ID

16822

Description

HLA typing results of patient and donor should be attached and sent: - to your NATIONAL REGISTRY if - you normally report to your National Registry and - you are based in the Netherlands, Switzerland, Turkey or the UK - to the EBMT REGISTRY OFFICE in London for any other centre Contact: Shelley Hewerdine EBMT Registry Office 4th Floor, Tabard House Guy's Hospital Great Maze Pond London SE1 9RT United Kingdom Phone: 00 44-207-188-8409 Fax: 00 44-207-188-8411 Email: shelley.hewerdine@ebmt.org

Keywords

  1. 8/9/16 8/9/16 -
  2. 9/23/16 9/23/16 -
  3. 9/24/16 9/24/16 -
  4. 9/20/21 9/20/21 -
Uploaded on

August 9, 2016

DOI

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License

Creative Commons BY-NC 3.0

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100days past HSCT EBMT

20pp 100days past HSCT 02MED

CENTRE IDENTIFICATION
Description

CENTRE IDENTIFICATION

EBMT Code (CIC)
Description

EBMT Code (CIC)

Data type

text

Hospital
Description

Klinik

Data type

text

Alias
UMLS CUI [1]
C0019994
Unit
Description

Unit

Data type

text

Contact person
Description

Contact person

Data type

text

Phone
Description

Phone

Data type

text

Fax
Description

Fax

Data type

text

e-mail
Description

e-mail

Data type

text

PATIENT DATA
Description

PATIENT DATA

Date of this report
Description

Date of this report

Data type

date

Alias
UMLS CUI [1]
C1302584
Patient following national / international study / trial
Description

Patient following national / international study / trial

Data type

integer

Alias
UMLS CUI [1]
C1997894
Name of study / trial
Description

Name of study / trial

Data type

text

Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Initials (first name(s) _family name(s))
Description

Initials

Data type

text

Date of Birth
Description

PersonBirthDate

Data type

date

Alias
UMLS CUI [1,1]
C0027361
UMLS CUI [1,2]
C0005615
UMLS CUI [1,3]
C0011008
Sex
Description

Sex

Data type

text

Alias
UMLS CUI [1]
C0079399
DISEASE
Description

DISEASE

Date of initial diagnosis
Description

Date of initial diagnosis

Data type

date

Alias
UMLS CUI [1]
C2316983
PRIMARY DISEASE DIAGNOSIS
Description

PRIMARY DISEASE DIAGNOSIS

Data type

text

HSCT
Description

HSCT

Performance score (if alive)
Description

Performance score

Data type

integer

Alias
UMLS CUI [1]
C1518965
Score achived
Description

Score

Data type

text

Alias
UMLS CUI [1]
C1518965
Type of HSCT
Description

Type of HSCT

Data type

integer

Patient CMV status (for allografts)
Description

Patient CMV status

Data type

text

Multiple donors/products
Description

Multiple donors/products

Data type

boolean

if yes, Number (including multiple CB units or different stem cell products from same donor)
Description

Multiple donors/products

Data type

text

STEM CELLS (autograft or allograft)
Description

STEM CELLS (autograft or allograft)

Source of Stem Cells (check all that apply)
Description

Source of Stem Cells

Data type

text

if other, please specify
Description

Source of Stem Cells

Data type

text

Donor ID
Description

Donor ID

Data type

text

Alias
UMLS CUI [1]
C1718162
if autograft, go to Graft manipulation below
Description

Donor ID

Data type

integer

HLA match type (for allografts)
Description

HLA match type

Data type

text

Degree of mismatch
Description

Degree of mismatch

Data type

integer

Name of donor registry/CB Bank
Description

Name of donor registry/CB Bank

Data type

text

BMDW/WMDA code (up to 4 characters)
Description

BMDW/WMDA code (up to 4 characters)

Data type

text

Number of mismatches A
Description

Number of mismatches

Data type

text

Number of mismatches B
Description

Number of mismatches

Data type

text

Number of mismatches C
Description

Number of mismatches

Data type

text

Number of mismatches DRB1
Description

Number of mismatches

Data type

text

Number of mismatches DQB1
Description

Number of mismatches

Data type

text

Number of mismatches DPB1
Description

Number of mismatches

Data type

text

Donor Sex
Description

Donor Sex

Data type

text

Donor age
Description

Donor age ys

Data type

integer

Graft manipulation ex-vivo (including T-cell depletion) other than for RBC removal or volume reduction
Description

Graft manipulation ex-vivo (including T-cell depletion) other than for RBC removal or volume reduction

Data type

boolean

HSCT
Description

HSCT

Chronological number of HSCT for this patient?
Description

Chronological number of HSCT for this patient?

Data type

text

If >1, date of last HSCT before this one
Description

If >1, date of last HSCT before this one

Data type

date

If >1, type of last HSCT before this one
Description

If >1, type of last HSCT before this one

Data type

text

HSCT part of a planned multiple graft protocol?
Description

HSCT part of a planned multiple graft protocol?

Data type

boolean

Preparative (conditioning) regimen given?
Description

Preparative (conditioning) regimen given?

Data type

boolean

Was this intended to be myeloablative?
Description

Was this intended to be myeloablative?

Data type

boolean

Reason
Description

Reason

Data type

text

if other reason, please specify
Description

Reason

Data type

text

Ara-C (cytarabine)
Description

Ara-C (cytarabine)

Data type

float

Measurement units
  • mg
mg
Unit of dosing
Description

Ara-C (cytarabine)

Data type

integer

ALG, ATG (ALS, ATS)
Description

ALG, ATG (ALS, ATS)

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Animal origin
Description

Animal origin

Data type

integer

Animal origin if other, please specify
Description

Animal origin

Data type

text

Bleomycin
Description

Bleomycin

Data type

float

Unit of dosing
Description

Unit of doseing

Data type

integer

Busulfan
Description

Busulfan

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Busulfan
Description

Busulfan

Data type

integer

BCNU
Description

BCNU

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Bexar (radiolabelled MoAB)
Description

Bexar (radiolabelled MoAB)

Data type

float

unit of dosing
Description

Unit of dosing

Data type

integer

CCNU
Description

CCNU

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Campath (antiCD52)
Description

Campath (antiCD52)

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Carboplatin
Description

Carboplatin

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Cisplatin
Description

Cisplatin

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Corticosteroids
Description

Corticosteroids

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Cyclophosphamide
Description

Cyclophosphamide

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Daunorubicin
Description

Daunorubicin

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Doxorubicin (adriamycine)
Description

Doxorubicin (adriamycine)

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Etoposide (VP16)
Description

Etoposide (VP16)

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Fludarabine
Description

Fludarabine

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Gemtuzumab
Description

Gemtuzumab

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Idarubicin
Description

Idarubicin

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Ifosfamide
Description

Ifosfamide

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Imatinib mesylate
Description

Imatinib mesylate

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Melphalan
Description

Melphalan

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Mitoxantrone
Description

Mitoxantrone

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Paclitaxel
Description

Paclitaxel

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Rituximab (mabthera, antiCD20)
Description

Rituximab (mabthera, antiCD20)

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Teniposide
Description

Teniposide

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Thiotepa
Description

Thiotepa

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Zevalin (radiolabelled MoAB)
Description

Zevalin (radiolabelled MoAB)

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Other radiolabelled MoAB
Description

Other radiolabelled MoAB

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

if other, please specify
Description

Other radiolabelled MoAB

Data type

text

Other MoAB
Description

Other MoAB

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Other
Description

Other

Data type

float

Unit of dosing
Description

Unit of dosing

Data type

integer

Total body irradiation
Description

Total body irradiation

Data type

boolean

Alias
UMLS CUI [1]
C0043162
if yes, please specify value
Description

Total Body Irradiation

Data type

text

TLI, TNI, TAI
Description

TLI, TNI, TAI

Data type

boolean

if yes, please specify value
Description

TLI, TNI, TAI

Data type

text

AFTER HSCT
Description

AFTER HSCT

GvHD prophylaxis or preventive treatment (Allografts only)
Description

GvHD prophylaxis or preventive treatment

Data type

boolean

if yes, please specify
Description

GvHD prophylaxis or preventive treatment

Data type

integer

if other agent, please specify
Description

GvHD prophylaxis or preventive treatment

Data type

text

if other, please specify
Description

GvHD prophylaxis or preventive treatment

Data type

text

if Other monoclonal antibody, please specify
Description

GvHD prophylaxis or preventive treatment

Data type

text

Absolute neutrophil count (ANC) recovery (engraftment) (Neutrophils >0.5X109 /L)
Description

Absolute neutrophil count (ANC) recovery (engraftment) (Neutrophils >0.5X109 /L)

Data type

integer

Date of last assessment
Description

Date of last assessment

Data type

date

Date of ANC recovery
Description

Date of ANC recovery

Data type

date

Date of last assessment
Description

Date of last assessment

Data type

date

Maximum Grade
Description

Maximum grade

Data type

integer

ADDITIONAL TREATMENT INCLUDING CELL THERAPY
Description

ADDITIONAL TREATMENT INCLUDING CELL THERAPY

Cell infusion (CI)
Description

Cell infusion (CI)

Data type

boolean

Date of first infusion
Description

(can be the same as HSCT date)

Data type

date

Type of cell(s): (check all that apply)
Description

Type of cell(s): (check all that apply)

Data type

integer

if other, please specify
Description

Type of cell(s): (check all that apply)

Data type

text

Chronological no. of CI for this patient
Description

Chronological no. of CI for this patient

Data type

text

Indication (check all that apply)
Description

Indication

Data type

text

Alias
UMLS CUI [1,1]
C3146298
UMLS CUI [1,2]
C0302189
if other, please specify
Description

Indication:

Data type

text

Number of infusions within 10 weeks (count only infusions that are part of same regimen and given for the same indication)
Description

Infusion count

Data type

float

Alias
UMLS CUI [1,1]
C0574032
UMLS CUI [1,2]
C0750480
Disease treatment
Description

Disease treatment

Data type

integer

Alias
UMLS CUI [1]
C0087111
DISEASE STATUS
Description

DISEASE STATUS

Best disease status (response) after HSCT (prior to treatment modification in response to a post HSCT disease assessment)
Description

Best disease status (response) after HSCT

Data type

integer

CR achieved: Date achieved
Description

CR achieved: Date achieved

Data type

date

Never in CR: Date assessed
Description

Never in CR: Date assessed

Data type

date

Date of last follow up or death
Description

Date of last follow up or death

Data type

date

Alias
UMLS CUI [1,1]
C3694716
UMLS CUI [1,2]
C0011065
Date of last follow up or death
Description

Date of last follow up or death

First Relapse or Progression after HSCT
Description

First Relapse or Progression after HSCT

Data type

text

Date assessed
Description

Date assessed

Data type

date

Date first seen
Description

Date first seen

Data type

date

Relapse/progression detected by clinical/haematological method
Description

Relapse/progression detected by clinical/haematological method

Data type

text

Date assessed
Description

Date assessed

Data type

date

Date first seen
Description

Date first seen

Data type

date

Relapse/progression detected by cytogenetic method
Description

Relapse/progression detected by cytogenetic method

Data type

integer

Date assessed
Description

Date assessed

Data type

date

Date first seen
Description

Date first seen

Data type

date

Relapse/progression detected by molecular method
Description

Relapse/progression detected by molecular method

Data type

integer

Date assessed
Description

Date assessed

Data type

date

Date first seen
Description

Date first seen

Data type

date

DISEASE PRESENCE/DETECTION AT LAST CONTACT
Description

DISEASE PRESENCE/DETECTION AT LAST CONTACT

Was disease detected by clinical/haematological method?:
Description

Was disease detected by clinical/haematological method?:

Data type

date

Last date assessed
Description

Last date assessed

Data type

date

Was disease detected by cytogenetic/FISH method?:
Description

Was disease detected by cytogenetic/FISH method?:

Data type

integer

Considered disease relapse/progression
Description

Considered disease relapse/progression

Data type

boolean

Last date assessed
Description

Last date assessed

Data type

date

PATIENT STATUS AT LAST CONTACT
Description

PATIENT STATUS AT LAST CONTACT

Survival Status
Description

Survival Status

Data type

text

Check here if patient lost to follow up
Description

Check here if patient lost to follow up

Data type

boolean

Main Cause of Death
Description

Cause of Death

Data type

integer

Alias
UMLS CUI [1]
C0007465
HSCT related cause
Description

HSCT related cause

Data type

integer

Date of this HSCT
Description

DATE OF NEXT HSCT

Data type

date

COVER PAGE FOR HISTOCOMPATIBILITY REPORTS
Description

COVER PAGE FOR HISTOCOMPATIBILITY REPORTS

EBMT Code (CIC):
Description

EBMT Code (CIC):

Data type

text

Name of the hospital
Description

Hospital

Data type

text

Alias
UMLS CUI [1]
C0019994
Unit:
Description

Unit:

Data type

text

Contact person
Description

Contact person

Data type

text

e-mail
Description

e-mail

Data type

text

Has the HSCT been registered in the EBMT database ?
Description

Has the HSCT been registered in the EBMT database ?

Data type

boolean

Alias
UMLS CUI [1]
C0421512
If Yes: UIC number
Description

Has the HSCT been registered in the EBMT database ?

Data type

text

Hospital Unique Patient Number/ Code
Description

Hospital Unique Patient Number/ Code

Data type

text

Initials
Description

Initials

Data type

text

Gender
Description

Gender

Data type

text

Date of Birth
Description

Date of Birth

Data type

date

Date of HSCT
Description

Date of HSCT

Data type

date

Donor ID
Description

Donor ID

Data type

text

PATIENT ETHNIC OR RACIAL ORIGIN
Description

PATIENT ETHNIC OR RACIAL ORIGIN

Ethnic Group
Description

Ethnic Group

Data type

text

Race
Description

Race

Data type

text

DISEASE OF SECONDARY ORIGIN
Description

DISEASE OF SECONDARY ORIGIN

Agents involved Tick all that apply:
Description

Agents involved

Data type

text

MOLECULAR BIOLOGYCompulsory for CIBMTR Research centres. Fill only for MPS. Janus kinase 2 (jak2)
Description

MOLECULAR BIOLOGY

Data type

integer

THERAPY GIVEN PRIOR TO THIS HSCT
Description

THERAPY GIVEN PRIOR TO THIS HSCT

THERAPY GIVEN PRIOR TO THIS HSCT
Description

THERAPY GIVEN PRIOR TO THIS HSCT

Data type

boolean

Date started
Description

THERAPY GIVEN PRIOR TO THIS HSCT

Data type

date

Tyrosine kinase receptor antagonist given
Description

Tyrosine kinase receptor antagonist given

Data type

boolean

if yes, please specify
Description

Tyrosine kinase receptor antagonist given

Data type

integer

Other agent, Fill only for CML
Description

Other agent

Data type

text

Were there any clinically significant co-existing disease or organ impairment at time of patient assessment prior to preparative (conditioning) regimen?
Description

Were there any clinically significant co-existing disease or organ impairment at time of patient assessment prior to preparative (conditioning) regimen?

Data type

boolean

Comorbidity
Description

Comorbidity

Solid tumour, previously present
Description

Treated at any time point in the patient's past history, excluding nonmelanoma skin cancer

Data type

integer

limited food choices due to celiac sprue or inflammatory bowel disease
Description

Crohn's disease or ulcerative colitis

Data type

integer

Alias
UMLS CUI [1]
C0021390
Rheumatologic
Description

SLE, RA, polymyositis, mixed CTD, or polymyalgia rheumatica

Data type

integer

Infection
Description

Requiring continuation of antimicrobial treatment after day 0

Data type

integer

Diabetes
Description

Requiring treatment with insulin or oral hypoglycaemics but not diet alone

Data type

integer

Renal: moderate/severe
Description

Serum creatinine > 2 mg/dL or >177 μmol/L, on dialysis, or prior renal transplantation

Data type

integer

Hepatic: mild
Description

Chronic hepatitis, bilirubin between Upper Limit Normal (ULN) and 1.5 x the ULN, or AST/ALT between ULN and 2.5 × ULN

Data type

integer

Hepatic: moderate/severe
Description

Liver cirrhosis, bilirubin greater than 1.5 × ULN, or AST/ALT greater than 2.5 × ULN

Data type

integer

Arrhythmia
Description

Atrial fibrillation or flutter, sick sinus syndrome, or ventricular arrhythmias

Data type

integer

Cardiac CARDIAC
Description

Coronary artery disease, congestive heart failure, myocardial infarction, or EF ≤ 50%

Data type

integer

Cerebrovascular disease
Description

Transient ischemic attack or cerebrovascular accident

Data type

integer

Heart valve disease
Description

Except mitral valve prolapse

Data type

integer

Pulmonary: moderate
Description

DLco and/or FEV1 66-80% or dyspnoea on slight activity

Data type

integer

Pulmonary severe
Description

DLco and/or FEV1 ≤ 65% or dyspnoea at rest or requiring oxygen

Data type

integer

Obesity
Description

Patients with a body mass index > 35 kg/m2

Data type

integer

Peptic ulcer
Description

Peptic ulcer

Data type

integer

Psychiatric disturbance
Description

Depression or anxiety requiring psychiatric consult or treatment

Data type

integer

if other Comorbidity, please specify
Description

Other Comorbidity

Data type

text

GRAFT PERFORMANCE Compulsory for CIBMTR Research centres
Description

GRAFT PERFORMANCE Compulsory for CIBMTR Research centres

(Platelets >20X109 /L; first of 3 consecutive days)
Description

Platelet reconstitution

Data type

text

Date Platelets > 20 x 10 9 /l
Description

Date Platelets > 20 x 10 9 /l

Data type

date

GRAFT PERFORMANCE
Description

GRAFT PERFORMANCE

Platelet reconstitution (Platelets >20X109 /L; first of 3 consecutive days)
Description

Platelet reconstitution

Data type

text

Date Platelets > 20 x 10 9 /l
Description

Date Platelets > 20 x 10 9 /l

Data type

date

PLANNED THERAPY GIVEN AFTER THIS HSCT, Date started
Description

Compulsory for CIBMTR Research centres. Fill in only if you answered Yes: Planned to the question on Disease treatment under Additional treatment

Data type

date

Chemo/drug
Description

Chemo/drug

Data type

boolean

if yes
Description

Chemo/drug

Data type

integer

Radiotherapy
Description

Radiotherapy

Data type

boolean

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 1
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 1

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number/Code (UPN)
Description

Hospital Unique Patient Number/Code (UPN)

Data type

text

Date of Initial Diagnosis
Description

Date of Initial Diagnosis

Data type

date

Classification
Description

Classification

AML with recurrent genetic abnormalities
Description

AML with recurrent genetic abnormalities

Data type

integer

AML not otherwise categorised
Description

AML not otherwise categorised

Data type

integer

Precursor Lymphoid Neoplasms (old ALL)
Description

Precursor Lymphoid Neoplasms (old ALL)

Data type

integer

AML transformed from
Description

AML transformed from

Data type

integer

Secondary origin
Description

Secondary origin

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

Status at HSCT
Description

Status at HSCT

Data type

integer

NUMBER (complete only for CR or relapse)
Description

NUMBER

Data type

integer

Cytogenetic FOR COMPLETE REMISSION ONLY, TYPE OF REMISSION
Description

Cytogenetic

Data type

integer

Molecular FOR COMPLETE REMISSION ONLY, TYPE OF REMISSION
Description

Molecular

Data type

integer

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 2
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 2

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of initial diagnosis
Description

Date of initial diagnosis

Data type

date

Alias
UMLS CUI [1]
C2316983
Classification
Description

Classification

At least one investigation must be positive: Translocation (9;22)
Description

Translocation (9;22)

Data type

text

Alias
UMLS CUI [1]
C3897138
At least one investigation must be positive: bcr-abl
Description

bcr-abl

Data type

text

Alias
UMLS CUI [1]
C1835417
Date of this HSCT
Description

Date of this HSCT

Data type

date

Status at HSCT Phase
Description

Status at HSCT

Data type

integer

NUMBER
Description

NUMBER

Data type

integer

Haematological
Description

Haematological

Data type

text

Cytogenetic (t[9;22))
Description

Cytogenetic (t[9;22))

Data type

integer

Molecular (bcr-abl)
Description

Molecular (bcr-abl)

Data type

integer

Classification
Description

Classification

Classification
Description

Classification

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

Status at HSCT
Description

Status at HSCT

Data type

integer

HSCT - Minimum Essential Data – A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 3
Description

HSCT - Minimum Essential Data – A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 3

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of Initial Diagnosis
Description

Date of Initial Diagnosis

Data type

date

Mature B-cell Neoplasms
Description

Mature B-cell Neoplasms

Data type

integer

Follicular lymphoma
Description

Follicular lymphoma

Data type

integer

Mature T-cell & NK-cell Neoplasms
Description

Mature T-cell & NK-cell Neoplasms

Data type

integer

Hodgkin
Description

Hodgkin

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

STATUS HSCT
Description

STATUS HSCT

Data type

integer

NUMBER complete only for CR, PR>1 or relapse
Description

NUMBER

Data type

integer

SENSITIVITY TO CHEMOTHERAPY (complete only for relapse)
Description

SENSITIVITY TO CHEMOTHERAPY

Data type

text

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 4
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 4

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of initial diagnosis
Description

Date of initial diagnosis

Data type

date

Alias
UMLS CUI [1]
C2316983
WHO Classification at diagnosis
Description

WHO Classification at diagnosis

Data type

integer

FAB Classification at diagnosis
Description

FAB Classification at diagnosis

Data type

integer

Status at HSCT Treated with chemotherapy
Description

Status at HSCT

Data type

integer

NUMBER (complete for CR or relapse)
Description

NUMBER

Data type

text

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 5
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 5

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of Initial Diagnosis
Description

Date of Initial Diagnosis

Data type

date

Classification at diagnosis
Description

Classification at diagnosis

Data type

integer

Classification at HSCT
Description

Classification at HSCT

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

CMML (including Transformed to AML) / Atypical CML Status at HSCT
Description

Treated with chemotherapy

Data type

integer

NUMBER (complete for CR or relapse)
Description

NUMBER

Data type

integer

jMML
Description

jMML

Data type

integer

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 6
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 6

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of initial diagnosis
Description

Date of initial diagnosis

Data type

date

Alias
UMLS CUI [1]
C2316983
Classification at diagnosis
Description

Classification at diagnosis

Data type

integer

Secondary origin (other than transformed to AML)
Description

Secondary origin

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

Classification at HSCT
Description

Classification at HSCT

Data type

integer

if other, please specify
Description

Classification at HSCT

Data type

text

Status at HSCT Treated with chemotherapy
Description

Status at HSCT

Data type

text

NUMBER (complete for CR or relapse)
Description

NUMBER (complete for CR or relapse)

Data type

integer

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 7
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 7

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of Initial Diagnosis
Description

Date of Initial Diagnosis

Data type

date

Classification
Description

Classification

Data type

integer

LIGHT CHAIN TYPE
Description

LIGHT CHAIN TYPE

Data type

text

SALMON & DURIE STAGE AT DIAGNOSIS (Multiple Myeloma only)
Description

SALMON & DURIE STAGE AT DIAGNOSIS

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

Status at HSCT
Description

Status at HSCT

Data type

text

NUMBER (complete for sCR, CR,VGPR, PR or relapse)
Description

NUMBER (complete for sCR, CR,VGPR, PR or relapse)

Data type

integer

BONE MARROW FAILURE SYNDROMES including APLASTIC ANAEMIA (main disease code 7)ISMC
Description

BONE MARROW FAILURE SYNDROMES including APLASTIC ANAEMIA (main disease code 7)ISMC

Classification
Description

Classification

Data type

integer

Acquired Severe Aplastic Anaemia (SAA)
Description

Acquired Severe Aplastic Anaemia (SAA)

Data type

integer

Congenital
Description

Congenital

Data type

integer

if other, please specify
Description

Congenital

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

HAEMOGLOBINOPATHY Classification
Description

HAEMOGLOBINOPATHY Classification

Data type

text

if other, please specify
Description

HAEMOGLOBINOPATHY Classification

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 8
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 8

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of initial diagnosis
Description

Date of initial diagnosis

Data type

date

Alias
UMLS CUI [1]
C2316983
Staging at Diagnosis METASTASES
Description

Staging at Diagnosis

Data type

text

STAGE (complete only if No distant metastasis)
Description

STAGE

Data type

integer

CLASSIFICATION
Description

CLASSIFICATION

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

Status at HSCT
Description

Status at HSCT

Data type

integer

Status at HSCT
Description

Complete remission (CR)

Data type

integer

Relapse
Description

Relapse

Data type

integer

OTHER MALIGNANCIES (main disease code 5) Classification:
Description

OTHER MALIGNANCIES (main disease code 5) Classification

Data type

text

if other, please specify
Description

Classification

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

Status at HSCT
Description

Status at HSCT

Data type

text

Complete remission (CR)
Description

Complete remission (CR)

Data type

integer

NUMBER (complete only for CR or relapse)
Description

NUMBER

Data type

integer

SENSITIVITY TO CHEMOTHERAPY (complete only for relapse)
Description

SENSITIVITY TO CHEMOTHERAPY

Data type

integer

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 9
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 9

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of Initial Diagnosis
Description

Date of Initial Diagnosis

Data type

date

Classification PRIMARY IMMUNE DEFICIENCIES (main disease code 8)
Description

Classification

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

INHERITED DISORDERS OF METABOLISM (main disease code 8) DISMCLFD INHDIS Classification
Description

INHERITED DISORDERS OF METABOLISM (main disease code 8) DISMCLFD INHDIS Classification

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

Classification
Description

INHERITED DISORDERS OF METABOLISM (main disease code 8)

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

Classification
Description

PLATELET and OTHER INHERITED DISORDERS (main disease code 8)

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

Classification
Description

HISTIOCYTIC DISORDERS (main disease code 9)

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 10
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 10

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of initial diagnosis
Description

Date of initial diagnosis

Data type

date

Alias
UMLS CUI [1]
C2316983
Name of Referring Physician
Description

Name of Referring Physician

Data type

text

Address
Description

Address

Data type

text

Fax
Description

Fax

Data type

text

Email
Description

Email

Data type

text

Classification CONNECTIVE TISSUE DISEASE
Description

AUTOIMMUNE DISORDERS – I (main disease code 10)

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

Involvement/Clinical problem
Description

diffuse cutaneous

Data type

boolean

Involvement/Clinical problem
Description

limited cutaneous

Data type

boolean

Involvement/Clinical problem
Description

lung parenchyma

Data type

boolean

Involvement/Clinical problem
Description

pulmonary hypertension

Data type

boolean

Involvement/Clinical problem
Description

systemic hypertension

Data type

boolean

Involvement/Clinical problem
Description

renal (biopsy type

Data type

boolean

Involvement/Clinical problem
Description

oesophagus

Data type

boolean

Involvement/Clinical problem
Description

other GI tract

Data type

boolean

Involvement/Clinical problem
Description

Raynaud

Data type

boolean

Involvement/Clinical problem
Description

CREST

Data type

boolean

Indication for HSCT
Description

diffuse cutaneous

Data type

boolean

Indication for HSCT
Description

limited cutaneous

Data type

boolean

Indication for HSCT
Description

lung parenchyma

Data type

boolean

Indication for HSCT
Description

pulmonary hypertension

Data type

boolean

Indication for HSCT
Description

systemic hypertension

Data type

boolean

Indication for HSCT
Description

renal (biopsy type

Data type

boolean

Indication for HSCT
Description

oesophagus

Data type

boolean

Indication for HSCT
Description

other GI tract

Data type

boolean

Indication for HSCT
Description

Raynaud

Data type

boolean

Indication for HSCT
Description

CREST

Data type

boolean

Antibodies studied
Description

Antibodies studied

Data type

integer

Scl 70 positive
Description

Scl 70 positive

Data type

text

ACA positive
Description

ACA positive

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

renal (biopsy type)
Description

renal

Data type

text

Presence
Description

renal

Data type

boolean

Indication for HSCT
Description

renal

Data type

boolean

CNS type
Description

CNS

Data type

text

CNS Presence
Description

CNS

Data type

boolean

CNS Indication for HSCT
Description

CNS

Data type

boolean

PNS type
Description

PNS

Data type

text

PNS Presence
Description

PNS

Data type

boolean

PNS Indication for HSCT
Description

PNS

Data type

boolean

lung Presence
Description

lung

Data type

boolean

lung Indication für HSCT
Description

lung

Data type

boolean

serositis Presence
Description

serositis

Data type

boolean

serositis Infication for HSCT
Description

serositis

Data type

boolean

arthritis Presence
Description

arthritis

Data type

boolean

arthritis Indication for HSCT
Description

arthritis

Data type

boolean

skin type
Description

skin

Data type

text

skin Presence
Description

skin

Data type

boolean

skin Indication for HSCT
Description

skin

Data type

boolean

haematological type
Description

haematological

Data type

text

haematological Presence
Description

haematological

Data type

boolean

haematological Indication for HSCT
Description

haematological

Data type

boolean

vasculitis type
Description

vasculitis

Data type

text

vasculitis Presence
Description

vasculitis

Data type

boolean

vasculitis Indication for HSCT
Description

vasculitis

Data type

boolean

Complement reduced
Description

Complement reduced

Data type

integer

Antibodies studied if yes
Description

Antibodies studied

Data type

text

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 11
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 11

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of Initial Diagnosis
Description

Date of Initial Diagnosis

Data type

date

Name of Referring Physician
Description

Name of Referring Physician

Data type

text

Address
Description

Address

Data type

text

Fax
Description

Fax

Data type

text

Email
Description

Email

Data type

text

Alias
UMLS CUI [1]
C0013849
UTOIMMUNE DISORDERS – II (main disease code 10) Classification
Description

UTOIMMUNE DISORDERS – II (main disease code 10) Classification

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

proximal weakness Presence
Description

proximal weakness

Data type

boolean

proximal weakness Indication for HSCT
Description

proximal weakness

Data type

boolean

generalized weakness (including bulbar) Presence
Description

generalized weakness (including bulbar)

Data type

boolean

generalized weakness (including bulbar) Indication for HSCT
Description

generalized weakness (including bulbar)

Data type

boolean

pulmonary fibrosis Presence
Description

pulmonary fibrosis

Data type

boolean

pulmonary fibrosis Indication for HSCT
Description

pulmonary fibrosis

Data type

boolean

vasculitis t<pe
Description

vasculitis

Data type

text

vasculitis Presence
Description

vasculitis

Data type

boolean

vasculitis Indication for HSCT
Description

vasculitis

Data type

boolean

Manifestation with
Description

Manifestation with

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

SICCA Presence
Description

SICCA

Data type

boolean

SICCA Indication for HSCT
Description

SICCA

Data type

boolean

exocrine gland swelling Presence
Description

exocrine gland swelling

Data type

boolean

exocrine gland swelling Indication for HSCT
Description

exocrine gland swelling

Data type

boolean

other organ lymphocytic infiltration Presence
Description

other organ lymphocytic infiltration

Data type

boolean

other organ lymphocytic infiltration Indication for HSCT
Description

other organ lymphocytic infiltration

Data type

boolean

lymphoma, paraproteinaemia Presence
Description

lymphoma, paraproteinaemia

Data type

boolean

lymphoma, paraproteinaemia Indication for HSCT
Description

lymphoma, paraproteinaemia

Data type

boolean

other, please specify
Description

other clinical problem

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

hrombosis type
Description

hrombosis

Data type

text

hrombosis Presence
Description

hrombosis

Data type

boolean

hrombosis Indication for HSCT
Description

hrombosis

Data type

boolean

CNS type
Description

CNS

Data type

text

CNS Presence
Description

CNS

Data type

boolean

CNS Indication for HSCT
Description

CNS

Data type

boolean

abortion Presence
Description

abortion

Data type

boolean

abortion Indication for HSCT
Description

abortion

Data type

boolean

skin (livido, vasculitis) Presence
Description

skin

Data type

boolean

skin (livido, vasculitis) Indication for HSCT
Description

skin (livido, vasculitis)

Data type

boolean

haematological type
Description

haematological

Data type

text

haematological Presence
Description

haematological

Data type

boolean

haematological Indication for HSCT
Description

haematological

Data type

boolean

if other, please specify
Description

Other Involvement/Clinical problem

Data type

text

Antibodies studied
Description

Antibodies studied

Data type

integer

Anticardiolipin lgG
Description

Anticardiolipin lgG

Data type

integer

Anticardiolipin lgM
Description

Anticardiolipin lgM

Data type

integer

if yes, please specify
Description

Other Antibodies studied

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 12
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 12

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of Initial Diagnosis
Description

Date of Initial Diagnosis

Data type

date

Name of Referring Physician
Description

Name of Referring Physician

Data type

text

Address
Description

Address

Data type

text

Fax
Description

Fax

Data type

text

Email
Description

Email

Data type

text

Alias
UMLS CUI [1]
C0013849
Classification VASCULITIS
Description

Classification VASCULITIS

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

upper respiratory tract Presence
Description

upper respiratory tract

Data type

boolean

upper respiratory tract Indication for HSCT
Description

upper respiratory tract

Data type

boolean

pulmonary Presence
Description

pulmonary

Data type

boolean

pulmonary Indication for HSCT
Description

pulmonary

Data type

boolean

renal biobsy type
Description

renal

Data type

text

renal Presence
Description

renal

Data type

boolean

renal Indication for HSCT
Description

renal

Data type

boolean

skin Presence
Description

skin

Data type

boolean

skin Indication for HSCT
Description

skin

Data type

boolean

If Other Involvement / Clinical problem please specify
Description

Other Involvement / Clinical problem

Data type

text

Antibodies studied
Description

Antibodies studied

Data type

integer

c-ANCA
Description

c-ANCA

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

renal type
Description

renal

Data type

text

renal Presence
Description

renal

Data type

boolean

renal Indication for HSCT
Description

renal

Data type

boolean

mononeuritis multiplex Presence
Description

mononeuritis multiplex

Data type

boolean

mononeuritis multiplex Indication for HSCT
Description

mononeuritis multiplex

Data type

boolean

pulmonary haemorrhage Presence
Description

pulmonary haemorrhage

Data type

boolean

pulmonary haemorrhage Indication for HSCT
Description

pulmonary haemorrhage

Data type

boolean

skin presence
Description

skin

Data type

boolean

skin Indication for HSCT
Description

skin

Data type

boolean

GI tract Presence
Description

GI tract

Data type

boolean

GI tract Indication for HSCT
Description

GI tract

Data type

boolean

if other Involvement/Clinical problem, please specify
Description

Involvement/Clinical problem

Data type

text

Antibodies studied
Description

Antibodies studied

Data type

integer

p-ANCA
Description

p-ANCA

Data type

integer

c-ANCA
Description

c-ANCA

Data type

integer

Hepatitis serology
Description

Hepatitis serology

Data type

integer

Other vasculitis
Description

Other vasculitis

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 13
Description

HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 13

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of Initial Diagnosis
Description

Date of Initial Diagnosis

Data type

date

Name of Referring Physician
Description

Name of Referring Physician

Data type

text

Address
Description

Address

Data type

text

Fax
Description

Fax

Data type

text

Email
Description

Email

Data type

text

Alias
UMLS CUI [1]
C0013849
AUTOIMMUNE DISORDERS – IV (main disease code 10) ARTHRITIS
Description

AUTOIMMUNE DISORDERS – IV (main disease code 10) ARTHRITIS

Data type

integer

Date of this HSCT
Description

Date of this HSCT

Data type

date

destructive arthritis Presence
Description

destructive arthritis

Data type

boolean

destructive arthritis Indication for HSCT
Description

destructive arthritis

Data type

boolean

eye type
Description

eye

Data type

text

eye Presence
Description

eye

Data type

boolean

eye Indication for HSCT
Description

eye

Data type

boolean

pulmonary Presence
Description

pulmonary

Data type

boolean

pulmonary Indication for HSCT
Description

pulmonary

Data type

boolean

if extra articular, please specify
Description

extra articular

Data type

text

extra articular Presence
Description

extra articular

Data type

boolean

extra articular Indication for HSCT
Description

extra articular

Data type

boolean

Date of this HSCT
Description

Date of this HSCT

Data type

date

destructive arthritis Presence
Description

destructive arthritis

Data type

boolean

destructive arthritis Indication for HSCT
Description

destructive arthritis

Data type

boolean

psoriasis Presence
Description

psoriasis

Data type

text

psoriasis Indication for HSCT
Description

psoriasis

Data type

boolean

Date of this HSCT
Description

Date of this HSCT

Data type

date

MULTIPLE SCLEROSIS
Description

MULTIPLE SCLEROSIS

Data type

boolean

Date of this HSCT
Description

Date of this HSCT

Data type

date

MULTIPLE SCLEROSIS
Description

MULTIPLE SCLEROSIS

Data type

integer

OTHER NEUROLOGICAL AUTOIMMUNE DISEASE
Description

OTHER NEUROLOGICAL AUTOIMMUNE DISEASE

Data type

text

Other autoimmune neurological disorder, specify
Description

Other autoimmune neurological disorder

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

HAEMATOLOGICAL AUTOIMMUNE DISEASES
Description

HAEMATOLOGICAL AUTOIMMUNE DISEASES

Data type

integer

other autoimmune cytopenia, specify
Description

other autoimmune cytopenia

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

BOWEL DISEASE
Description

BOWEL DISEASE

Data type

text

Other autoimmune bowel disease, specify
Description

Other autoimmune bowel disease

Data type

text

Date of this HSCT
Description

Date of this HSCT

Data type

date

HSCT - Minimum Essential Data - A Follow up report: 1 year post transplant and annually thereafter
Description

HSCT - Minimum Essential Data - A Follow up report: 1 year post transplant and annually thereafter

PRIMARY DISEASE DIAGNOSIS
Description

PRIMARY DISEASE DIAGNOSIS

Data type

text

EBMT Code (CIC)
Description

EBMT Code (CIC)

Data type

text

Hospital:
Description

Hospital:

Data type

text

Hospital
Description

Klinik

Data type

text

Alias
UMLS CUI [1]
C0019994
Unit
Description

Unit

Data type

text

Name of contact person
Description

Contact person

Data type

text

Alias
UMLS CUI [1]
C0337611
Date of this Report
Description

Date of this Report

Data type

date

Patient following national / international study / trial
Description

Patient following national / international study / trial

Data type

integer

Name of study / trial
Description

Name of study / trial

Data type

text

Hospital Unique Patient Number/Code (Compulsory, registrations will not be accepted without this item)
Description

Hospital Unique Patient Number/Code

Data type

text

Initials
Description

Initials

Data type

text

Date of Birth
Description

Date of Birth

Data type

date

Sex
Description

Sex

Data type

text

Alias
UMLS CUI [1]
C0079399
Date of the most recent transplant before this follow up
Description

Date of the most recent transplant before this follow up

Data type

date

Best disease status (response) after transplant (prior to treatment modification in response to a post transplant disease assessment)
Description

Best disease status (response) after transplant

Data type

integer

Date achieved
Description

Date achieved

Data type

date

Date assessed
Description

Date assessed

Data type

date

Date of last follow up or death
Description

Date of last follow up or death

Data type

date

Chronic Graft Versus Host Disease present during this period (allografts only)
Description

Chronic Graft Versus Host Disease present during this period

Data type

text

Date of diagnosis of cGvHD
Description

Date of diagnosis of cGvHD

Data type

date

Date first evidence of cGVHD during this period
Description

Date first evidence of cGVHD during this period

Data type

date

Maximum extent during this period
Description

Maximum extent during this period

Data type

integer

Late graft failure (allografts only)
Description

Late graft failure (allografts only)

Data type

boolean

Did a secondary malignancy, lymphoproliferative or myeloproliferative disorder occur?
Description

Did a secondary malignancy, lymphoproliferative or myeloproliferative disorder occur?

Data type

boolean

Date of diagnosis
Description

Date of diagnosis

Data type

date

Diagnosis:
Description

Diagnosis:

Data type

text

ADDITIONAL DISEASE TREATMENT INCLUDING CELL THERAPY
Description

ADDITIONAL DISEASE TREATMENT INCLUDING CELL THERAPY

Data type

boolean

Date
Description

ADDITIONAL DISEASE TREATMENT INCLUDING CELL THERAPY

Data type

date

Additional cell infusion (not HSCT or auto re-infusion)
Description

Additional cell infusion (not HSCT or auto re-infusion)

Data type

boolean

Other treatment of disease
Description

Other treatment of disease

Data type

integer

First Relapse or Progression after HSCT
Description

First Relapse or Progression after HSCT

Data type

text

Date assessed
Description

Date assessed

Data type

date

Date first seen
Description

Date first seen

Data type

date

Relapse/progression detected by clinical/haematological method
Description

Relapse/progression detected by clinical/haematological method

Data type

integer

Date assessed
Description

Date assessed

Data type

date

Date first seen
Description

Date first seen

Data type

date

Relapse/progression detected by cytogenetic method
Description

Relapse/progression detected by cytogenetic method

Data type

integer

Date assessed
Description

Date assessed

Data type

boolean

Date first seen
Description

Date first seen

Data type

date

Relapse/progression detected by molecular method
Description

Relapse/progression detected by molecular method

Data type

integer

Date assessed
Description

Date assessed

Data type

date

Date first seen
Description

Date first seen

Data type

date

Was disease detected by clinical/haematological method?:
Description

Last disease status (record the most recent status and date for each method, relating to the initial disease for which HSCT was given)

Data type

integer

Last date assessed
Description

Last date assessed

Data type

date

Was disease detected by cytogenetic/FISH method?:
Description

Was disease detected by cytogenetic/FISH method?:

Data type

boolean

Considered disease relapse/progression
Description

Considered disease relapse/progression

Data type

boolean

Last date assessed
Description

Last date assessed

Data type

date

Was disease detected by molecular method? Fill in only for acute and chronic LEUKAEMIAS
Description

Was disease detected by molecular method?

Data type

integer

Considered disease relapse/progression
Description

Considered disease relapse/progression

Data type

boolean

Last date assessed
Description

Last date assessed

Data type

date

Has patient or partner become pregnant after this transplant?
Description

Has patient or partner become pregnant after this transplant?

Data type

integer

Survival Status
Description

Survival Status

Data type

integer

Alias
UMLS CUI [1]
C1148433
Check here if patient lost to follow up
Description

Check here if patient lost to follow up

Data type

boolean

Main Cause of Death
Description

Cause of Death

Data type

integer

Alias
UMLS CUI [1]
C0007465
HSCT Related Cause
Description

HSCT Related Cause

Data type

text

HSCT Related Cause if other, please specify
Description

HSCT Related Cause

Data type

text

HSCT - Minimum Essential Data - A Follow up report: Annual follow up CELL INFUSION (CI) SHEET
Description

HSCT - Minimum Essential Data - A Follow up report: Annual follow up CELL INFUSION (CI) SHEET

EBMT Centre Identification Code (CIC)
Description

EBMT Centre Identification Code (CIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number/Code
Description

Hospital Unique Patient Number/Code

Data type

text

Date of first infusion
Description

Date of first infusion

Data type

date

Disease status before this CI
Description

Disease status before this CI

Data type

integer

Date of first infusion
Description

Date of first infusion

Data type

date

Disease status before this CI
Description

Disease status before this CI

Data type

integer

Cell infusion (CI) regimen (not HSCT or autologous stem cell re-infusion) Type of cell(s): (check all that apply)
Description

Cell infusion (CI) regimen

Data type

text

if other, please specify
Description

Cell infusion (CI) regimen

Data type

text

Chronological no. of CI for this patient
Description

Chronological no. of CI for this patient

Data type

text

Indication
Description

Indication

Data type

integer

Number of infusions within 10 weeks (count only infusions that are part of same regimen and given for the same indication)
Description

Infusion count

Data type

float

Alias
UMLS CUI [1,1]
C0574032
UMLS CUI [1,2]
C0750480
Maximum Grade
Description

Maximum Grade

Data type

integer

Similar models

20pp 100days past HSCT 02MED

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
CENTRE IDENTIFICATION
EBMT Code (CIC)
Item
EBMT Code (CIC)
text
Klinik
Item
Hospital
text
C0019994 (UMLS CUI [1])
Unit
Item
Unit
text
Contact person
Item
Contact person
text
Phone
Item
Phone
text
Fax
Item
Fax
text
e-mail
Item
e-mail
text
Item Group
PATIENT DATA
Date of this report
Item
Date of this report
date
C1302584 (UMLS CUI [1])
Item
Patient following national / international study / trial
integer
C1997894 (UMLS CUI [1])
Code List
Patient following national / international study / trial
CL Item
no (1)
CL Item
yes (2)
CL Item
unknown (3)
Name of study / trial
Item
Name of study / trial
text
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Initials
Item
Initials (first name(s) _family name(s))
text
PersonBirthDate
Item
Date of Birth
date
C0027361 (UMLS CUI [1,1])
C0005615 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item
Sex
text
C0079399 (UMLS CUI [1])
Code List
Sex
CL Item
Male (1)
CL Item
Female (2)
Item Group
DISEASE
Date of initial diagnosis
Item
Date of initial diagnosis
date
C2316983 (UMLS CUI [1])
PRIMARY DISEASE DIAGNOSIS
Item
PRIMARY DISEASE DIAGNOSIS
text
Item Group
HSCT
Item
Performance score (if alive)
integer
C1518965 (UMLS CUI [1])
Code List
Performance score (if alive)
CL Item
Karnofsky (1)
CL Item
Lansky (2)
Item
Score achived
text
C1518965 (UMLS CUI [1])
Code List
Score achived
CL Item
10 (1)
CL Item
100 (10)
CL Item
20 (2)
CL Item
30 (3)
CL Item
40 (4)
CL Item
50 (5)
CL Item
60 (6)
CL Item
70 (7)
CL Item
80 (8)
CL Item
90 (9)
Item
Type of HSCT
integer
Code List
Type of HSCT
CL Item
Autologous (1)
CL Item
Allogeneic (2)
Item
Patient CMV status (for allografts)
text
Code List
Patient CMV status (for allografts)
CL Item
Negative  (Negative )
CL Item
Positive (Positive)
CL Item
Not evaluated  (Not evaluated )
CL Item
Unknown (Unknown)
Multiple donors/products
Item
Multiple donors/products
boolean
Multiple donors/products
Item
if yes, Number (including multiple CB units or different stem cell products from same donor)
text
Item Group
STEM CELLS (autograft or allograft)
Item
Source of Stem Cells (check all that apply)
text
Code List
Source of Stem Cells (check all that apply)
CL Item
Bone Marrow VBMSC  (Bone Marrow VBMSC )
CL Item
Peripheral Blood VPBSC (Peripheral Blood VPBSC)
CL Item
Cord Blood VCBSC  (Cord Blood VCBSC )
CL Item
Other (Other)
Source of Stem Cells
Item
if other, please specify
text
Donor ID
Item
Donor ID
text
C1718162 (UMLS CUI [1])
Item
if autograft, go to Graft manipulation below
integer
Code List
if autograft, go to Graft manipulation below
CL Item
N/A (1)
Item
HLA match type (for allografts)
text
Code List
HLA match type (for allografts)
CL Item
Syngeneic (monozygotic twin) (Syngeneic (monozygotic twin))
CL Item
HLA-identical sibling (may include non-monozygotic twin)  (HLA-identical sibling (may include non-monozygotic twin) )
CL Item
HLA-matched other relative (HLA-matched other relative)
CL Item
HLA-mismatched relative (HLA-mismatched relative)
CL Item
Unrelated donor (Unrelated donor)
Item
Degree of mismatch
integer
Code List
Degree of mismatch
CL Item
1 HLA antigen mismatch (1)
CL Item
> 2 HLA antigen mismatch (2)
Name of donor registry/CB Bank
Item
Name of donor registry/CB Bank
text
BMDW/WMDA code (up to 4 characters)
Item
BMDW/WMDA code (up to 4 characters)
text
Item
Number of mismatches A
text
Code List
Number of mismatches A
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not done (ND)
Item
Number of mismatches B
text
Code List
Number of mismatches B
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not done (ND)
Item
Number of mismatches C
text
Code List
Number of mismatches C
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not done (ND)
Item
Number of mismatches DRB1
text
Code List
Number of mismatches DRB1
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not done (ND)
Item
Number of mismatches DQB1
text
Code List
Number of mismatches DQB1
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not done (ND)
Item
Number of mismatches DPB1
text
Code List
Number of mismatches DPB1
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not done (ND)
Item
Donor Sex
text
Code List
Donor Sex
CL Item
Male  (Male )
CL Item
Female (Female)
Item
Donor age
integer
Code List
Donor age
CL Item
Negative (1)
CL Item
Positive (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Graft manipulation ex-vivo (including T-cell depletion) other than for RBC removal or volume reduction
Item
Graft manipulation ex-vivo (including T-cell depletion) other than for RBC removal or volume reduction
boolean
Item Group
HSCT
Chronological number of HSCT for this patient?
Item
Chronological number of HSCT for this patient?
text
If >1, date of last HSCT before this one
Item
If >1, date of last HSCT before this one
date
Item
If >1, type of last HSCT before this one
text
Code List
If >1, type of last HSCT before this one
CL Item
Allo  (Allo )
CL Item
Auto  (Auto )
CL Item
N/A (N/A)
HSCT part of a planned multiple graft protocol?
Item
HSCT part of a planned multiple graft protocol?
boolean
Preparative (conditioning) regimen given?
Item
Preparative (conditioning) regimen given?
boolean
Was this intended to be myeloablative?
Item
Was this intended to be myeloablative?
boolean
Item
Reason
text
Code List
Reason
CL Item
Age of recipient (Age of recipient)
CL Item
Comorbid conditions (Comorbid conditions)
CL Item
Prior HSCT (Prior HSCT)
CL Item
Protocol driven REASRIOT (Protocol driven REASRIOT)
CL Item
Other (Other)
Reason
Item
if other reason, please specify
text
Ara-C (cytarabine)
Item
Ara-C (cytarabine)
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
ALG, ATG (ALS, ATS)
Item
ALG, ATG (ALS, ATS)
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Item
Animal origin
integer
Code List
Animal origin
CL Item
Horse  (1)
CL Item
Rabbit  (2)
CL Item
Other (3)
Animal origin
Item
Animal origin if other, please specify
text
Bleomycin
Item
Bleomycin
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Busulfan
Item
Busulfan
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Item
Busulfan
integer
Code List
Busulfan
CL Item
Oral  (1)
CL Item
IV  (2)
CL Item
Both (3)
BCNU
Item
BCNU
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Bexar (radiolabelled MoAB)
Item
Bexar (radiolabelled MoAB)
float
Item
unit of dosing
integer
Code List
unit of dosing
CL Item
mCi  (1)
CL Item
MBq (2)
CCNU
Item
CCNU
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Campath (antiCD52)
Item
Campath (antiCD52)
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Carboplatin
Item
Carboplatin
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Cisplatin
Item
Cisplatin
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Corticosteroids
Item
Corticosteroids
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Cyclophosphamide
Item
Cyclophosphamide
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Daunorubicin
Item
Daunorubicin
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Doxorubicin (adriamycine)
Item
Doxorubicin (adriamycine)
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Etoposide (VP16)
Item
Etoposide (VP16)
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Fludarabine
Item
Fludarabine
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Gemtuzumab
Item
Gemtuzumab
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Idarubicin
Item
Idarubicin
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Ifosfamide
Item
Ifosfamide
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Imatinib mesylate
Item
Imatinib mesylate
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Melphalan
Item
Melphalan
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Mitoxantrone
Item
Mitoxantrone
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Paclitaxel
Item
Paclitaxel
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Rituximab (mabthera, antiCD20)
Item
Rituximab (mabthera, antiCD20)
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Teniposide
Item
Teniposide
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Thiotepa
Item
Thiotepa
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Zevalin (radiolabelled MoAB)
Item
Zevalin (radiolabelled MoAB)
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mCi  (1)
CL Item
MBq (2)
Other radiolabelled MoAB
Item
Other radiolabelled MoAB
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mCi  (1)
CL Item
MBq (2)
Other radiolabelled MoAB
Item
if other, please specify
text
Other MoAB
Item
Other MoAB
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Other
Item
Other
float
Item
Unit of dosing
integer
Code List
Unit of dosing
CL Item
mg/m2  (1)
CL Item
mg/Kg (2)
Total body irradiation
Item
Total body irradiation
boolean
C0043162 (UMLS CUI [1])
Total Body Irradiation
Item
if yes, please specify value
text
TLI, TNI, TAI
Item
TLI, TNI, TAI
boolean
TLI, TNI, TAI
Item
if yes, please specify value
text
Item Group
AFTER HSCT
GvHD prophylaxis or preventive treatment
Item
GvHD prophylaxis or preventive treatment (Allografts only)
boolean
Item
if yes, please specify
integer
Code List
if yes, please specify
CL Item
Drugs (Immunosuppressive chemo) VAGVHDP5 (1)
CL Item
ALG, ALS, ATG, ATS (given after day 0) (2)
CL Item
Anti CD25 (MoAB in vivo) (3)
CL Item
Campath (MoAB in vivo; can be "in the bag") (4)
CL Item
Corticosteroids (5)
CL Item
Cyclosporine (6)
CL Item
Cyclophosphamide (given after day 0) (7)
CL Item
Etanercept (MoAB in vivo) (8)
CL Item
FK 506 (Tacrolimus, Prograf) (9)
CL Item
Infliximab (MoAB in vivo) (10)
CL Item
Methotrexate (11)
CL Item
Mycophenolate (MMF) (12)
CL Item
Sirolimus (13)
CL Item
Other monoclonal antibody (in vivo), (14)
CL Item
specify (15)
CL Item
Other agent (in vivo), specify (16)
CL Item
Extracorporeal photopheresis (ECP) (17)
CL Item
Other, specify (18)
GvHD prophylaxis or preventive treatment
Item
if other agent, please specify
text
GvHD prophylaxis or preventive treatment
Item
if other, please specify
text
GvHD prophylaxis or preventive treatment
Item
if Other monoclonal antibody, please specify
text
Item
Absolute neutrophil count (ANC) recovery (engraftment) (Neutrophils >0.5X109 /L)
integer
Code List
Absolute neutrophil count (ANC) recovery (engraftment) (Neutrophils >0.5X109 /L)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Lost fraft (3)
CL Item
Never below (4)
CL Item
Unknown (5)
Date of last assessment
Item
Date of last assessment
date
Date of ANC recovery
Item
Date of ANC recovery
date
Date of last assessment
Item
Date of last assessment
date
Item
Maximum Grade
integer
Code List
Maximum Grade
CL Item
0 (none) (1)
CL Item
I (2)
CL Item
II (3)
CL Item
III (4)
CL Item
IV (5)
CL Item
Present but grade unknown (6)
CL Item
Not evaluated (7)
Item Group
ADDITIONAL TREATMENT INCLUDING CELL THERAPY
Cell infusion (CI)
Item
Cell infusion (CI)
boolean
Date of first infusion
Item
Date of first infusion
date
Item
Type of cell(s): (check all that apply)
integer
Code List
Type of cell(s): (check all that apply)
CL Item
Lymphocyte (DLI)  (1)
CL Item
Mesenchymal  (2)
CL Item
Fibroblasts (3)
CL Item
Dendritic cells  (4)
CL Item
Other (5)
Type of cell(s): (check all that apply)
Item
if other, please specify
text
Chronological no. of CI for this patient
Item
Chronological no. of CI for this patient
text
Item
Indication (check all that apply)
text
C3146298 (UMLS CUI [1,1])
C0302189 (UMLS CUI [1,2])
Code List
Indication (check all that apply)
CL Item
Loss/decreased chimaerism (Loss/decreased chimaerism)
CL Item
Mixed chimaerism (Mixed chimaerism)
CL Item
Other (Other)
CL Item
Planned/ protocol (Planned/ protocol)
CL Item
Prophylactic (Prophylactic)
CL Item
Treatment for disease (Treatment for disease)
CL Item
Treatment of GvHD (Treatment of GvHD)
CL Item
Treatment PTLD, EBV, lymphoma (Treatment PTLD, EBV, lymphoma)
CL Item
Treatment viral infection (Treatment viral infection)
Indication:
Item
if other, please specify
text
Infusion count
Item
Number of infusions within 10 weeks (count only infusions that are part of same regimen and given for the same indication)
float
C0574032 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
Item
Disease treatment
integer
C0087111 (UMLS CUI [1])
Code List
Disease treatment
CL Item
No (1)
CL Item
Yes: Planned (planned before HSCT took place) (2)
CL Item
Yes: Not planned (for relapse/progression or persistent disease) (3)
CL Item
Unknown (4)
Item Group
DISEASE STATUS
Item
Best disease status (response) after HSCT (prior to treatment modification in response to a post HSCT disease assessment)
integer
Code List
Best disease status (response) after HSCT (prior to treatment modification in response to a post HSCT disease assessment)
CL Item
Continued complete remission (CCR) (1)
CL Item
CR achieved: Date achieved (2)
CL Item
Never in CR: Date assessed (3)
CL Item
Not evaluated (4)
CR achieved: Date achieved
Item
CR achieved: Date achieved
date
Never in CR: Date assessed
Item
Never in CR: Date assessed
date
Date of last follow up or death
Item
Date of last follow up or death
date
C3694716 (UMLS CUI [1,1])
C0011065 (UMLS CUI [1,2])
Item Group
Date of last follow up or death
Item
First Relapse or Progression after HSCT
text
Code List
First Relapse or Progression after HSCT
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Continuous progression since HSCT (Continuous progression since HSCT)
Date assessed
Item
Date assessed
date
Date first seen
Item
Date first seen
date
Item
Relapse/progression detected by clinical/haematological method
text
Code List
Relapse/progression detected by clinical/haematological method
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Mot evaluated (Mot evaluated)
Date assessed
Item
Date assessed
date
Date first seen
Item
Date first seen
date
Item
Relapse/progression detected by cytogenetic method
integer
Code List
Relapse/progression detected by cytogenetic method
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Date assessed
Item
Date assessed
date
Date first seen
Item
Date first seen
date
Item
Relapse/progression detected by molecular method
integer
Code List
Relapse/progression detected by molecular method
CL Item
No  (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Date assessed
Item
Date assessed
date
Date first seen
Item
Date first seen
date
Item Group
DISEASE PRESENCE/DETECTION AT LAST CONTACT
Was disease detected by clinical/haematological method?:
Item
Was disease detected by clinical/haematological method?:
date
Last date assessed
Item
Last date assessed
date
Item
Was disease detected by cytogenetic/FISH method?:
integer
Code List
Was disease detected by cytogenetic/FISH method?:
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Considered disease relapse/progression
Item
Considered disease relapse/progression
boolean
Last date assessed
Item
Last date assessed
date
Item Group
PATIENT STATUS AT LAST CONTACT
Item
Survival Status
text
Code List
Survival Status
CL Item
Alive  (Alive )
CL Item
Dead  (Dead )
CL Item
Died before HSCT (Died before HSCT)
Check here if patient lost to follow up
Item
Check here if patient lost to follow up
boolean
Item
Main Cause of Death
integer
C0007465 (UMLS CUI [1])
Code List
Main Cause of Death
CL Item
Relapse or Progression (if indication: primary disease) (1)
CL Item
HSCT related (if applicable) (2)
CL Item
Cell Therapy  (3)
CL Item
Other (4)
CL Item
Unknown (5)
Item
HSCT related cause
integer
Code List
HSCT related cause
CL Item
GVHD GVH  (1)
CL Item
Cardiac Toxicity CTX (2)
CL Item
Rejection/Poor graft function REJ  (3)
CL Item
Infection INF (4)
CL Item
Pulmonary toxicity PTX  (5)
CL Item
Veno occlusive disorder (6)
CL Item
Other (7)
DATE OF NEXT HSCT
Item
Date of this HSCT
date
Item Group
COVER PAGE FOR HISTOCOMPATIBILITY REPORTS
EBMT Code (CIC):
Item
EBMT Code (CIC):
text
Hospital
Item
Name of the hospital
text
C0019994 (UMLS CUI [1])
Unit:
Item
Unit:
text
Contact person
Item
Contact person
text
e-mail
Item
e-mail
text
Has the HSCT been registered in the EBMT database ?
Item
Has the HSCT been registered in the EBMT database ?
boolean
C0421512 (UMLS CUI [1])
Has the HSCT been registered in the EBMT database ?
Item
If Yes: UIC number
text
Hospital Unique Patient Number/ Code
Item
Hospital Unique Patient Number/ Code
text
Initials
Item
Initials
text
Gender
Item
Gender
text
Date of Birth
Item
Date of Birth
date
Date of HSCT
Item
Date of HSCT
date
Donor ID
Item
Donor ID
text
Item
Ethnic Group
text
Code List
Ethnic Group
CL Item
Hispanic or Latino  (Hispanic or Latino )
CL Item
Not Hispanic or Latino (Not Hispanic or Latino)
Item
Race
text
Code List
Race
CL Item
White (White)
CL Item
Black (Black)
CL Item
Asian ETHNIC12  (Asian ETHNIC12 )
CL Item
American Indian/Alaska Native  (American Indian/Alaska Native )
CL Item
Native Hawaiian/Other Pacific Islander (Native Hawaiian/Other Pacific Islander)
Item Group
DISEASE OF SECONDARY ORIGIN
Item
Agents involved Tick all that apply:
text
Code List
Agents involved Tick all that apply:
CL Item
Alkylating agent/radiation-related (Alkylating agent/radiation-related)
CL Item
Topoisomerase II inhibitor-related (Topoisomerase II inhibitor-related)
CL Item
Unknown (Unknown)
Item
MOLECULAR BIOLOGYCompulsory for CIBMTR Research centres. Fill only for MPS. Janus kinase 2 (jak2)
integer
Code List
MOLECULAR BIOLOGYCompulsory for CIBMTR Research centres. Fill only for MPS. Janus kinase 2 (jak2)
CL Item
Absent  (1)
CL Item
Present  (2)
CL Item
Unknown (3)
Item Group
THERAPY GIVEN PRIOR TO THIS HSCT
THERAPY GIVEN PRIOR TO THIS HSCT
Item
THERAPY GIVEN PRIOR TO THIS HSCT
boolean
THERAPY GIVEN PRIOR TO THIS HSCT
Item
Date started
date
Tyrosine kinase receptor antagonist given
Item
Tyrosine kinase receptor antagonist given
boolean
Item
if yes, please specify
integer
Code List
if yes, please specify
CL Item
Imatinib mesylate (Gleevec, Glivec) (1)
CL Item
Dasatinib (Sprycel) (2)
CL Item
Nilotinib (Tasigna) (3)
CL Item
Other (4)
Item
Other agent, Fill only for CML
text
Code List
Other agent, Fill only for CML
CL Item
Combination chemotherapy  (Combination chemotherapy )
CL Item
Hydroxyurea (Hydroxyurea)
CL Item
Interferon (Interferon)
CL Item
Other (Other)
Were there any clinically significant co-existing disease or organ impairment at time of patient assessment prior to preparative (conditioning) regimen?
Item
Were there any clinically significant co-existing disease or organ impairment at time of patient assessment prior to preparative (conditioning) regimen?
boolean
Item Group
Comorbidity
Item
Solid tumour, previously present
integer
Code List
Solid tumour, previously present
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
limited food choices due to celiac sprue or inflammatory bowel disease
integer
C0021390 (UMLS CUI [1])
Code List
limited food choices due to celiac sprue or inflammatory bowel disease
CL Item
Combination chemotherapy  (Combination chemotherapy )
CL Item
Hydroxyurea (Hydroxyurea)
CL Item
Interferon (Interferon)
CL Item
Other (Other)
Item
Rheumatologic
integer
Code List
Rheumatologic
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Infection
integer
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Diabetes
integer
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Renal: moderate/severe
integer
Code List
Renal: moderate/severe
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Hepatic: mild
integer
Code List
Hepatic: mild
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Hepatic: moderate/severe
integer
Code List
Hepatic: moderate/severe
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Arrhythmia
integer
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Cardiac CARDIAC
integer
Code List
Cardiac CARDIAC
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Cerebrovascular disease
integer
Code List
Cerebrovascular disease
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Heart valve disease
integer
Code List
Heart valve disease
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Pulmonary: moderate
integer
Code List
Pulmonary: moderate
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Pulmonary severe
integer
Code List
Pulmonary severe
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Obesity
integer
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Peptic ulcer
integer
Code List
Peptic ulcer
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Psychiatric disturbance
integer
Code List
Psychiatric disturbance
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Other Comorbidity
Item
if other Comorbidity, please specify
text
Item Group
GRAFT PERFORMANCE Compulsory for CIBMTR Research centres
Item
(Platelets >20X109 /L; first of 3 consecutive days)
text
Code List
(Platelets >20X109 /L; first of 3 consecutive days)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Never below this lever (Never below this lever)
CL Item
Unknown (Unknown)
Date Platelets > 20 x 10 9 /l
Item
Date Platelets > 20 x 10 9 /l
date
Item
Platelet reconstitution (Platelets >20X109 /L; first of 3 consecutive days)
text
Code List
Platelet reconstitution (Platelets >20X109 /L; first of 3 consecutive days)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Never below this lever (Never below this lever)
CL Item
Unknown (Unknown)
Date Platelets > 20 x 10 9 /l
Item
Date Platelets > 20 x 10 9 /l
date
PLANNED THERAPY GIVEN AFTER THIS HSCT
Item
PLANNED THERAPY GIVEN AFTER THIS HSCT, Date started
date
Chemo/drug
Item
Chemo/drug
boolean
Item
if yes
integer
Code List
if yes
CL Item
Imatinib mesylate (Gleevec, Glivec) (Imatinib mesylate (Gleevec, Glivec))
CL Item
Dasatinib (Sprycel) (Dasatinib (Sprycel))
CL Item
Nilotinib (Tasigna) (Nilotinib (Tasigna))
CL Item
Bortezomib (Velcade) (Bortezomib (Velcade))
CL Item
Intrathecal chemotherapy (Intrathecal chemotherapy)
CL Item
Lenalidomide (Revlimid) (Lenalidomide (Revlimid))
CL Item
Rituximab (Rituxan, mabthera) (Rituximab (Rituxan, mabthera))
CL Item
Velafermin (FGF) (Velafermin (FGF))
CL Item
Lepivance (KGF, palifermin) (Lepivance (KGF, palifermin))
CL Item
Thalidomide (Thalidomide)
CL Item
Other (Other)
Radiotherapy
Item
Radiotherapy
boolean
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 1
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number/Code (UPN)
Item
Hospital Unique Patient Number/Code (UPN)
text
Date of Initial Diagnosis
Item
Date of Initial Diagnosis
date
Item Group
Classification
Item
AML with recurrent genetic abnormalities
integer
Code List
AML with recurrent genetic abnormalities
CL Item
AML with t(8;21)(q22;q22); RUNX1-RUNX1T1 (1)
CL Item
AML with inv(16)(p13.1;q22) or t(16;16)(p13.1;q22); CBFB-MYH11 (2)
CL Item
Acute promyelocytic leukaemia with t(15;17)(q22;q12); PML/RARA (3)
CL Item
AML with t(9;11) (p22;q23); MLLT 3-MLL (4)
CL Item
AML with myelodysplasia related changes (5)
CL Item
(with multilineage dysplasia; w/o MDS or MDS/MPN antecedents) (6)
CL Item
AML with t(6;9) (p23;q24); DEK-NUP214 (7)
CL Item
AML with inv(3) (q21;q26.2) or t(3;3) (q21;q26.2); RPN1-EVI1 (8)
CL Item
AML (megakaryoblastic) with t(1;22) (p13;q13); RBM15-MKL1 (9)
Item
AML not otherwise categorised
integer
Code List
AML not otherwise categorised
CL Item
AML with minimal differentiation (FAB M0) (1)
CL Item
AML without maturation (FAB M1) (2)
CL Item
AML with maturation (FAB M2) (3)
CL Item
Acute myelomonocytic leukaemia (FAB M4) (4)
CL Item
Acute monoblastic and monocytic leukaemia (FAB M5) (5)
CL Item
Acute erythroid leukaemia (erythroid/myeloid and pure erythroleukaemia) (FAB M6) (6)
CL Item
Acute megakaryoblastic leukaemia (FAB M7) (7)
CL Item
Acute basophilic leukaemia (8)
CL Item
Acute panmyelosis with myelofibrosis (9)
CL Item
Myeloid sarcoma (10)
CL Item
Myeloid proliferations related to Down syndrome (11)
CL Item
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) (12)
CL Item
Acute myeloid leukaemia not otherwise specified or other (13)
Item
Precursor Lymphoid Neoplasms (old ALL)
integer
Code List
Precursor Lymphoid Neoplasms (old ALL)
CL Item
B lymphoblastic leukaemia/lymphoma NOS (old Precursor B-cell ALL)  (1)
CL Item
with t(9;22)(q34;q11.2); BCR-ABL1 (2)
CL Item
with t(v;11q23); MLL rearranged (3)
CL Item
with t(12;21)(p13;q22); TEL-AML1 (ETV-UNX1) (4)
CL Item
with hyperdiploidy (5)
CL Item
with hypodiploidy (6)
CL Item
with t(5;14)(q31;q32); IL3-IGH (7)
CL Item
with t(1;19)(q23;p13.3); E2A-PBX1 (8)
CL Item
T lymphoblastic leukaemia/lymphoma (old precursor T-cell ALL) (9)
CL Item
Lymphoblastic leukaemia/lymphoma not otherwise specified or other (10)
Item
AML transformed from
integer
Code List
AML transformed from
CL Item
Transformed from MDS (1)
CL Item
Transformed from MD/MPN (2)
CL Item
Transformed from MPS (3)
Item
Secondary origin
text
Code List
Secondary origin
CL Item
Yes: Disease related to prior exposure to therapeutic drugs or radiation (Yes: Disease related to prior exposure to therapeutic drugs or radiation)
CL Item
No (No)
CL Item
Unknown (Unknown)
Date of this HSCT
Item
Date of this HSCT
date
Item
Status at HSCT
integer
Code List
Status at HSCT
CL Item
Primary induction failure (1)
CL Item
Complete haematological remission (CR) (2)
CL Item
Relapse (3)
CL Item
Never treated (4)
Item
NUMBER (complete only for CR or relapse)
integer
Code List
NUMBER (complete only for CR or relapse)
CL Item
1st (1)
CL Item
2nd (2)
CL Item
3rd or higher (3)
Item
Cytogenetic FOR COMPLETE REMISSION ONLY, TYPE OF REMISSION
integer
Code List
Cytogenetic FOR COMPLETE REMISSION ONLY, TYPE OF REMISSION
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Molecular FOR COMPLETE REMISSION ONLY, TYPE OF REMISSION
integer
Code List
Molecular FOR COMPLETE REMISSION ONLY, TYPE OF REMISSION
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 2
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of initial diagnosis
Item
Date of initial diagnosis
date
C2316983 (UMLS CUI [1])
Item
At least one investigation must be positive: Translocation (9;22)
text
C3897138 (UMLS CUI [1])
Code List
At least one investigation must be positive: Translocation (9;22)
CL Item
Absent (Absent)
CL Item
Not evaluated (Not evaluated)
CL Item
Present (Present)
Item
At least one investigation must be positive: bcr-abl
text
C1835417 (UMLS CUI [1])
Code List
At least one investigation must be positive: bcr-abl
CL Item
Absent (Absent)
CL Item
Not evaluated (Not evaluated)
CL Item
Present (Present)
Date of this HSCT
Item
Date of this HSCT
date
Item
Status at HSCT Phase
integer
Code List
Status at HSCT Phase
CL Item
Chronic phase (CP) (1)
CL Item
Accelerated phase (2)
CL Item
Blast crisis (3)
Item
NUMBER
integer
Code List
NUMBER
CL Item
1st (1)
CL Item
2nd (2)
CL Item
3rd or higher (3)
Item
Haematological
text
Code List
Haematological
CL Item
Yes  (Yes )
CL Item
No  (No )
CL Item
Not evaluated  (Not evaluated )
CL Item
Unknown (Unknown)
Item
Cytogenetic (t[9;22))
integer
Code List
Cytogenetic (t[9;22))
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Molecular (bcr-abl)
integer
Code List
Molecular (bcr-abl)
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Classification
integer
Code List
Classification
CL Item
Chronic lymphocytic leukaemia (CLL) (1)
CL Item
Prolymphocytic Leukaemia (2)
CL Item
PLL, B-cell (3)
CL Item
PLL, T-cell (4)
CL Item
Hairy Cell Leukaemia (5)
CL Item
Other leukaemia (6)
Date of this HSCT
Item
Date of this HSCT
date
Item
Status at HSCT
integer
Code List
Status at HSCT
CL Item
Complete remission (CR) (Complete remission (CR))
CL Item
Partial remission (PR) Nodular Partial remission (nPR) (Partial remission (PR) Nodular Partial remission (nPR))
CL Item
Relapse (Relapse)
CL Item
Progression (Progression)
CL Item
Never treated (Never treated)
CL Item
Stable disease/No response (Stable disease/No response)
Item Group
HSCT - Minimum Essential Data – A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 3
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of Initial Diagnosis
Item
Date of Initial Diagnosis
date
Item
Mature B-cell Neoplasms
integer
Code List
Mature B-cell Neoplasms
CL Item
Splenic marginal zone lymphoma (Splenic marginal zone lymphoma)
CL Item
Extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (MALT) (Extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (MALT))
CL Item
Nodal marginal zone lymphoma (Nodal marginal zone lymphoma)
CL Item
Lymphoplasmacytic lymphoma (LPL) (Lymphoplasmacytic lymphoma (LPL))
CL Item
Waldenstrom macroglobulinaemia (LPL with monoclonal IgM) (Waldenstrom macroglobulinaemia (LPL with monoclonal IgM))
CL Item
Follicular lymphoma (Follicular lymphoma)
CL Item
Primary cutaneous follicle centre lymphoma (Primary cutaneous follicle centre lymphoma)
CL Item
Mantle cell lymphoma (Mantle cell lymphoma)
CL Item
Diffuse large B-cell lymphoma (DLBCL), (NOS) (Diffuse large B-cell lymphoma (DLBCL), (NOS))
CL Item
T-cell/hystiocyte rich large B cell lymphoma (T-cell/hystiocyte rich large B cell lymphoma)
CL Item
Primary DLBCL of the CNS (Primary DLBCL of the CNS)
CL Item
Primary cutaneous DLBCL, leg type (Primary cutaneous DLBCL, leg type)
CL Item
EBV positive DLBCL of the elderly (EBV positive DLBCL of the elderly)
CL Item
DLBCL associated with chronic inflammation (DLBCL associated with chronic inflammation)
CL Item
Lymphomatoid granulomatosis (Lymphomatoid granulomatosis)
CL Item
Primary mediastinal (thymic) large B-cell lymphoma (Primary mediastinal (thymic) large B-cell lymphoma)
CL Item
Intravascular large B-cell lymphoma (Intravascular large B-cell lymphoma)
CL Item
ALK positive large B-cell lymphoma (ALK positive large B-cell lymphoma)
CL Item
Plasmablastic lymphoma (Plasmablastic lymphoma)
CL Item
Large B-cell lymphoma arising in HHV8- associated multicentric Castleman disease (Large B-cell lymphoma arising in HHV8- associated multicentric Castleman disease)
CL Item
Primary effusion lymphoma (PEL) (Primary effusion lymphoma (PEL))
CL Item
Burkitt lymphoma (BL) (Burkitt lymphoma (BL))
CL Item
B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma (Intermediate DLCBL/BL) (B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma (Intermediate DLCBL/BL))
CL Item
B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma (Intermediate DLCBL/HD) (B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma (Intermediate DLCBL/HD))
CL Item
Other B-cell (Other B-cell)
Item
Follicular lymphoma
integer
Code List
Follicular lymphoma
CL Item
Grade I  (1)
CL Item
Grade II  (2)
CL Item
Grade III  (3)
CL Item
Not evaluated (4)
Item
Mature T-cell & NK-cell Neoplasms
integer
Code List
Mature T-cell & NK-cell Neoplasms
CL Item
T-cell large granular lymphocytic leukaemia (1)
CL Item
Aggressive NK-cell leukaemia (2)
CL Item
Systemic EBV positive T-cell lymphoproliferative disease of childhood (3)
CL Item
Hydroa vacciniforme-like lymphoma (4)
CL Item
Adult T-cell leukaemia/lymphoma (5)
CL Item
Extranodal NK/T-cell lymphoma, nasal type (6)
CL Item
Enteropathy-associated T-cell lymphoma (7)
CL Item
Hepatosplenic T-cell lymphoma (8)
CL Item
Subcutaneous panniculitis-like T-cell lymphoma (9)
CL Item
Mycosis fungoides (MF) (10)
CL Item
Sézary syndrome (11)
CL Item
Lymphomatoid papulosis (12)
CL Item
Primary cutaneous anaplastic large cell lymphoma (13)
CL Item
Primary cutaneous gamma-delta T-cell lymphoma (14)
CL Item
Primary cutaneous CD8 positive aggressive epidermotropic cytotoxic T-cell lymphoma (15)
CL Item
Primary cutaneous CD4 positive small/medium T-cell lymphoma (16)
CL Item
Peripheral T-cell lymphoma, NOS (PTCL) (17)
CL Item
Angioimmunoblastic T-cell lymphoma (18)
CL Item
Anaplastic large-cell lymphoma (ALCL), ALK-positive (19)
CL Item
Anaplastic large-cell lymphoma (ALCL), ALK-negative (20)
CL Item
Other T-cell (21)
CL Item
Hodgkin (22)
Item
Hodgkin
integer
Code List
Hodgkin
CL Item
Nodular lymphocyte predominant (1)
CL Item
Classical predominant  (2)
CL Item
Lymphocyte rich  (3)
CL Item
Nodular sclerosis (4)
CL Item
Mixed cellularity (5)
CL Item
Lymphocyte depleted (6)
CL Item
Other (7)
Date of this HSCT
Item
Date of this HSCT
date
Item
STATUS HSCT
integer
Code List
STATUS HSCT
CL Item
Never treated (Never treated)
CL Item
Primary refractory (Primary refractory)
CL Item
Complete remission (CR) (Complete remission (CR))
CL Item
Confirmed  (Confirmed )
CL Item
Unconfirmed (CRU*) (Unconfirmed (CRU*))
CL Item
1st Partial response (PR1) (1st Partial response (PR1))
CL Item
Partial response>1 (never in CR) (PR>1) (Partial response>1 (never in CR) (PR>1))
CL Item
Relapse (Relapse)
CL Item
Progression (Progression)
Item
NUMBER complete only for CR, PR>1 or relapse
integer
Code List
NUMBER complete only for CR, PR>1 or relapse
CL Item
1st (1)
CL Item
2nd (2)
CL Item
3nd or higher (3)
Item
SENSITIVITY TO CHEMOTHERAPY (complete only for relapse)
text
Code List
SENSITIVITY TO CHEMOTHERAPY (complete only for relapse)
CL Item
Sensitive (Sensitive)
CL Item
Resistan (Resistan)
CL Item
Untreated (Untreated)
CL Item
Unknown (Unknown)
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 4
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of initial diagnosis
Item
Date of initial diagnosis
date
C2316983 (UMLS CUI [1])
Item
WHO Classification at diagnosis
integer
Code List
WHO Classification at diagnosis
CL Item
Refractory anaemia (without ring sideroblasts) RA (Refractory anaemia (without ring sideroblasts) RA)
CL Item
RA with ring sideroblasts (RARS) (RA with ring sideroblasts (RARS))
CL Item
MDS associated with isolated del(5q) (MDS associated with isolated del(5q))
CL Item
Refractory cytopenia with multilineage dysplasia (RCMD) (Refractory cytopenia with multilineage dysplasia (RCMD))
CL Item
RCMD with ringed sideroblasts (RCMD-RS) (RCMD with ringed sideroblasts (RCMD-RS))
CL Item
RA with excess of blasts-1 (RAEB-1) (RA with excess of blasts-1 (RAEB-1))
CL Item
RA with excess of blasts-2 (RAEB-2) (RA with excess of blasts-2 (RAEB-2))
CL Item
MDS Unclassifiable (MDS-U) (MDS Unclassifiable (MDS-U))
CL Item
Childhood myelodysplastic syndrome (Childhood myelodysplastic syndrome)
Item
FAB Classification at diagnosis
integer
Code List
FAB Classification at diagnosis
CL Item
RA (1)
CL Item
RARS (2)
CL Item
RAEB (3)
CL Item
RAEB in transformation (RAEB-t) (4)
CL Item
Unclassified (5)
Item
Status at HSCT Treated with chemotherapy
integer
Code List
Status at HSCT Treated with chemotherapy
CL Item
Primary refractory phase (no change) (1)
CL Item
Complete remission (CR) (2)
CL Item
Improvement but no CR (3)
CL Item
Relapse (after CR) (4)
CL Item
Progression/worse (5)
CL Item
Never treated (Supportive care or treatment without chemotherapy) (6)
Item
NUMBER (complete for CR or relapse)
text
Code List
NUMBER (complete for CR or relapse)
CL Item
1st (1st)
CL Item
2nd (2nd)
CL Item
3rd or higher (3rd or higher)
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 5
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of Initial Diagnosis
Item
Date of Initial Diagnosis
date
Item
Classification at diagnosis
integer
Code List
Classification at diagnosis
CL Item
Chronic myelomonocytic leukaemia (CMMoL, CMML) (1)
CL Item
Juvenile myelomonocytic leukaemia (JCMMoL, JMML, JCML, JCMML) (2)
CL Item
Atypical CML ((t(9;22) negative and bcr/abl negative) (3)
Item
Classification at HSCT
integer
Code List
Classification at HSCT
CL Item
Chronic myelomonocytic leukaemia (CMMoL, CMML) (1)
CL Item
Juvenile myelomonocytic leukaemia (JCMMoL, JMML, JCML, JCMML) (2)
CL Item
Atypical CML ((t(9;22) negative and bcr/abl negative) (3)
CL Item
Transformed to AML: Date of transformation (4)
Date of this HSCT
Item
Date of this HSCT
date
Item
CMML (including Transformed to AML) / Atypical CML Status at HSCT
integer
Code List
CMML (including Transformed to AML) / Atypical CML Status at HSCT
CL Item
Primary refractory phase (no change) (1)
CL Item
Complete remission (CR) (2)
CL Item
Improvement but no CR (3)
CL Item
Relapse (after CR) (4)
CL Item
Progression/worse (5)
Item
NUMBER (complete for CR or relapse)
integer
Code List
NUMBER (complete for CR or relapse)
CL Item
1st (1st)
CL Item
2nd (2nd)
CL Item
3rd or higher (3rd or higher)
Item
jMML
integer
Code List
jMML
CL Item
Stable disease (SD) (1)
CL Item
Complete response (CR) (2)
CL Item
Minimal response (MR) (3)
CL Item
Partial response (PR) (4)
CL Item
Progression (PD) (5)
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 6
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of initial diagnosis
Item
Date of initial diagnosis
date
C2316983 (UMLS CUI [1])
Item
Classification at diagnosis
integer
Code List
Classification at diagnosis
CL Item
Chronic idiopathic myelofibrosis (primary myelofibrosis, fibrosis with myeloid metaplasia) (1)
CL Item
Polycythaemia vera (2)
CL Item
Essential or primary thrombocythaemia (3)
CL Item
Hyper eosinophilic syndrome (HES) (4)
CL Item
Chronic eosinophilic leukaemia (CEL) (5)
CL Item
Chronic neutrophilic leukaemia (6)
CL Item
Stem cell leukaemia-lymphoma syndrome (8p11 syndrome) (7)
CL Item
Systemic mastocytosis (8)
CL Item
MPS not otherwise specified (9)
CL Item
Other (10)
Item
Secondary origin (other than transformed to AML)
integer
Code List
Secondary origin (other than transformed to AML)
CL Item
Yes: Disease related to prior exposure to therapeutic drugs or radiation (1)
CL Item
No (2)
CL Item
Unknown (3)
Date of this HSCT
Item
Date of this HSCT
date
Item
Classification at HSCT
integer
Code List
Classification at HSCT
CL Item
Chronic idiopathic myelofibrosis (primary myelofibrosis, fibrosis with myeloid metaplasia) (1)
CL Item
Polycythaemia vera (2)
CL Item
Essential or primary thrombocythaemia (3)
CL Item
Hyper eosinophilic syndrome (HES) (4)
CL Item
Chronic eosinophilic leukaemia (CEL) (5)
CL Item
Chronic neutrophilic leukaemia (6)
CL Item
Stem cell leukaemia-lymphoma syndrome (8p11 syndrome) (7)
CL Item
Myelofibrosis transformed from Polycythaemia vera/ Essential thrombocythaemia (8)
CL Item
Transformed to AML (9)
CL Item
MPS not otherwise specified (10)
CL Item
Other (11)
Item
if other, please specify
text
Code List
if other, please specify
CL Item
Classification at HSCT (Classification at HSCT)
Item
Status at HSCT Treated with chemotherapy
text
Code List
Status at HSCT Treated with chemotherapy
CL Item
Primary refractory phase (no change) (Primary refractory phase (no change))
CL Item
Complete remission (CR) (Complete remission (CR))
CL Item
Improvement but no CR (Improvement but no CR)
CL Item
Relapse (after CR) (Relapse (after CR))
CL Item
Progression/worse (Progression/worse)
CL Item
Never treated (Supportive care or treatment without chemotherapy) (Never treated (Supportive care or treatment without chemotherapy))
Item
NUMBER (complete for CR or relapse)
integer
Code List
NUMBER (complete for CR or relapse)
CL Item
1st (1st)
CL Item
2nd (2nd)
CL Item
3rd or higher (3rd or higher)
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 7
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of Initial Diagnosis
Item
Date of Initial Diagnosis
date
Item
Classification
integer
Code List
Classification
CL Item
Multiple myeloma IgG (1)
CL Item
Multiple myeloma IgA (2)
CL Item
Multiple myeloma IgD (3)
CL Item
Multiple myeloma IgE (4)
CL Item
Multiple myeloma IgM (not Waldenstrom) (5)
CL Item
Multiple myeloma-light chain only (6)
CL Item
Multiple myeloma-non-secretory (7)
CL Item
Plasma cell leukaemia (8)
CL Item
Solitary plasmacytoma (9)
CL Item
Primary amyloidosis (10)
CL Item
POEMS (11)
CL Item
Monoclonal light and heavy chain deposition disease (LCDD/HCDD) (12)
CL Item
Other (13)
Item
LIGHT CHAIN TYPE
text
Code List
LIGHT CHAIN TYPE
CL Item
Kappa (Kappa)
CL Item
Lambda (Lambda)
Item
SALMON & DURIE STAGE AT DIAGNOSIS (Multiple Myeloma only)
integer
Code List
SALMON & DURIE STAGE AT DIAGNOSIS (Multiple Myeloma only)
CL Item
I (I)
CL Item
II (II)
CL Item
III (III)
CL Item
A (A)
CL Item
B (B)
Date of this HSCT
Item
Date of this HSCT
date
Item
Status at HSCT
text
Code List
Status at HSCT
CL Item
Never treated (Never treated)
CL Item
Stringent complete remission (sCR) (Stringent complete remission (sCR))
CL Item
Complete remission (CR) (Complete remission (CR))
CL Item
Very good partial remission (VGPR) (Very good partial remission (VGPR))
CL Item
Partial remission (PR) (Partial remission (PR))
CL Item
Relapse from CR (untreated) (Relapse from CR (untreated))
CL Item
Progression (Progression)
CL Item
No change / stable disease (No change / stable disease)
Item
NUMBER (complete for sCR, CR,VGPR, PR or relapse)
integer
Code List
NUMBER (complete for sCR, CR,VGPR, PR or relapse)
CL Item
I (I)
CL Item
II (II)
CL Item
III (III)
CL Item
A (A)
CL Item
B (B)
Item Group
BONE MARROW FAILURE SYNDROMES including APLASTIC ANAEMIA (main disease code 7)ISMC
Item
Classification
integer
Code List
Classification
CL Item
Acquired Severe Aplastic Anaemia (SAA) (1)
CL Item
Amegakaryocytosis, acquired (not congenital) (2)
CL Item
Acquired Pure Red Cell Aplasia (PRCA) (not congenital) (3)
CL Item
Paroxysmal nocturnal haemoglobinuria (PNH) (4)
CL Item
Other acquired cytopenic syndrome (5)
Item
Acquired Severe Aplastic Anaemia (SAA)
integer
Code List
Acquired Severe Aplastic Anaemia (SAA)
CL Item
Secondary to hepatitis (1)
CL Item
Secondary to toxin/other drug (2)
CL Item
Idiopathic (3)
CL Item
Other (4)
Item
Congenital
integer
Code List
Congenital
CL Item
Amegakaryocytosis / thrombocytopenia (1)
CL Item
Fanconi anaemia (2)
CL Item
Diamond-Blackfan anaemia (congenital PRCA) (3)
CL Item
Shwachman-Diamond Syndrome (4)
CL Item
Other congenital anaemia (5)
Congenital
Item
if other, please specify
text
Date of this HSCT
Item
Date of this HSCT
date
Item
HAEMOGLOBINOPATHY Classification
text
Code List
HAEMOGLOBINOPATHY Classification
CL Item
Thalassaemia (Thalassaemia)
CL Item
Sickle cell disease (Sickle cell disease)
CL Item
Other haemoglobinopathy (Other haemoglobinopathy)
HAEMOGLOBINOPATHY Classification
Item
if other, please specify
text
Date of this HSCT
Item
Date of this HSCT
date
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 8
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of initial diagnosis
Item
Date of initial diagnosis
date
C2316983 (UMLS CUI [1])
Item
Staging at Diagnosis METASTASES
text
Code List
Staging at Diagnosis METASTASES
CL Item
No distant metastases (No distant metastases)
CL Item
Distant metastasis (Distant metastasis)
Item
STAGE (complete only if No distant metastasis)
integer
Code List
STAGE (complete only if No distant metastasis)
CL Item
O (1)
CL Item
I (2)
CL Item
II (3)
CL Item
III (4)
Item
CLASSIFICATION
integer
Code List
CLASSIFICATION
CL Item
Inflammatory (1)
CL Item
Non-inflammatory (2)
Date of this HSCT
Item
Date of this HSCT
date
Item
Status at HSCT
integer
Code List
Status at HSCT
CL Item
Adjuvant (Stage II, III only) (1)
CL Item
Never treated (upfront) (2)
CL Item
Primary refractory (3)
CL Item
Complete remission (CR) (4)
CL Item
1st Partial response (PR1) (5)
CL Item
Relapse (6)
Item
Status at HSCT
integer
Code List
Status at HSCT
CL Item
Confirmed (1)
CL Item
Unconfirmed (CRU*) (2)
CL Item
Unknown (3)
Item
Relapse
integer
Code List
Relapse
CL Item
Local (1)
CL Item
Metastatic (2)
Item
OTHER MALIGNANCIES (main disease code 5) Classification:
text
Code List
OTHER MALIGNANCIES (main disease code 5) Classification:
CL Item
Bone sarcoma (excluding Ewing sarcoma/PNET) (Bone sarcoma (excluding Ewing sarcoma/PNET))
CL Item
Central nervous system tumours (include CNS PNET) (Central nervous system tumours (include CNS PNET))
CL Item
Colorecta (Colorecta)
CL Item
Ewing sarcoma/PNET, extra-skeletal (Ewing sarcoma/PNET, extra-skeletal)
CL Item
Ewing sarcoma/PNET, skeletal (Ewing sarcoma/PNET, skeletal)
CL Item
Germ cell tumour, extragonadal only (Germ cell tumour, extragonadal only)
CL Item
Hepatobiliary (Hepatobiliary)
CL Item
Lung cancer, non-small cell (Lung cancer, non-small cell)
CL Item
Lung cancer, small cell (Lung cancer, small cell)
CL Item
Medulloblastoma (Medulloblastoma)
CL Item
Melanoma (Melanoma)
CL Item
Neuroblastoma (Neuroblastoma)
CL Item
Ovarian (Ovarian)
CL Item
Pancreas (Pancreas)
CL Item
Prostate (Prostate)
CL Item
Renal cell (Renal cell)
CL Item
Retinoblastoma (Retinoblastoma)
CL Item
Rhabdomyosarcoma (Rhabdomyosarcoma)
CL Item
Soft tissue sarcoma (Soft tissue sarcoma)
CL Item
Testicular (Testicular)
CL Item
Thymoma (Thymoma)
CL Item
Wilm tumour (Wilm tumour)
CL Item
Other (Other)
Classification
Item
if other, please specify
text
Date of this HSCT
Item
Date of this HSCT
date
Item
Status at HSCT
text
Code List
Status at HSCT
CL Item
Adjuvant (Adjuvant)
CL Item
Never treated (upfront) (Never treated (upfront))
CL Item
Stable disease/no response (Stable disease/no response)
CL Item
Complete remission (CR) (Complete remission (CR))
CL Item
1st Partial response (PR1) (1st Partial response (PR1))
CL Item
Relapse (Relapse)
CL Item
Progressive disease (PD) (Progressive disease (PD))
Item
Complete remission (CR)
integer
Code List
Complete remission (CR)
CL Item
Confirmed (1)
CL Item
Unconfirmed (CRU complete response with persistent scan abnormalities of unknown significance) (2)
Item
NUMBER (complete only for CR or relapse)
integer
Code List
NUMBER (complete only for CR or relapse)
CL Item
1st (1)
CL Item
2nd (2)
CL Item
3rd or higher (3)
Item
SENSITIVITY TO CHEMOTHERAPY (complete only for relapse)
integer
Code List
SENSITIVITY TO CHEMOTHERAPY (complete only for relapse)
CL Item
Sensitive (1)
CL Item
Resistant (2)
CL Item
Untreated (3)
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 9
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of Initial Diagnosis
Item
Date of Initial Diagnosis
date
Item
Classification PRIMARY IMMUNE DEFICIENCIES (main disease code 8)
integer
Code List
Classification PRIMARY IMMUNE DEFICIENCIES (main disease code 8)
CL Item
Absence of T and B cells SCID (1)
CL Item
Kostmann syndrome-congenital neutropenia (2)
CL Item
Absence of T, normal B cell SCID (3)
CL Item
Leukocyte adhesion deficiencies (4)
CL Item
ADA deficiency (Adenosine deaminase deficiency)  (5)
CL Item
Neutrophil actin deficiency (6)
CL Item
Ataxia telangiectasia (7)
CL Item
Omenn syndrome (8)
CL Item
Bare lymphocyte syndrome  (9)
CL Item
PNP deficiency Purine nucleoside phosphorylase deficiency) (10)
CL Item
Cartilage hair hypoplasiaVD (11)
CL Item
Reticular dysgenesis (12)
CL Item
CD 40 Ligand deficiency (13)
CL Item
SCID other (14)
CL Item
Chediak-Higashi syndrome (15)
CL Item
SCID, unspecified (16)
CL Item
Chronic granulomatous disease (17)
CL Item
Wiskott Aldrich syndrome (18)
CL Item
Common variable immunodeficiency (19)
CL Item
X-linked lymphoproliferative syndrome (20)
CL Item
DiGeorge anomaly (21)
CL Item
Other (22)
CL Item
Immune deficiencies, not otherwise specified (23)
Date of this HSCT
Item
Date of this HSCT
date
Item
INHERITED DISORDERS OF METABOLISM (main disease code 8) DISMCLFD INHDIS Classification
integer
Code List
INHERITED DISORDERS OF METABOLISM (main disease code 8) DISMCLFD INHDIS Classification
CL Item
Adrenoleukodystrophy (1)
CL Item
Metachromatic leukodystrophy (2)
CL Item
Aspartyl glucosaminuria (3)
CL Item
Morquio (IV) (4)
CL Item
B-glucuronidase deficiency (VII) (5)
CL Item
Mucolipidoses, unspecified (6)
CL Item
Fucosidosis (7)
CL Item
Mucopolysaccharidosis (V) (8)
CL Item
Gaucher disease  (9)
CL Item
Mucopolysaccharidosis, unspecified (10)
CL Item
Glucose storage disease (11)
CL Item
Niemann-Pick disease (Type A,B) (12)
CL Item
Hunter syndrome (II) (13)
CL Item
Niemann-Pick disease (Type C,D,E) (14)
CL Item
Hurler syndrome (IH) (15)
CL Item
Neuronal ceroid – lipofuscinosis (Batten disease) (16)
CL Item
T-cell disease (17)
CL Item
Polysaccharide hydrolase abnormalities, unspecified  (18)
CL Item
Krabbe disease (globoid leukodystrophy) (19)
CL Item
Sanfilippo (III) (20)
CL Item
Lesch-Nyhan (HGPRT deficiency) (21)
CL Item
Scheie syndrome (IS) (22)
CL Item
Mannosidosis (23)
CL Item
Wolman disease (24)
CL Item
Maroteaux-Lamy (VI) (25)
CL Item
Other (26)
CL Item
Inherited disorders of metabolism, not otherwise specified (27)
Date of this HSCT
Item
Date of this HSCT
date
CL Item
Adrenoleukodystrophy (Adrenoleukodystrophy)
CL Item
Metachromatic leukodystrophy (Metachromatic leukodystrophy)
CL Item
Aspartyl glucosaminuria (Aspartyl glucosaminuria)
CL Item
Morquio (IV) (Morquio (IV))
CL Item
B-glucuronidase deficiency (VII) (B-glucuronidase deficiency (VII))
CL Item
Mucolipidoses, unspecified (Mucolipidoses, unspecified)
CL Item
Fucosidosis (Fucosidosis)
CL Item
Mucopolysaccharidosis (V) (Mucopolysaccharidosis (V))
CL Item
Gaucher disease  (Gaucher disease )
CL Item
Mucopolysaccharidosis, unspecified (Mucopolysaccharidosis, unspecified)
CL Item
Glucose storage disease (Glucose storage disease)
CL Item
Niemann-Pick disease (Type A,B) (Niemann-Pick disease (Type A,B))
CL Item
Hunter syndrome (II) (Hunter syndrome (II))
CL Item
Niemann-Pick disease (Type C,D,E) (Niemann-Pick disease (Type C,D,E))
CL Item
Hurler syndrome (IH) (Hurler syndrome (IH))
CL Item
Neuronal ceroid – lipofuscinosis (Batten disease) (Neuronal ceroid – lipofuscinosis (Batten disease))
CL Item
I-cell disease (I-cell disease)
CL Item
Polysaccharide hydrolase abnormalities, unspecified (Polysaccharide hydrolase abnormalities, unspecified)
CL Item
Krabbe disease (globoid leukodystrophy) (Krabbe disease (globoid leukodystrophy))
CL Item
Sanfilippo (III) (Sanfilippo (III))
CL Item
Lesch-Nyhan (HGPRT deficiency) (Lesch-Nyhan (HGPRT deficiency))
CL Item
Scheie syndrome (IS) (Scheie syndrome (IS))
CL Item
Mannosidosis (Mannosidosis)
CL Item
Wolman disease (Wolman disease)
CL Item
Maroteaux-Lamy (VI) (Maroteaux-Lamy (VI))
CL Item
Other (Other)
CL Item
Inherited disorders of metabolism, not otherwise specified (Inherited disorders of metabolism, not otherwise specified)
Date of this HSCT
Item
Date of this HSCT
date
CL Item
Glanzmann thrombasthenia (1)
CL Item
Other inherited platelet abnormalities (2)
CL Item
Osteopetrosis (malignant infantile osteopetrosis) (3)
CL Item
Other osteoclast defects (4)
Date of this HSCT
Item
Date of this HSCT
date
CL Item
Histiocytic disorders, not otherwise specified  (Histiocytic disorders, not otherwise specified )
CL Item
Familial erythro/haemophagocytic lymphohistiocytosis (FELH)  (Familial erythro/haemophagocytic lymphohistiocytosis (FELH) )
CL Item
Langerhans Cell Histiocytosis (Histiocytosis-X)  Haemophagocytosis (reactive or viral associated)  (Langerhans Cell Histiocytosis (Histiocytosis-X)  Haemophagocytosis (reactive or viral associated) )
CL Item
Malignant histiocytosis HISTIOCY  (Malignant histiocytosis HISTIOCY )
CL Item
Other (Other)
Date of this HSCT
Item
Date of this HSCT
date
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 10
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of initial diagnosis
Item
Date of initial diagnosis
date
C2316983 (UMLS CUI [1])
Name of Referring Physician
Item
Name of Referring Physician
text
Address
Item
Address
text
Fax
Item
Fax
text
Email
Item
Email
text
Item
Classification CONNECTIVE TISSUE DISEASE
integer
Code List
Classification CONNECTIVE TISSUE DISEASE
CL Item
Systemic sclerosis (SS) (1)
CL Item
Systemic lupus erythematosus (SLE) (2)
Date of this HSCT
Item
Date of this HSCT
date
diffuse cutaneous
Item
Involvement/Clinical problem
boolean
limited cutaneous
Item
Involvement/Clinical problem
boolean
lung parenchyma
Item
Involvement/Clinical problem
boolean
pulmonary hypertension
Item
Involvement/Clinical problem
boolean
systemic hypertension
Item
Involvement/Clinical problem
boolean
renal (biopsy type
Item
Involvement/Clinical problem
boolean
oesophagus
Item
Involvement/Clinical problem
boolean
other GI tract
Item
Involvement/Clinical problem
boolean
Raynaud
Item
Involvement/Clinical problem
boolean
CREST
Item
Involvement/Clinical problem
boolean
diffuse cutaneous
Item
Indication for HSCT
boolean
limited cutaneous
Item
Indication for HSCT
boolean
lung parenchyma
Item
Indication for HSCT
boolean
pulmonary hypertension
Item
Indication for HSCT
boolean
systemic hypertension
Item
Indication for HSCT
boolean
renal (biopsy type
Item
Indication for HSCT
boolean
oesophagus
Item
Indication for HSCT
boolean
other GI tract
Item
Indication for HSCT
boolean
Raynaud
Item
Indication for HSCT
boolean
CREST
Item
Indication for HSCT
boolean
Item
Antibodies studied
integer
Code List
Antibodies studied
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
Scl 70 positive
text
Code List
Scl 70 positive
CL Item
Normal/Negative  (Normal/Negative )
CL Item
Elevated/Positive  (Elevated/Positive )
CL Item
Not evaluated (Not evaluated)
Item
ACA positive
integer
Code List
ACA positive
CL Item
Normal/Negative  (1)
CL Item
Elevated/Positive  (2)
CL Item
Not evaluated (3)
Date of this HSCT
Item
Date of this HSCT
date
renal
Item
renal (biopsy type)
text
renal
Item
Presence
boolean
renal
Item
Indication for HSCT
boolean
CNS
Item
CNS type
text
CNS
Item
CNS Presence
boolean
CNS
Item
CNS Indication for HSCT
boolean
PNS
Item
PNS type
text
PNS
Item
PNS Presence
boolean
PNS
Item
PNS Indication for HSCT
boolean
lung
Item
lung Presence
boolean
lung
Item
lung Indication für HSCT
boolean
serositis
Item
serositis Presence
boolean
serositis
Item
serositis Infication for HSCT
boolean
arthritis
Item
arthritis Presence
boolean
arthritis
Item
arthritis Indication for HSCT
boolean
skin
Item
skin type
text
skin
Item
skin Presence
boolean
skin
Item
skin Indication for HSCT
boolean
haematological
Item
haematological type
text
haematological
Item
haematological Presence
boolean
haematological
Item
haematological Indication for HSCT
boolean
vasculitis
Item
vasculitis type
text
vasculitis
Item
vasculitis Presence
boolean
vasculitis
Item
vasculitis Indication for HSCT
boolean
Item
Complement reduced
integer
Code List
Complement reduced
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Item
Antibodies studied if yes
text
Code List
Antibodies studied if yes
CL Item
DNA  (DNA )
CL Item
Normal/Negative  (Normal/Negative )
CL Item
Elevated/Positive  (Elevated/Positive )
CL Item
Not evaluated (Not evaluated)
CL Item
Other (Other)
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 11
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of Initial Diagnosis
Item
Date of Initial Diagnosis
date
Name of Referring Physician
Item
Name of Referring Physician
text
Address
Item
Address
text
Fax
Item
Fax
text
Email
Item
Email
text
C0013849 (UMLS CUI [1])
Item
UTOIMMUNE DISORDERS – II (main disease code 10) Classification
integer
Code List
UTOIMMUNE DISORDERS – II (main disease code 10) Classification
CL Item
Polymyositis- dermatomyositis (1)
CL Item
Sjögren syndrome (2)
CL Item
Antiphospholipid syndrome (3)
CL Item
Other type of connective tisue disease (4)
Date of this HSCT
Item
Date of this HSCT
date
proximal weakness
Item
proximal weakness Presence
boolean
proximal weakness
Item
proximal weakness Indication for HSCT
boolean
generalized weakness (including bulbar)
Item
generalized weakness (including bulbar) Presence
boolean
generalized weakness (including bulbar)
Item
generalized weakness (including bulbar) Indication for HSCT
boolean
pulmonary fibrosis
Item
pulmonary fibrosis Presence
boolean
pulmonary fibrosis
Item
pulmonary fibrosis Indication for HSCT
boolean
vasculitis
Item
vasculitis t<pe
text
vasculitis
Item
vasculitis Presence
boolean
vasculitis
Item
vasculitis Indication for HSCT
boolean
Item
Manifestation with
text
Code List
Manifestation with
CL Item
typical biopsy (typical biopsy)
CL Item
typical EMG (typical EMG)
CL Item
typical rash (DM) (typical rash (DM))
CL Item
CPK elevated (CPK elevated)
CL Item
malignancy (malignancy)
Date of this HSCT
Item
Date of this HSCT
date
SICCA
Item
SICCA Presence
boolean
SICCA
Item
SICCA Indication for HSCT
boolean
exocrine gland swelling
Item
exocrine gland swelling Presence
boolean
exocrine gland swelling
Item
exocrine gland swelling Indication for HSCT
boolean
other organ lymphocytic infiltration
Item
other organ lymphocytic infiltration Presence
boolean
other organ lymphocytic infiltration
Item
other organ lymphocytic infiltration Indication for HSCT
boolean
lymphoma, paraproteinaemia
Item
lymphoma, paraproteinaemia Presence
boolean
lymphoma, paraproteinaemia
Item
lymphoma, paraproteinaemia Indication for HSCT
boolean
other clinical problem
Item
other, please specify
text
Date of this HSCT
Item
Date of this HSCT
date
hrombosis
Item
hrombosis type
text
hrombosis
Item
hrombosis Presence
boolean
hrombosis
Item
hrombosis Indication for HSCT
boolean
CNS
Item
CNS type
text
CNS
Item
CNS Presence
boolean
CNS
Item
CNS Indication for HSCT
boolean
abortion
Item
abortion Presence
boolean
abortion
Item
abortion Indication for HSCT
boolean
skin
Item
skin (livido, vasculitis) Presence
boolean
skin (livido, vasculitis)
Item
skin (livido, vasculitis) Indication for HSCT
boolean
haematological
Item
haematological type
text
haematological
Item
haematological Presence
boolean
haematological
Item
haematological Indication for HSCT
boolean
Other Involvement/Clinical problem
Item
if other, please specify
text
Item
Antibodies studied
integer
Code List
Antibodies studied
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
Anticardiolipin lgG
integer
Code List
Anticardiolipin lgG
CL Item
Normal/Negative  (1)
CL Item
Elevated/Positive  (2)
CL Item
Not evaluated (3)
Item
Anticardiolipin lgM
integer
Code List
Anticardiolipin lgM
CL Item
Normal/Negative  (1)
CL Item
Elevated/Positive  (2)
CL Item
Not evaluated (3)
Other Antibodies studied
Item
if yes, please specify
text
Date of this HSCT
Item
Date of this HSCT
date
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 12
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of Initial Diagnosis
Item
Date of Initial Diagnosis
date
Name of Referring Physician
Item
Name of Referring Physician
text
Address
Item
Address
text
Fax
Item
Fax
text
Email
Item
Email
text
C0013849 (UMLS CUI [1])
Item
Classification VASCULITIS
integer
Code List
Classification VASCULITIS
CL Item
Wegener granulomatosis (1)
CL Item
Classical polyarteritis nodosa (2)
Date of this HSCT
Item
Date of this HSCT
date
upper respiratory tract
Item
upper respiratory tract Presence
boolean
upper respiratory tract
Item
upper respiratory tract Indication for HSCT
boolean
pulmonary
Item
pulmonary Presence
boolean
pulmonary
Item
pulmonary Indication for HSCT
boolean
renal
Item
renal biobsy type
text
renal
Item
renal Presence
boolean
renal
Item
renal Indication for HSCT
boolean
skin
Item
skin Presence
boolean
skin
Item
skin Indication for HSCT
boolean
Other Involvement / Clinical problem
Item
If Other Involvement / Clinical problem please specify
text
Item
Antibodies studied
integer
Code List
Antibodies studied
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
c-ANCA
integer
Code List
c-ANCA
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated (3)
Date of this HSCT
Item
Date of this HSCT
date
renal
Item
renal type
text
renal
Item
renal Presence
boolean
renal
Item
renal Indication for HSCT
boolean
mononeuritis multiplex
Item
mononeuritis multiplex Presence
boolean
mononeuritis multiplex
Item
mononeuritis multiplex Indication for HSCT
boolean
pulmonary haemorrhage
Item
pulmonary haemorrhage Presence
boolean
pulmonary haemorrhage
Item
pulmonary haemorrhage Indication for HSCT
boolean
skin
Item
skin presence
boolean
skin
Item
skin Indication for HSCT
boolean
GI tract
Item
GI tract Presence
boolean
GI tract
Item
GI tract Indication for HSCT
boolean
Involvement/Clinical problem
Item
if other Involvement/Clinical problem, please specify
text
Item
Antibodies studied
integer
Code List
Antibodies studied
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
p-ANCA
integer
Code List
p-ANCA
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated (3)
Item
c-ANCA
integer
Code List
c-ANCA
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated (3)
Item
Hepatitis serology
integer
Code List
Hepatitis serology
CL Item
Negative  (Negative )
CL Item
Positive  (Positive )
CL Item
Not evaluated (Not evaluated)
Item
Other vasculitis
integer
Code List
Other vasculitis
CL Item
Churg-Strauss  (1)
CL Item
Giant cell arteritis  (2)
CL Item
Takayasu  (3)
CL Item
Behçet’s syndrome  (4)
CL Item
Overlap necrotising arteritis  (5)
CL Item
Other (6)
Date of this HSCT
Item
Date of this HSCT
date
Item Group
HSCT - Minimum Essential Data - A First report - 100 days after HSCT DISEASE CLASSIFICATION SHEET 13
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of Initial Diagnosis
Item
Date of Initial Diagnosis
date
Name of Referring Physician
Item
Name of Referring Physician
text
Address
Item
Address
text
Fax
Item
Fax
text
Email
Item
Email
text
C0013849 (UMLS CUI [1])
Item
AUTOIMMUNE DISORDERS – IV (main disease code 10) ARTHRITIS
integer
Code List
AUTOIMMUNE DISORDERS – IV (main disease code 10) ARTHRITIS
CL Item
Rheumatoid arthritis (Rheumatoid arthritis)
CL Item
Psoriatic arthritis/psoriasis (Psoriatic arthritis/psoriasis)
CL Item
Juvenile idiopathic arthritis (JIA), systemic (Stills disease) (Juvenile idiopathic arthritis (JIA), systemic (Stills disease))
CL Item
Juvenile idiopathic arthritis (JIA), articular (Juvenile idiopathic arthritis (JIA), articular)
CL Item
Juvenile idiopathic arthritis (Juvenile idiopathic arthritis)
CL Item
Other (Other)
Date of this HSCT
Item
Date of this HSCT
date
destructive arthritis
Item
destructive arthritis Presence
boolean
destructive arthritis
Item
destructive arthritis Indication for HSCT
boolean
eye
Item
eye type
text
eye
Item
eye Presence
boolean
eye
Item
eye Indication for HSCT
boolean
pulmonary
Item
pulmonary Presence
boolean
pulmonary
Item
pulmonary Indication for HSCT
boolean
extra articular
Item
if extra articular, please specify
text
extra articular
Item
extra articular Presence
boolean
extra articular
Item
extra articular Indication for HSCT
boolean
Date of this HSCT
Item
Date of this HSCT
date
destructive arthritis
Item
destructive arthritis Presence
boolean
destructive arthritis
Item
destructive arthritis Indication for HSCT
boolean
psoriasis
Item
psoriasis Presence
text
psoriasis
Item
psoriasis Indication for HSCT
boolean
Date of this HSCT
Item
Date of this HSCT
date
MULTIPLE SCLEROSIS
Item
MULTIPLE SCLEROSIS
boolean
Date of this HSCT
Item
Date of this HSCT
date
Item
MULTIPLE SCLEROSIS
integer
Code List
MULTIPLE SCLEROSIS
CL Item
primary progressive VDISESTA  (1)
CL Item
secondary progressive  (2)
CL Item
relapsing/remitting  (3)
CL Item
other (4)
Item
OTHER NEUROLOGICAL AUTOIMMUNE DISEASE
text
Code List
OTHER NEUROLOGICAL AUTOIMMUNE DISEASE
CL Item
Myasthenia gravis  (Myasthenia gravis )
CL Item
Amyotrophic lateral sclerosis (ALS) (Amyotrophic lateral sclerosis (ALS))
CL Item
Chronic inflammatory demyelinating polyneuropathy (CIDP) (Chronic inflammatory demyelinating polyneuropathy (CIDP))
CL Item
Other autoimmune neurological disorder (Other autoimmune neurological disorder)
Other autoimmune neurological disorder
Item
Other autoimmune neurological disorder, specify
text
Date of this HSCT
Item
Date of this HSCT
date
Item
HAEMATOLOGICAL AUTOIMMUNE DISEASES
integer
Code List
HAEMATOLOGICAL AUTOIMMUNE DISEASES
CL Item
Idiopathic thrombocytopenic purpura (ITP) (1)
CL Item
Haemolytic anaemia  Autoimmune lymphoproliferative syndrome (primary diagnosis, not subsequent to HSCT) (2)
CL Item
Evan syndrome  (3)
CL Item
other autoimmune cytopenia (4)
other autoimmune cytopenia
Item
other autoimmune cytopenia, specify
text
Date of this HSCT
Item
Date of this HSCT
date
Item
BOWEL DISEASE
text
Code List
BOWEL DISEASE
CL Item
Crohn’s disease (Crohn’s disease)
CL Item
Ulcerative colitis (Ulcerative colitis)
CL Item
Other autoimmune bowel disease (Other autoimmune bowel disease)
Other autoimmune bowel disease
Item
Other autoimmune bowel disease, specify
text
Date of this HSCT
Item
Date of this HSCT
date
Item Group
HSCT - Minimum Essential Data - A Follow up report: 1 year post transplant and annually thereafter
PRIMARY DISEASE DIAGNOSIS
Item
PRIMARY DISEASE DIAGNOSIS
text
EBMT Code (CIC)
Item
EBMT Code (CIC)
text
Hospital:
Item
Hospital:
text
Klinik
Item
Hospital
text
C0019994 (UMLS CUI [1])
Unit
Item
Unit
text
Contact person
Item
Name of contact person
text
C0337611 (UMLS CUI [1])
Date of this Report
Item
Date of this Report
date
Item
Patient following national / international study / trial
integer
Code List
Patient following national / international study / trial
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Name of study / trial
Item
Name of study / trial
text
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code (Compulsory, registrations will not be accepted without this item)
text
Initials
Item
Initials
text
Date of Birth
Item
Date of Birth
date
Item
Sex
text
C0079399 (UMLS CUI [1])
Code List
Sex
CL Item
Male (1)
CL Item
Female (2)
Date of the most recent transplant before this follow up
Item
Date of the most recent transplant before this follow up
date
Item
Best disease status (response) after transplant (prior to treatment modification in response to a post transplant disease assessment)
integer
Code List
Best disease status (response) after transplant (prior to treatment modification in response to a post transplant disease assessment)
CL Item
Continued complete remission (CR) (1)
CL Item
CR achieved (2)
CL Item
Never in CR: Date assessed (3)
CL Item
Previously reported (4)
Date achieved
Item
Date achieved
date
Date assessed
Item
Date assessed
date
Date of last follow up or death
Item
Date of last follow up or death
date
Item
Chronic Graft Versus Host Disease present during this period (allografts only)
text
Code List
Chronic Graft Versus Host Disease present during this period (allografts only)
CL Item
No (never) (No (never))
CL Item
Yes (Yes)
CL Item
Yes, First episode since last HSCT (Yes, First episode since last HSCT)
CL Item
Yes, Recurrence (Yes, Recurrence)
CL Item
Continuous since last reported episode (Continuous since last reported episode)
CL Item
Resolved since last report (currently absent) (Resolved since last report (currently absent))
Date of diagnosis of cGvHD
Item
Date of diagnosis of cGvHD
date
Date first evidence of cGVHD during this period
Item
Date first evidence of cGVHD during this period
date
Item
Maximum extent during this period
integer
Code List
Maximum extent during this period
CL Item
Limited  (1)
CL Item
Extensive  (2)
CL Item
Unknown (3)
Late graft failure (allografts only)
Item
Late graft failure (allografts only)
boolean
Did a secondary malignancy, lymphoproliferative or myeloproliferative disorder occur?
Item
Did a secondary malignancy, lymphoproliferative or myeloproliferative disorder occur?
boolean
Date of diagnosis
Item
Date of diagnosis
date
Diagnosis:
Item
Diagnosis:
text
ADDITIONAL DISEASE TREATMENT INCLUDING CELL THERAPY
Item
ADDITIONAL DISEASE TREATMENT INCLUDING CELL THERAPY
boolean
ADDITIONAL DISEASE TREATMENT INCLUDING CELL THERAPY
Item
Date
date
Additional cell infusion (not HSCT or auto re-infusion)
Item
Additional cell infusion (not HSCT or auto re-infusion)
boolean
Item
Other treatment of disease
integer
Code List
Other treatment of disease
CL Item
No  (1)
CL Item
Yes (2)
CL Item
Yes Plannes (3)
CL Item
Yes Not plannes (4)
Item
First Relapse or Progression after HSCT
text
Code List
First Relapse or Progression after HSCT
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Continuous progression since HSCT (Continuous progression since HSCT)
Date assessed
Item
Date assessed
date
Date first seen
Item
Date first seen
date
Item
Relapse/progression detected by clinical/haematological method
integer
Code List
Relapse/progression detected by clinical/haematological method
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Date assessed
Item
Date assessed
date
Date first seen
Item
Date first seen
date
Item
Relapse/progression detected by cytogenetic method
integer
Code List
Relapse/progression detected by cytogenetic method
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Date assessed
Item
Date assessed
boolean
Date first seen
Item
Date first seen
date
Item
Relapse/progression detected by molecular method
integer
Code List
Relapse/progression detected by molecular method
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Date assessed
Item
Date assessed
date
Date first seen
Item
Date first seen
date
Item
Was disease detected by clinical/haematological method?:
integer
Code List
Was disease detected by clinical/haematological method?:
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Last date assessed
Item
Last date assessed
date
Was disease detected by cytogenetic/FISH method?:
Item
Was disease detected by cytogenetic/FISH method?:
boolean
Considered disease relapse/progression
Item
Considered disease relapse/progression
boolean
Last date assessed
Item
Last date assessed
date
Item
Was disease detected by molecular method? Fill in only for acute and chronic LEUKAEMIAS
integer
Code List
Was disease detected by molecular method? Fill in only for acute and chronic LEUKAEMIAS
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Considered disease relapse/progression
Item
Considered disease relapse/progression
boolean
Last date assessed
Item
Last date assessed
date
Item
Has patient or partner become pregnant after this transplant?
integer
Code List
Has patient or partner become pregnant after this transplant?
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
Survival Status
integer
C1148433 (UMLS CUI [1])
Code List
Survival Status
CL Item
alive (0)
CL Item
dead (1)
Check here if patient lost to follow up
Item
Check here if patient lost to follow up
boolean
Item
Main Cause of Death
integer
C0007465 (UMLS CUI [1])
Code List
Main Cause of Death
CL Item
Relapse or Progression (if indication: primary disease) (1)
CL Item
HSCT related (if applicable) (2)
CL Item
Cell Therapy  (3)
CL Item
Other (4)
CL Item
Unknown (5)
Item
HSCT Related Cause
text
Code List
HSCT Related Cause
CL Item
GVHD GVH  (GVHD GVH )
CL Item
Cardiac Toxicity CTX (Cardiac Toxicity CTX)
CL Item
Rejection/Poor graft function REJ  (Rejection/Poor graft function REJ )
CL Item
Infection INF (Infection INF)
CL Item
Pulmonary toxicity PTX  (Pulmonary toxicity PTX )
CL Item
Veno occlusive disorder (Veno occlusive disorder)
CL Item
Other (Other)
HSCT Related Cause
Item
HSCT Related Cause if other, please specify
text
Item Group
HSCT - Minimum Essential Data - A Follow up report: Annual follow up CELL INFUSION (CI) SHEET
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number/Code
Item
Hospital Unique Patient Number/Code
text
Date of first infusion
Item
Date of first infusion
date
Item
Disease status before this CI
integer
Code List
Disease status before this CI
CL Item
CR (1)
CL Item
Not on CR (2)
CL Item
Not evaluated (3)
Date of first infusion
Item
Date of first infusion
date
Item
Disease status before this CI
integer
Code List
Disease status before this CI
CL Item
CR (1)
CL Item
Not in CR (2)
CL Item
Not evaluated (3)
Item
Cell infusion (CI) regimen (not HSCT or autologous stem cell re-infusion) Type of cell(s): (check all that apply)
text
Code List
Cell infusion (CI) regimen (not HSCT or autologous stem cell re-infusion) Type of cell(s): (check all that apply)
CL Item
Lymphocytes (DLI)  (Lymphocytes (DLI) )
CL Item
Mesenchymal  (Mesenchymal )
CL Item
Fibroblasts  (Fibroblasts )
CL Item
Dendritic cells  (Dendritic cells )
CL Item
Other (Other)
Cell infusion (CI) regimen
Item
if other, please specify
text
Chronological no. of CI for this patient
Item
Chronological no. of CI for this patient
text
Item
Indication
integer
Code List
Indication
CL Item
Planned (1)
CL Item
Prophylactic (2)
CL Item
Mixed chimaerism (3)
CL Item
Loss / decreased chimaerism (4)
CL Item
Treatment of GvHD (5)
CL Item
Treatment for disease (6)
CL Item
Treatment PTLD, EBV lymphoma (7)
CL Item
Treatment viral infection (8)
CL Item
Other (9)
Infusion count
Item
Number of infusions within 10 weeks (count only infusions that are part of same regimen and given for the same indication)
float
C0574032 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
Item
Maximum Grade
integer
Code List
Maximum Grade
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
Present but grade unknown (6)

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