ID

13674

Beschreibung

The Cell Therapy Registry (CTR) aims to collect data on fetal or adult stem cells, or progenitor cells used for treatment other than haematopoietic stem cell transplantation or donor lymphocyte infusion, as well as data on the clinical characteristics and outcome of the patients. Data will be collected on characteristics of the cell graft, /in/ or /ex vivo/ cell manipulation and the cell origin (autologous versus allogeneic). Data will include details on patients treated with mesenchymal cells, for instance, to enhance haematopoietic engraftment, for prophylaxis and treatment of GvHD. The registry will also include data on patients treated by other disciplines for neurologic, rheumatologic, cardiac and inflammatory bowel diseases and tissue regeneration. For further information, please contact: please refer: http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx

Link

http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx

Stichworte

  1. 26.02.16 26.02.16 -
  2. 11.07.16 11.07.16 -
  3. 27.09.21 27.09.21 -
Hochgeladen am

26. Februar 2016

DOI

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Lizenz

Creative Commons BY-NC 3.0

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Cell Therapy Registry EBMT

4pp Cell Therapy Registry 25CTR.pdf

Cell Therapy Registry – Med-A
Beschreibung

Cell Therapy Registry – Med-A

First report – 6 months after cell therapy
Beschreibung

First report – 6 months after cell therapy

Datentyp

text

CENTRE IDENTIFICATION
Beschreibung

CENTRE IDENTIFICATION

EBMT Code (CIC) Number
Beschreibung

OrganizationalUnit::EBMT(CIC)CodeNumber

Datentyp

float

Alias
UMLS CUI [1,1]
C0237753
UMLS CUI [1,2]
C0805701
UMLS CUI [1,3]
C0805701
UMLS CUI [1,4]
C0029246
Hospital
Beschreibung

Klinik

Datentyp

text

Alias
UMLS CUI [1]
C0019994
Unit
Beschreibung

Unit

Datentyp

text

Contact person
Beschreibung

Contact person

Datentyp

text

Phone
Beschreibung

ContactPersonTelephoneNumber

Datentyp

text

Alias
UMLS CUI [1,1]
C0237753
UMLS CUI [1,2]
C0027361
UMLS CUI [1,3]
C0039457
UMLS CUI [1,4]
C0337611
Fax
Beschreibung

ContactPersonFaxNumber

Datentyp

text

Alias
UMLS CUI [1,1]
C0237753
UMLS CUI [1,2]
C0027361
UMLS CUI [1,3]
C0337611
UMLS CUI [1,4]
C0085205
E-mail
Beschreibung

ContactPersonE-mailText

Datentyp

text

Alias
UMLS CUI [1,1]
C1527021
UMLS CUI [1,2]
C0027361
UMLS CUI [1,3]
C0013849
UMLS CUI [1,4]
C0337611
REPORT INFORMATION
Beschreibung

REPORT INFORMATION

Date of this report
Beschreibung

Date of this report

Datentyp

date

Maßeinheiten
  • yyyy/mm/dd
Alias
UMLS CUI [1]
C1302584
yyyy/mm/dd
PATIENT IDENTIFICATION
Beschreibung

PATIENT IDENTIFICATION

Unique Patient Number or Code
Beschreibung

Unique Patient Number or Code

Datentyp

text

Initials
Beschreibung

(first name(s) _family name(s)

Datentyp

text

Alias
UMLS CUI [1]
C2986440
Date of Birth
Beschreibung

Date of Birth

Datentyp

date

Gender:
Beschreibung

Gender

Datentyp

text

INDICATION FOR TREATMENT If Primary disease
Beschreibung

INDICATION FOR TREATMENT If Primary disease

Date of diagnosis
Beschreibung

Diagnose-Datum

Datentyp

date

Alias
UMLS CUI [1,1]
C2316983
UMLS CUI [1,2]
C1274082
Autoimmune disease, specify
Beschreibung

Autoimmune disease, specify

Datentyp

text

Neurologic disorder, specify
Beschreibung

Neurologic disorder, specify

Datentyp

text

Heart disease, specify
Beschreibung

Heart disease, specify

Datentyp

text

Haematologic, specify
Beschreibung

Haematologic, specify

Datentyp

text

Other, specify
Beschreibung

Other, specify

Datentyp

text

If Haematopoietic stem cell transplant related
Beschreibung

If Haematopoietic stem cell transplant related

Datentyp

text

CELL THERAPY TREATMENT
Beschreibung

CELL THERAPY TREATMENT

Date of first cell infusion
Beschreibung

Date of first cell infusion

Datentyp

date

Performance score (if alive)
Beschreibung

Performance score

Datentyp

integer

Alias
UMLS CUI [1]
C1518965
Score achived
Beschreibung

Score

Datentyp

text

Alias
UMLS CUI [1]
C1518965
Status at therapy
Beschreibung

Status at therapy

Datentyp

text

Cell origin
Beschreibung

Cell origin

Datentyp

text

Tissue cell source
Beschreibung

Tissue cell source

Datentyp

text

Tissue cell source, specify other
Beschreibung

Tissue cell source

Datentyp

text

Cell characteristic
Beschreibung

Cell characteristic

Datentyp

text

Cell characteristic, specify other
Beschreibung

Cell characteristic

Datentyp

text

Chronological no. of cell therapy for this patient
Beschreibung

f more than 6 months apart

Datentyp

integer

GRAFT MANIPULATION
Beschreibung

GRAFT MANIPULATION

Ex-vivo manipulation
Beschreibung

Ex-vivo manipulation

Datentyp

integer

Ex-vivo manipulation, Growth factor, specify
Beschreibung

Ex-vivo manipulation

Datentyp

text

Ex-vivo manipulation, other
Beschreibung

Ex-vivo manipulation

Datentyp

text

In-vivo manipulation, in the donor
Beschreibung

In-vivo manipulation

Datentyp

text

In-vivo manipulation In the donor, growth factor, specify
Beschreibung

In-vivo manipulation In the donor

Datentyp

text

In-vivo manipulation In the donor, other
Beschreibung

In-vivo manipulation In the donor

Datentyp

text

In-vivo manipulation, in the patient
Beschreibung

In-vivo manipulation

Datentyp

text

In-vivo manipulation in the patient, growth factor, specify
Beschreibung

In-vivo manipulation, in the patient

Datentyp

text

In-vivo manipulation in the patient, other
Beschreibung

In-vivo manipulation, in the patient

Datentyp

text

TREATMENT
Beschreibung

TREATMENT

Route of infusion
Beschreibung

Route of infusion

Datentyp

text

Route of infusion, Locally intra-arterially, specify artery
Beschreibung

Route of infusion

Datentyp

text

Route of infusion, pther route
Beschreibung

Route of infusion

Datentyp

text

Dose
Beschreibung

Dose

Datentyp

text

Dose, Total No of infusions
Beschreibung

Dose

Datentyp

integer

Dose, No of cells infused per infusion
Beschreibung

Dose

Datentyp

integer

Maßeinheiten
  • x 106/kg
x 106/kg
Associated procedure
Beschreibung

Associated procedure

Datentyp

text

Associated procedure, Yes: specify
Beschreibung

Associated procedure

Datentyp

text

RESPONSE
Beschreibung

RESPONSE

Best clinical/biological response after cell therapy
Beschreibung

Best clinical/biological response after cell therapy

Datentyp

integer

Laboratory response
Beschreibung

Laboratory response

Datentyp

text

Laboratory response, Specify laboratory parameter
Beschreibung

Laboratory response

Datentyp

text

DATE OF LAST CONTACT
Beschreibung

DATE OF LAST CONTACT

Date of last follow up or death
Beschreibung

Date of last follow up or death

Datentyp

date

Survival Status
Beschreibung

Survival Status

Datentyp

text

Main Cause of Death
Beschreibung

Main Cause of Death

Datentyp

text

Main Cause of Death, HSCT related (if applicable
Beschreibung

Main Cause of Death

Datentyp

text

Main Cause of Death, Cell Therapy related:
Beschreibung

Main Cause of Death

Datentyp

text

Main Cause of Death, Other
Beschreibung

Main Cause of Death

Datentyp

text

CENTRE IDENTIFICATION
Beschreibung

CENTRE IDENTIFICATION

EBMT Code (CIC) Number
Beschreibung

OrganizationalUnit::EBMT(CIC)CodeNumber

Datentyp

float

Alias
UMLS CUI [1,1]
C0237753
UMLS CUI [1,2]
C0805701
UMLS CUI [1,3]
C0805701
UMLS CUI [1,4]
C0029246
Hospital
Beschreibung

Hospital

Datentyp

text

Unit
Beschreibung

Unit

Datentyp

text

Contact person
Beschreibung

Contact person

Datentyp

text

Phone
Beschreibung

ContactPersonTelephoneNumber

Datentyp

text

Alias
UMLS CUI [1,1]
C0237753
UMLS CUI [1,2]
C0027361
UMLS CUI [1,3]
C0039457
UMLS CUI [1,4]
C0337611
Fax
Beschreibung

ContactPersonFaxNumber

Datentyp

text

Alias
UMLS CUI [1,1]
C0237753
UMLS CUI [1,2]
C0027361
UMLS CUI [1,3]
C0337611
UMLS CUI [1,4]
C0085205
Contact Person E-Mail
Beschreibung

CentralLaboratoryContactPersonEmailAddressText

Datentyp

text

Alias
UMLS CUI [1,1]
C0027361
UMLS CUI [1,2]
C0022877
UMLS CUI [1,3]
C0337611
UMLS CUI [1,4]
C1705961
UMLS CUI [1,5]
C0013849
REPORT INFORMATION
Beschreibung

REPORT INFORMATION

Date of this Report
Beschreibung

Date of this Report

Datentyp

date

PATIENT IDENTIFICATION
Beschreibung

PATIENT IDENTIFICATION

Unique Patient Number or Code
Beschreibung

Unique Patient Number or Code

Datentyp

integer

Initials, first name(s), family name(s)
Beschreibung

Compulsory, registrations will not be accepted without this item

Datentyp

text

Date of Birth
Beschreibung

PersonBirthDate

Datentyp

date

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

Sex

Datentyp

text

Alias
UMLS CUI [1]
C0079399
DATE OF LAST CONTACT
Beschreibung

DATE OF LAST CONTACT

Datentyp

date

DISEASE PRESENCE/DETECTION AT LAST CONTACT
Beschreibung

Was disease detected

Datentyp

text

PATIENT STATUS, Survival Status
Beschreibung

PATIENT STATUS

Datentyp

text

Main Cause of Death
Beschreibung

Main Cause of Death

Datentyp

text

Main Cause of Death, HSCT related (if applicable)
Beschreibung

Main Cause of Death

Datentyp

text

Main Cause of Death, Cell Therapy related
Beschreibung

Main Cause of Death

Datentyp

text

Main Cause of Death, Other
Beschreibung

Main Cause of Death

Datentyp

text

Ähnliche Modelle

4pp Cell Therapy Registry 25CTR.pdf

Name
Typ
Description | Question | Decode (Coded Value)
Datentyp
Alias
Item Group
Cell Therapy Registry – Med-A
First report – 6 months after cell therapy
Item
First report – 6 months after cell therapy
text
Item Group
CENTRE IDENTIFICATION
OrganizationalUnit::EBMT(CIC)CodeNumber
Item
EBMT Code (CIC) Number
float
C0237753 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
C0805701 (UMLS CUI [1,3])
C0029246 (UMLS CUI [1,4])
Klinik
Item
Hospital
text
C0019994 (UMLS CUI [1])
Unit
Item
Unit
text
Contact person
Item
Contact person
text
ContactPersonTelephoneNumber
Item
Phone
text
C0237753 (UMLS CUI [1,1])
C0027361 (UMLS CUI [1,2])
C0039457 (UMLS CUI [1,3])
C0337611 (UMLS CUI [1,4])
ContactPersonFaxNumber
Item
Fax
text
C0237753 (UMLS CUI [1,1])
C0027361 (UMLS CUI [1,2])
C0337611 (UMLS CUI [1,3])
C0085205 (UMLS CUI [1,4])
ContactPersonE-mailText
Item
E-mail
text
C1527021 (UMLS CUI [1,1])
C0027361 (UMLS CUI [1,2])
C0013849 (UMLS CUI [1,3])
C0337611 (UMLS CUI [1,4])
Item Group
REPORT INFORMATION
Date of this report
Item
Date of this report
date
C1302584 (UMLS CUI [1])
Item Group
PATIENT IDENTIFICATION
Unique Patient Number or Code
Item
Unique Patient Number or Code
text
Initialen
Item
Initials
text
C2986440 (UMLS CUI [1])
Date of Birth
Item
Date of Birth
date
Item
Gender:
text
Code List
Gender:
CL Item
male  (1)
CL Item
female (2)
Item Group
INDICATION FOR TREATMENT If Primary disease
Diagnose-Datum
Item
Date of diagnosis
date
C2316983 (UMLS CUI [1,1])
C1274082 (UMLS CUI [1,2])
Autoimmune disease, specify
Item
Autoimmune disease, specify
text
Neurologic disorder, specify
Item
Neurologic disorder, specify
text
Heart disease, specify
Item
Heart disease, specify
text
Haematologic, specify
Item
Haematologic, specify
text
Other, specify
Item
Other, specify
text
Item
If Haematopoietic stem cell transplant related
text
Code List
If Haematopoietic stem cell transplant related
CL Item
GvHD prophylaxis (1)
CL Item
GvHD treatment (2)
CL Item
Prevention of rejection (3)
CL Item
Graft enhancement (4)
CL Item
Bone marrow failure (5)
Item Group
CELL THERAPY TREATMENT
Date of first cell infusion
Item
Date of first cell infusion
date
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
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)
CL Item
100 (10)
Item
Status at therapy
text
Code List
Status at therapy
CL Item
Chronic (1)
CL Item
Acute (2)
CL Item
Acute exacerbation of chronic disease (3)
Item
Cell origin
text
Code List
Cell origin
CL Item
Allogeneic  (1)
CL Item
Autologous (2)
Item
Tissue cell source
text
Code List
Tissue cell source
CL Item
Bone Marrow VBMSC (1)
CL Item
Peripheral Blood VPBSC (2)
CL Item
Cord Blood VCBSC (3)
CL Item
Adipose ADIPCELL (4)
CL Item
Endothelial cell progenitor ENDOCELL (5)
CL Item
Other, specify (6)
Tissue cell source
Item
Tissue cell source, specify other
text
Item
Cell characteristic
text
Code List
Cell characteristic
CL Item
Mononuclear cells  (1)
CL Item
CD34+ CD34POS (2)
CL Item
Mesenchymal MESECHYM (3)
CL Item
Unseparated bone marrow (4)
CL Item
Other, specify (5)
Cell characteristic
Item
Cell characteristic, specify other
text
Chronological no. of cell therapy for this patient
Item
Chronological no. of cell therapy for this patient
integer
Item Group
GRAFT MANIPULATION
Item
Ex-vivo manipulation
integer
Code List
Ex-vivo manipulation
CL Item
no (1)
CL Item
yes (2)
CL Item
unknown (3)
CL Item
Growth factor, specify  (4)
CL Item
Other (5)
CL Item
Expansion (6)
Ex-vivo manipulation
Item
Ex-vivo manipulation, Growth factor, specify
text
Ex-vivo manipulation
Item
Ex-vivo manipulation, other
text
Item
In-vivo manipulation, in the donor
text
Code List
In-vivo manipulation, in the donor
CL Item
No  (1)
CL Item
Yes:  (2)
CL Item
Growth factor, specify  (3)
CL Item
Other (4)
CL Item
unknown (5)
In-vivo manipulation In the donor
Item
In-vivo manipulation In the donor, growth factor, specify
text
In-vivo manipulation In the donor
Item
In-vivo manipulation In the donor, other
text
Item
In-vivo manipulation, in the patient
text
Code List
In-vivo manipulation, in the patient
CL Item
No  (1)
CL Item
Yes (2)
CL Item
Growth factor, specify (3)
CL Item
Other  (4)
CL Item
Unknown (5)
In-vivo manipulation, in the patient
Item
In-vivo manipulation in the patient, growth factor, specify
text
In-vivo manipulation, in the patient
Item
In-vivo manipulation in the patient, other
text
Item Group
TREATMENT
Item
Route of infusion
text
Code List
Route of infusion
CL Item
Intravenous (1)
CL Item
Locally intra-arterially, specify artery (2)
CL Item
Locally into tissue (3)
CL Item
Intra bone (4)
CL Item
Other route (5)
CL Item
Intraperiteonally (6)
CL Item
ntrathecal (7)
Route of infusion
Item
Route of infusion, Locally intra-arterially, specify artery
text
Route of infusion
Item
Route of infusion, pther route
text
Item
Dose
text
Code List
Dose
CL Item
Total No of infusions (1)
CL Item
No of cells infused per infusion (2)
Dose
Item
Dose, Total No of infusions
integer
Dose
Item
Dose, No of cells infused per infusion
integer
Code List
Associated procedure
CL Item
no (1)
CL Item
yes (2)
CL Item
Prior to cell therapy (3)
CL Item
Simultaneous (4)
CL Item
Post cell therapy (5)
CL Item
unknown (6)
Associated procedure
Item
Associated procedure, Yes: specify
text
Item Group
RESPONSE
Item
Best clinical/biological response after cell therapy
integer
Code List
Best clinical/biological response after cell therapy
CL Item
Complete sustained remission (CR) (1)
CL Item
Partial sustained remission (PR) (2)
CL Item
Remission (CR or PR) followed by relapse or progression (3)
CL Item
Stable (4)
CL Item
Progression (5)
CL Item
Unknown (6)
Item
Laboratory response
text
Code List
Laboratory response
CL Item
Normalized (1)
CL Item
Improvement (2)
CL Item
Unchanged (3)
CL Item
Worsening (4)
CL Item
Specify laboratory parameter (5)
Laboratory response
Item
Laboratory response, Specify laboratory parameter
text
Item Group
DATE OF LAST CONTACT
Date of last follow up or death
Item
Date of last follow up or death
date
Item
Survival Status
text
Code List
Survival Status
CL Item
Alive (1)
CL Item
Dead (2)
CL Item
Check here if patient lost to follow up (3)
Item
Main Cause of Death
text
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 related (3)
CL Item
Other (4)
CL Item
Unknown (5)
Main Cause of Death
Item
Main Cause of Death, HSCT related (if applicable
text
Main Cause of Death
Item
Main Cause of Death, Cell Therapy related:
text
Main Cause of Death
Item
Main Cause of Death, Other
text
Item Group
CENTRE IDENTIFICATION
OrganizationalUnit::EBMT(CIC)CodeNumber
Item
EBMT Code (CIC) Number
float
C0237753 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
C0805701 (UMLS CUI [1,3])
C0029246 (UMLS CUI [1,4])
Hospital
Item
Hospital
text
Unit
Item
Unit
text
Contact person
Item
Contact person
text
ContactPersonTelephoneNumber
Item
Phone
text
C0237753 (UMLS CUI [1,1])
C0027361 (UMLS CUI [1,2])
C0039457 (UMLS CUI [1,3])
C0337611 (UMLS CUI [1,4])
ContactPersonFaxNumber
Item
Fax
text
C0237753 (UMLS CUI [1,1])
C0027361 (UMLS CUI [1,2])
C0337611 (UMLS CUI [1,3])
C0085205 (UMLS CUI [1,4])
CentralLaboratoryContactPersonEmailAddressText
Item
Contact Person E-Mail
text
C0027361 (UMLS CUI [1,1])
C0022877 (UMLS CUI [1,2])
C0337611 (UMLS CUI [1,3])
C1705961 (UMLS CUI [1,4])
C0013849 (UMLS CUI [1,5])
Item Group
REPORT INFORMATION
Date of this Report
Item
Date of this Report
date
Item Group
PATIENT IDENTIFICATION
Unique Patient Number or Code
Item
Unique Patient Number or Code
integer
Initials
Item
Initials, first name(s), family name(s)
text
PersonBirthDate
Item
Date of Birth
date
C0011008 (UMLS CUI [1,1])
C0027361 (UMLS CUI [1,2])
C0005615 (UMLS CUI [1,3])
Item
Sex
text
C0079399 (UMLS CUI [1])
Code List
Sex
CL Item
Male (1)
CL Item
Female (2)
DATE OF LAST CONTACT
Item
DATE OF LAST CONTACT
date
Item
DISEASE PRESENCE/DETECTION AT LAST CONTACT
text
Code List
DISEASE PRESENCE/DETECTION AT LAST CONTACT
CL Item
no (1)
CL Item
yes (2)
Item
PATIENT STATUS, Survival Status
text
Code List
PATIENT STATUS, Survival Status
CL Item
Alive (1)
CL Item
Dead (2)
CL Item
Check here if patient lost to follow up (3)
Item
Main Cause of Death
text
Code List
Main Cause of Death
CL Item
Relapse or Progression (1)
CL Item
Relapse or Progression (2)
CL Item
Cell Therapy related (3)
CL Item
Other (4)
CL Item
Unknown (5)
Main Cause of Death
Item
Main Cause of Death, HSCT related (if applicable)
text
Main Cause of Death
Item
Main Cause of Death, Cell Therapy related
text
Main Cause of Death
Item
Main Cause of Death, Other
text

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