
Identification
Data type
text
Alias
- UMLS CUI [1]
- C1718162
Description
Number in the infusion order
Data type
text
Alias
- UMLS CUI [1]
- C0237753
Description
Bone marrow
Data type
float
Measurement units
- %
Alias
- UMLS CUI [1]
- C0005953
Description
PB mononuclear cells (PBMC)
Data type
float
Measurement units
- %
Alias
- UMLS CUI [1]
- C1321301
Description
T-cell
Data type
float
Description
B-Cells
Data type
float
Measurement units
- %
Alias
- UMLS CUI [1]
- C0004561
Description
Red blood cells
Data type
float
Measurement units
- %
Alias
- UMLS CUI [1]
- C0014772
Description
Monocytes
Data type
float
Measurement units
- %
Alias
- UMLS CUI [1]
- C0026473
Description
PMNs (neutrophils)
Data type
float
Measurement units
- %
Alias
- UMLS CUI [1]
- C0200633
Description
Lymphocytes, NOS
Data type
float
Measurement units
- %
Alias
- UMLS CUI [1]
- C0024264
Description
Myeloid cells, NOS
Data type
float
Measurement units
- %
Alias
- UMLS CUI [1]
- C0887899
Description
Other cell type - value
Data type
float
Measurement units
- %
Alias
- UMLS CUI [1,1]
- C0449475
- UMLS CUI [1,2]
- C1522609
Description
Laboratory tests
Data type
integer
Alias
- UMLS CUI [1]
- C0022885
Description
TREATMENT FOR FAILURE
Data type
integer
Description
ACUTE GRAFT VERSUS HOST DISEASE (GvHD)
Description
Maximum grade
Data type
integer
Description
Date of onset
Data type
date
Alias
- UMLS CUI [1]
- C0574845
Description
aGvHD Stage Skin
Data type
integer
Alias
- UMLS CUI [1,1]
- C0856825
- UMLS CUI [1,2]
- C1306673
- UMLS CUI [1,3]
- C1306673
Description
aGvHD Stage liver
Data type
integer
Alias
- UMLS CUI [1,1]
- C0856825
- UMLS CUI [1,2]
- C1306673
- UMLS CUI [1,3]
- C0023884
Description
aGvHD stage gut
Data type
integer
Alias
- UMLS CUI [1,1]
- C0856825
- UMLS CUI [1,2]
- C1306673
- UMLS CUI [1,3]
- C0021853
Description
aGvHD Resolution
Data type
integer
Alias
- UMLS CUI [1,1]
- C0856825
- UMLS CUI [1,2]
- C1514893
Description
aGvHD Date of resolution
Data type
date
Measurement units
- yyyy/mm/dd
Alias
- UMLS CUI [1,1]
- C0856825
- UMLS CUI [1,2]
- C1514893
- UMLS CUI [1,3]
- C0011008
Description
Treatment
Data type
boolean
Description
Treatment
Data type
text
Description
COMPLICATIONS WITHIN THE FIRST 100 DAYS.
Description
INFECTION RELATED COMPLICATIONS
Data type
boolean
Alias
- UMLS CUI [1,1]
- C0009450
- UMLS CUI [1,2]
- C0009566
Description
Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
Data type
integer
Alias
- UMLS CUI [1]
- C0450254
Description
NON INFECTION RELATED COMPLICATIONS
Data type
integer
Alias
- UMLS CUI [1]
- C0009566
Description
Idiopathic pneumonia syndrome
Data type
text
Alias
- UMLS CUI [1]
- C1504431
Description
VOD
Data type
text
Alias
- UMLS CUI [1]
- C0948441
Description
Haemorrhagic cystitis, non infectious
Data type
text
Alias
- UMLS CUI [1]
- C0085692
Description
ARDS, non infectious
Data type
text
Alias
- UMLS CUI [1]
- C0035222
Description
Multiorgan failure, non infectious
Data type
integer
Alias
- UMLS CUI [1]
- C0026766
Description
HSCT-associated microangiopathy
Data type
text
Alias
- UMLS CUI [1]
- C0155765
Description
Renal failure requiring dialysis
Data type
text
Alias
- UMLS CUI [1]
- C0035078
Description
Haemolytic anaemia due to blood group
Data type
text
Alias
- UMLS CUI [1]
- C0002878
Description
Other type of infection
Data type
boolean
Alias
- UMLS CUI [1]
- C0457463
Description
Idiopathic pneumonia syndrome date
Data type
date
Alias
- UMLS CUI [1,1]
- C1504431
- UMLS CUI [1,2]
- C0011008
Description
Date VOD
Data type
date
Alias
- UMLS CUI [1,1]
- C0948441
- UMLS CUI [1,2]
- C0011008
Description
Date Haemorrhagic cystitis, non infectious
Data type
date
Alias
- UMLS CUI [1,1]
- C0085692
- UMLS CUI [1,2]
- C0011008
Description
Date ARDS, non infectious
Data type
date
Alias
- UMLS CUI [1,1]
- C0035222
- UMLS CUI [1,2]
- C0011008
Description
Date Multiorgan failure, non infectious
Data type
date
Alias
- UMLS CUI [1,1]
- C0026766
- UMLS CUI [1,2]
- C0011008
Description
Date HSCT-associated microangiopathy
Data type
date
Alias
- UMLS CUI [1,1]
- C0155765
- UMLS CUI [1,2]
- C0011008
Description
Date Renal failure requiring dialysis
Data type
date
Alias
- UMLS CUI [1,1]
- C0035078
- UMLS CUI [1,2]
- C0011008
Description
DAte Haemolytic anaemia due to blood group
Data type
date
Alias
- UMLS CUI [1,1]
- C0002878
- UMLS CUI [1,2]
- C0011008
Description
Date of other Type
Data type
date
Alias
- UMLS CUI [1,1]
- C2316983
- UMLS CUI [1,2]
- C0220886
Description
STATUS AT 100 DAYS
Description
LastContactDate
Data type
date
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C0011008
- UMLS CUI [1,3]
- C1705415
- UMLS CUI [1,4]
- C1517741
Description
Presence of cGVHD
Data type
integer
Alias
- UMLS CUI [1]
- C0867389
Description
Date of Onset
Data type
date
Alias
- UMLS CUI [1]
- C0574845
Description
cGvHD grade
Data type
integer
Alias
- UMLS CUI [1,1]
- C0867389
- UMLS CUI [1,2]
- C0441800
Description
Organs affected
Data type
integer
Alias
- UMLS CUI [1]
- C0449642
Description
Relapse or progression
Data type
integer
Alias
- UMLS CUI [1]
- C0035020
- UMLS CUI [2]
- C0242656
Description
RELAPSE OR PROGRESSION: If yes, date diagnosed
Data type
date
Alias
- UMLS CUI [1]
- C0035020
- UMLS CUI [2]
- C0242656
- UMLS CUI [3]
- C2316983
Description
Method of detection
Description
Clinical/hematological
Data type
integer
Alias
- UMLS CUI [1,1]
- C0018939
- UMLS CUI [1,2]
- C0205210
Description
Cinical/haematological relapse or progression
Data type
date
Description
Cinical/haematological relapse or progression
Data type
date
Description
Cytogenetic relapse or progression
Data type
integer
Alias
- UMLS CUI [1]
- C0010802
Description
Cytogenetic relapse or progression: Date assessed
Data type
date
Alias
- UMLS CUI [1,1]
- C0010802
- UMLS CUI [1,2]
- C0035020
- UMLS CUI [1,3]
- C2985720
Description
Cytogenetic relapse or progression: Date first seen
Data type
date
Alias
- UMLS CUI [1,1]
- C0035020
- UMLS CUI [1,2]
- C3483766
Description
Molecular relapse or progression
Data type
integer
Alias
- UMLS CUI [1]
- C0026376
Description
Molecular relapse or progression: date assessed
Data type
date
Alias
- UMLS CUI [1,1]
- C0035020
- UMLS CUI [1,2]
- C0011008
Description
Molecular relapse or progression: Date first seen
Data type
date
Alias
- UMLS CUI [1,1]
- C3483766
- UMLS CUI [1,2]
- C0035020
Description
LAST DISEASE STATUS
Description
Clincal/Hematological evaluation
Data type
integer
Alias
- UMLS CUI [1,1]
- C0018939
- UMLS CUI [1,2]
- C0205210
Description
Date of Evaluation
Data type
date
Measurement units
- yyyy/mm/dd
Alias
- UMLS CUI [1]
- C2985720
Description
Cytogenetics/FISH
Data type
integer
Alias
- UMLS CUI [1,1]
- C0010802
- UMLS CUI [1,2]
- C0162789
Description
Last date assessed
Data type
date
Description
Molecular
Data type
text
Alias
- UMLS CUI [1]
- C0026376
Description
Survival Status
Data type
integer
Alias
- UMLS CUI [1]
- C1148433
Description
Performance Score
Data type
text
Alias
- UMLS CUI [1]
- C1518965
Description
Performance score
Data type
integer
Alias
- UMLS CUI [1]
- C1518965
Description
Cause of death
Data type
integer
Alias
- UMLS CUI [1]
- C0007465
Description
GvHD
Data type
text
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C0018133
Description
Interstitial Pneumonitis
Data type
text
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C0206061
Description
Pulmonary toxicity
Data type
text
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C0919924
Description
Infection
Data type
integer
Alias
- UMLS CUI [1]
- C0009450
Description
Rejection / poor graft function
Data type
integer
Alias
- UMLS CUI [1]
- C0018129
Description
Veno-Occlusive disease (VOD)
Data type
integer
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C0948441
Description
Haemorrhage
Data type
text
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C0019080
Description
Cardiac toxicity
Data type
text
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C0876994
Description
Central nervous system toxicity
Data type
text
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C3160947
Description
Gastro intestinal toxicity
Data type
text
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C1142499
Description
Skin toxicity
Data type
text
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C1167791
Description
Renal failure
Data type
text
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C0035078
Description
Multiple organ failure
Data type
text
Alias
- UMLS CUI [1,1]
- C0007465
- UMLS CUI [1,2]
- C0026766
Description
COMMENTS
Data type
text
Alias
- UMLS CUI [1]
- C0947611
Description
IDENTIFICATION & SIGNATURE
Data type
text
Alias
- UMLS CUI [1,1]
- C0205396
- UMLS CUI [1,2]
- C1519316
Description
ADDITIONAL NOTES IF APPLICABLE
Description
ALLOGRAFT APPENDIX
Description
Ethnicity
Data type
text
Alias
- UMLS CUI [1]
- C0015031
Description
Race
Data type
text
Alias
- UMLS CUI [1]
- C0034510
Description
Was there any clinically significant co-existing disease or organ impairment at time of patient assessment prior to preparative (conditioning) regimen?
Data type
boolean
Alias
- UMLS CUI [1]
- C1275743
Description
Treated at any time point in the patient's past history, excluding nonmelanoma skin cancer
Data type
integer
Alias
- UMLS CUI [1]
- C0280100
Description
Crohn's disease or ulcerative colitis
Data type
integer
Alias
- UMLS CUI [1]
- C0021390
Description
Infection
Data type
integer
Alias
- UMLS CUI [1]
- C0009450
Description
Requiring treatment with insulin or oral hypoglycemics but not diet alone
Data type
integer
Alias
- UMLS CUI [1]
- C0011849
Description
Renal: moderate/severeor >177 μmol/L, on dialysis, or prior renal transplantation
Data type
integer
Measurement units
- mg/dL
Alias
- UMLS CUI [1]
- C0201976
Description
, bilirubine between Upper Limit Normal (ULN) and 1.5 x the ULN, or AST/ALT between ULN and 2.5 × ULN
Data type
integer
Alias
- UMLS CUI [1]
- C0019189
Description
, bilirubine greater than 1.5 × ULN, or AST/ALT greater than 2.5 × ULN
Data type
integer
Alias
- UMLS CUI [1]
- C0023890
Description
Atrial fibrillation or flutter, sick sinus syndrome, or ventricular arrhythmias
Data type
integer
Alias
- UMLS CUI [1]
- C0003811
Description
Coronary artery disease, congestive heart failure, myocardial infarction, or EF ≤ 50%
Data type
integer
Alias
- UMLS CUI [1]
- C1956346
Description
Transient ischemic attack or cerebrovascular accident
Data type
integer
Alias
- UMLS CUI [1]
- C0007820
Description
Except mitral valve prolapse
Data type
integer
Alias
- UMLS CUI [1]
- C0018824
Description
FEV1
Data type
integer
Alias
- UMLS CUI [1]
- C0748133
Description
Pulmonary: severeor dyspnea at rest or requiring oxygen
Data type
integer
Alias
- UMLS CUI [1]
- C0860906
Description
Patients with a body mass index > 35 kg/m2
Data type
integer
Alias
- UMLS CUI [1]
- C0028754
Description
Peptic ulcer
Data type
integer
Alias
- UMLS CUI [1]
- C0030920
Description
Depression or anxiety requiring psychiatric consult or treatment
Data type
integer
Alias
- UMLS CUI [1]
- C0004936
Description
comorbidity
Data type
text
Alias
- UMLS CUI [1]
- C0009488
Similar models
EBMT Allograft
- StudyEvent: ODM
C0449416 (UMLS CUI [1,2])
C0805701 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
|C0019994 (UMLS CUI [1,2])
C0449851 (UMLS CUI [1,2])
C0019721 (UMLS CUI [1,2])
C1827636 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,2])
C0882849 (UMLS CUI [1,2])
C0005953 (UMLS CUI [1,2])
C0005953 (UMLS CUI [1,2])
C2145394 (UMLS CUI [1,2])
C2145394 (UMLS CUI [1,2])
C2145394 (UMLS CUI [1,2])
C2145394 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0472699 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0472699 (UMLS CUI [1,2])
C1513784 (UMLS CUI [1,2])
C4035158 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0574032 (UMLS CUI [1,2])
C0199176 (UMLS CUI [1,2])
C4035158 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C1522609 (UMLS CUI [1,2])
C1306673 (UMLS CUI [1,2])
C1306673 (UMLS CUI [1,3])
C1306673 (UMLS CUI [1,2])
C0023884 (UMLS CUI [1,3])
C1306673 (UMLS CUI [1,2])
C0021853 (UMLS CUI [1,3])
C1514893 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C0009566 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0220886 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
C1517741 (UMLS CUI [1,4])
C0242656 (UMLS CUI [2])
C0242656 (UMLS CUI [2])
C2316983 (UMLS CUI [3])
C0205210 (UMLS CUI [1,2])
C0035020 (UMLS CUI [1,2])
C2985720 (UMLS CUI [1,3])
C3483766 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0035020 (UMLS CUI [1,2])
C0205210 (UMLS CUI [1,2])
C0018133 (UMLS CUI [1,2])
C0206061 (UMLS CUI [1,2])
C0919924 (UMLS CUI [1,2])
C0948441 (UMLS CUI [1,2])
C0019080 (UMLS CUI [1,2])
C0876994 (UMLS CUI [1,2])
C3160947 (UMLS CUI [1,2])
C1142499 (UMLS CUI [1,2])
C1167791 (UMLS CUI [1,2])
C0035078 (UMLS CUI [1,2])
C0026766 (UMLS CUI [1,2])
C1519316 (UMLS CUI [1,2])