Unique Identification Code (UIC)
Item
Unique Identification Code (UIC) (if known)
text
C2348585 (UMLS CUI [1])
Date of this report
Item
Date of this report
date
C1302584 (UMLS CUI [1])
Item
Patient following national/ international study/ trial
text
C2348568 (UMLS CUI [1])
Code List
Patient following national/ international study/ trial
CL Item
Unknown (Unknown)
Study Name
Item
If yes, specify Name of study/ trial
text
C2348560 (UMLS CUI [1])
Hospital Unique Patient Number
Item
Hospital Unique Patient Number
text
C2348585 (UMLS CUI [1])
Initials
Item
First name(s)_surname(s)
text
C2986440 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Date of last HSCT for this patient
Item
Date of last HSCT for this patient
date
C0472699 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Date of last contact or death
Item
Date of last contact or death
date
C0805839 (UMLS CUI [1])
C1148348 (UMLS CUI [2])
Item
Acute Graft versus Host Disease Maximum grade
text
C0856825 (UMLS CUI [1,1])
C0441799 (UMLS CUI [1,2])
Code List
Acute Graft versus Host Disease Maximum grade
CL Item
grade 0 (Absent) (grade 0 (Absent))
CL Item
grade I (grade I)
CL Item
grade II (grade II)
CL Item
grade III (grade III)
CL Item
grade IV (grade IV)
CL Item
Not evaluated (Not evaluated)
Item
If present, specify:
text
C0856825 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Code List
If present, specify:
CL Item
New onset (New onset)
CL Item
Recurrent (Recurrent)
CL Item
Persistent (Persistent)
Item
Reason for aGvHD
text
C0392360 (UMLS CUI [1,1])
C0856825 (UMLS CUI [1,2])
Code List
Reason for aGvHD
CL Item
Tapering (Tapering)
CL Item
Unexplained (Unexplained)
Date of onset
Item
Date of onset of this episode (if new or recurrent) (if applicable)
date
C0574845 (UMLS CUI [1])
Item
aGvHD: Stage skin
text
C0856825 (UMLS CUI [1,1])
C0037274 (UMLS CUI [1,2])
Code List
aGvHD: Stage skin
CL Item
Evaluated (Evaluated)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
aGvHD: Stage skin If evaluatd, specify:
text
C0856825 (UMLS CUI [1,1])
C0037274 (UMLS CUI [1,2])
C0441799 (UMLS CUI [1,3])
Code List
aGvHD: Stage skin If evaluatd, specify:
Item
aGvHD Stage liver
text
C0856825 (UMLS CUI [1,1])
C0023895 (UMLS CUI [1,2])
Code List
aGvHD Stage liver
CL Item
Evaluated (Evaluated)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
aGvHD Stage liver If evaluated, specify:
text
C0856825 (UMLS CUI [1,1])
C0023895 (UMLS CUI [1,2])
C0441799 (UMLS CUI [1,3])
Code List
aGvHD Stage liver If evaluated, specify:
Item
aGvHD Stage gut
text
C0856825 (UMLS CUI [1,1])
C0017178 (UMLS CUI [1,2])
Code List
aGvHD Stage gut
CL Item
Evaluated (Evaluated)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
aGvHD Stage gut If evaluated, specify:
text
C0856825 (UMLS CUI [1,1])
C0017178 (UMLS CUI [1,2])
C0441799 (UMLS CUI [1,3])
Code List
aGvHD Stage gut If evaluated, specify:
Resolution
Item
aGvHD Resolution
boolean
C0856825 (UMLS CUI [1,1])
C1514893 (UMLS CUI [1,2])
Date of resolution
Item
If yes, specify the date of resolution
date
C0011008 (UMLS CUI [1,1])
C1514893 (UMLS CUI [1,2])
Item
Presence of cGvHD
text
C0867389 (UMLS CUI [1])
Code List
Presence of cGvHD
CL Item
Present continously since last reported episode (Present continously since last reported episode)
CL Item
Resolved (Resolved)
Item
If yes, specify:
text
C0867389 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Code List
If yes, specify:
CL Item
First episode (First episode)
CL Item
Recurrence (Recurrence)
Date of onset of cGvHD
Item
If yes, specify Date of onset:
date
C0574845 (UMLS CUI [1,1])
C0867389 (UMLS CUI [1,2])
Item
If present continously since last report, specify cGvHD gade:
text
C0867389 (UMLS CUI [1,1])
C0441799 (UMLS CUI [1,2])
Code List
If present continously since last report, specify cGvHD gade:
CL Item
Limited (Limited)
CL Item
Extensive (Extensive)
Item
If present continously since last reported episode, speicfy affected organs:
text
C0867389 (UMLS CUI [1,1])
C0392760 (UMLS CUI [1,2])
C0178784 (UMLS CUI [1,3])
Code List
If present continously since last reported episode, speicfy affected organs:
CL Item
Unknown (Unknown)
Affected organs - specification
Item
If present continously since last reported episode, speicfy affected organs: If other, specify:
text
C0867389 (UMLS CUI [1,1])
C0392760 (UMLS CUI [1,2])
C0178784 (UMLS CUI [1,3])
C2348235 (UMLS CUI [1,4])
Date of Resolution
Item
If resolved, specify the date of resolution:
date
C1514893 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Infection related complications
Item
Infection related complications
boolean
C0009450 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])
Item
If yes, specify the type (bacteriaemia/ fungemia/ viremia/ parasites) (General)
text
C0004610 (UMLS CUI [1])
C0085082 (UMLS CUI [2])
C0042749 (UMLS CUI [3])
C0030498 (UMLS CUI [4])
Code List
If yes, specify the type (bacteriaemia/ fungemia/ viremia/ parasites) (General)
CL Item
Bacteria: (Bacteria:)
CL Item
S. pneumoniae (S. pneumoniae)
CL Item
Other gram positive (i.e. other streptococci, staphylococci, listeria,...) (Other gram positive (i.e. other streptococci, staphylococci, listeria,...))
CL Item
Haemophilus influenza (Haemophilus influenza)
CL Item
Other gram negative (i.e. E.coli, klebsiella, proteus, serratia, pseudomonas,...) (Other gram negative (i.e. E.coli, klebsiella, proteus, serratia, pseudomonas,...))
CL Item
Legionella sp (Legionella sp)
CL Item
Mycobacteria sp (Mycobacteria sp)
CL Item
Candida sp (Candida sp)
CL Item
Aspergillus sp (Aspergillus sp)
CL Item
Pneumocystis carinii (Pneumocystis carinii)
CL Item
Parasites: (Parasites:)
CL Item
Toxoplasma gondii (Toxoplasma gondii)
CL Item
Viruses: (Viruses:)
CL Item
Other respiratory virus (influenza, parainfluezna, rhinovirus) (Other respiratory virus (influenza, parainfluezna, rhinovirus))
CL Item
Adenovirus (Adenovirus)
CL Item
Papovirus (Papovirus)
CL Item
Parovirus (Parovirus)
Specification
Item
If other, specify (general):
text
C0009450 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Date of the episode
Item
Specify the date of the episode (General)
date
C0011008 (UMLS CUI [1])
Item
Systemic Symptoms of Infections
text
C2039684 (UMLS CUI [1,1])
C0009450 (UMLS CUI [1,2])
Code List
Systemic Symptoms of Infections
CL Item
Septic shock (Septic shock)
CL Item
Multiorgan failure due to infection (Multiorgan failure due to infection)
Item
Systemic Symptoms of Infections: specify the type (bacteriaemia/ fungemia/ viremia/ parasites)
text
C2039684 (UMLS CUI [1,1])
C0004610 (UMLS CUI [1,2])
C2039684 (UMLS CUI [2,1])
C0085082 (UMLS CUI [2,2])
C2039684 (UMLS CUI [3,1])
C0042749 (UMLS CUI [3,2])
C2039684 (UMLS CUI [4,1])
C0030498 (UMLS CUI [4,2])
Code List
Systemic Symptoms of Infections: specify the type (bacteriaemia/ fungemia/ viremia/ parasites)
CL Item
Bacteria: (Bacteria:)
CL Item
S. pneumoniae (S. pneumoniae)
CL Item
Other gram positive (i.e. other streptococci, staphylococci, listeria,...) (Other gram positive (i.e. other streptococci, staphylococci, listeria,...))
CL Item
Haemophilus influenza (Haemophilus influenza)
CL Item
Other gram negative (i.e. E.coli, klebsiella, proteus, serratia, pseudomonas,...) (Other gram negative (i.e. E.coli, klebsiella, proteus, serratia, pseudomonas,...))
CL Item
Legionella sp (Legionella sp)
CL Item
Mycobacteria sp (Mycobacteria sp)
CL Item
Candida sp (Candida sp)
CL Item
Aspergillus sp (Aspergillus sp)
CL Item
Pneumocystis carinii (Pneumocystis carinii)
CL Item
Parasites: (Parasites:)
CL Item
Toxoplasma gondii (Toxoplasma gondii)
CL Item
Viruses: (Viruses:)
CL Item
Other respiratory virus (influenza, parainfluezna, rhinovirus) (Other respiratory virus (influenza, parainfluezna, rhinovirus))
CL Item
Adenovirus (Adenovirus)
CL Item
Papovirus (Papovirus)
CL Item
Parovirus (Parovirus)
Specification of other systemic infections
Item
Systemic symptoms of infection: if other, specify:
text
C2039684 (UMLS CUI [1,1])
C0009450 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Systemic infection: date of the episode
Item
Systemic symptoms of infection: Specify the date of the episode
date
C2039684 (UMLS CUI [1,1])
C0009450 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item
Endorgan diseases
text
C0349410 (UMLS CUI [1,1])
C0009450 (UMLS CUI [1,2])
Code List
Endorgan diseases
CL Item
Pneumonia (Pneumonia)
CL Item
Hepatits (Hepatits)
CL Item
CNS infection (CNS infection)
CL Item
Gut infection (Gut infection)
CL Item
Skin infection (Skin infection)
CL Item
Cystitis (Cystitis)
CL Item
Retinitis (Retinitis)
Item
Endorgan disease: specify the type (bacteriaemia/ fungemia/ viremia/ parasites)
text
C0349410 (UMLS CUI [1,1])
C0004610 (UMLS CUI [1,2])
C0349410 (UMLS CUI [2,1])
C0085082 (UMLS CUI [2,2])
C0349410 (UMLS CUI [3,1])
C0042749 (UMLS CUI [3,2])
C0349410 (UMLS CUI [4,1])
C0030498 (UMLS CUI [4,2])
Code List
Endorgan disease: specify the type (bacteriaemia/ fungemia/ viremia/ parasites)
CL Item
Bacteria: (Bacteria:)
CL Item
S. pneumoniae (S. pneumoniae)
CL Item
Other gram positive (i.e. other streptococci, staphylococci, listeria,...) (Other gram positive (i.e. other streptococci, staphylococci, listeria,...))
CL Item
Haemophilus influenza (Haemophilus influenza)
CL Item
Other gram negative (i.e. E.coli, klebsiella, proteus, serratia, pseudomonas,...) (Other gram negative (i.e. E.coli, klebsiella, proteus, serratia, pseudomonas,...))
CL Item
Legionella sp (Legionella sp)
CL Item
Mycobacteria sp (Mycobacteria sp)
CL Item
Candida sp (Candida sp)
CL Item
Aspergillus sp (Aspergillus sp)
CL Item
Pneumocystis carinii (Pneumocystis carinii)
CL Item
Parasites: (Parasites:)
CL Item
Toxoplasma gondii (Toxoplasma gondii)
CL Item
Viruses: (Viruses:)
CL Item
Other respiratory virus (influenza, parainfluezna, rhinovirus) (Other respiratory virus (influenza, parainfluezna, rhinovirus))
CL Item
Adenovirus (Adenovirus)
CL Item
Papovirus (Papovirus)
CL Item
Parovirus (Parovirus)
Infection related complications
Item
Endorgan diseases: If other, specify:
text
C0349410 (UMLS CUI [1,1])
C0009450 (UMLS CUI [1,2])
Endorgan diseases: date of the episode
Item
Endorgan diseases: Specify the date of the episode
date
C0349410 (UMLS CUI [1,1])
C0009450 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Non infection related complications
Item
Non infection related complications
boolean
C0009566 (UMLS CUI [1])
Item
Specify: Idiopathic pneumonia syndrome
text
C1504431 (UMLS CUI [1])
Code List
Specify: Idiopathic pneumonia syndrome
CL Item
Unknown (Unknown)
Date of onset: Idiopathic pneumonia syndrome
Item
If yes, specify: Idiopathic pneumonia syndrome Date of onset
date
C1504431 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Item
Specify: VOD
text
C0948441 (UMLS CUI [1])
CL Item
Unknown (Unknown)
Date of onset: VOD
Item
If yes, specify: VOD Date of onset
date
C0948441 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Item
Specify: Cataract
text
C0086543 (UMLS CUI [1])
Code List
Specify: Cataract
CL Item
Unknown (Unknown)
Date of onset: Cataract
Item
If yes, specify: Cataract Date of onset
date
C0086543 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Item
Specify: Haemorrhagic cystitis, non infectious
text
C0085692 (UMLS CUI [1])
Code List
Specify: Haemorrhagic cystitis, non infectious
CL Item
Unknown (Unknown)
Date of onset: Haemorrhagic cystitis, non infectious
Item
If yes, specify: Haemorrhagic cystitis, non infectious Date of onset
date
C0085692 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Item
Specify: ARDS, non infectious
text
C0035222 (UMLS CUI [1])
Code List
Specify: ARDS, non infectious
CL Item
Unknown (Unknown)
Date of onset: ARDS, non infectious
Item
If yes, specify: ARDS, non infectious Date of onset
date
C0035222 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Item
Specify: Multiorgan-failre, non infectious
text
C0026766 (UMLS CUI [1])
Code List
Specify: Multiorgan-failre, non infectious
CL Item
Unknown (Unknown)
Date of onset: Multiorgan-failre, non infectious
Item
If yes, specify: Multiorgan-failre, non infectious Date of onset
date
C0026766 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Item
Specify: HSCT-associated microangiopathy
text
C0155765 (UMLS CUI [1])
Code List
Specify: HSCT-associated microangiopathy
CL Item
Unknown (Unknown)
Date of onset: HSCT-associated microangiopathy
Item
If yes, specify: HSCT-associated microangiopathy Date of onset
date
C0155765 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Item
Specify: Renal failure requiring dialysis
text
C0035078 (UMLS CUI [1])
Code List
Specify: Renal failure requiring dialysis
CL Item
Unknown (Unknown)
Date of onset: Renal failure requiring dialysis
Item
If yes, specify: Renal failure requiring dialysis Date of onset
date
C0035078 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Item
Specify: Haemolytic anaemia due to blood group
text
C0002878 (UMLS CUI [1])
Code List
Specify: Haemolytic anaemia due to blood group
CL Item
Unknown (Unknown)
Date of onset: Haemolytic anaemia due to blood group
Item
If yes, specify: Haemolytic anaemia due to blood group Date of onset
date
C0002878 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Item
Specify: Aseptic bone necrosis
text
C0158452 (UMLS CUI [1])
Code List
Specify: Aseptic bone necrosis
CL Item
Unknown (Unknown)
Date of onset: Aseptic bone necrosis
Item
If yes, specify: Aseptic bone necrosis Date of onset
date
C0158452 (UMLS CUI [1,1])
C0574845 (UMLS CUI [1,2])
Specification - other
Item
If other, specify:
text
C0200867 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Date of onset
Item
If other: Date of onset
date
C0574845 (UMLS CUI [1])
Date of test
Item
Date of test
date
C2826247 (UMLS CUI [1])
Identification
Item
Identification of donor or Cord Blood Unit given by the centre
text
C1718162 (UMLS CUI [1])
Number in the infusion order
Item
Number in the infusion order (if applicable)
text
C0237753 (UMLS CUI [1])
Bone marrow
Item
Cell type on which test was performed (% Donor Cells): BM
float
C0005953 (UMLS CUI [1])
PB mononuclear cells (PBMC)
Item
Cell type on which test was performed (% Donor cells): PB mononuclear cells (PBMC)
float
C1321301 (UMLS CUI [1])
T-Cells
Item
Cell type on which test was performed (% Donor cells): T-Cells
float
C0039194 (UMLS CUI [1])
B-Cells
Item
Cell type on which test was performed (% Donor cells): B-Cells
float
C0004561 (UMLS CUI [1])
Red blood cells
Item
Cell type on which test was performed (% Donor cells): Red blood cells
float
C0014772 (UMLS CUI [1])
Monocytes
Item
Cell type on which test was performed (% Donor cells): Monocytes
float
C0026473 (UMLS CUI [1])
PMNs (neutrophils)
Item
Cell type on which test was performed (% Donor cells): PMNs (neutrophils)
float
C0200633 (UMLS CUI [1])
Lymphocytes, NOS
Item
Cell type on which test was performed (% Donor cells): Lymphocytes, NOS
float
C0024264 (UMLS CUI [1])
Myeloid cells, NOS
Item
Cell type on which test was performed (% Donor cells): Myeloid cells, NOS
float
C0887899 (UMLS CUI [1])
Specification of other cell type
Item
Cell type on which test was performed: Other, specify:
text
C0449475 (UMLS CUI [1])
Other cell type - value
Item
Cell type on which test was performed (% Donor cells): Other
float
C0449475 (UMLS CUI [1,1])
C1522609 (UMLS CUI [1,2])
Item
Test used:
text
C0022885 (UMLS CUI [1])
CL Item
Molecular (Molecular)
CL Item
Cytogenetic (Cytogenetic)
CL Item
ABO group (ABO group)
CL Item
unknown (unknown)
Specification other labaratory tests
Item
Test used: If other, specify:
text
C0022885 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
Secondary Malignancy, Lymphoproliferative or Myeloproliferative disorder diagnosed
text
C3266877 (UMLS CUI [1,1])
C0024314 (UMLS CUI [1,2])
C0027022 (UMLS CUI [1,3])
Code List
Secondary Malignancy, Lymphoproliferative or Myeloproliferative disorder diagnosed
CL Item
Previously reported (Previously reported)
CL Item
No at date of this follow up (No at date of this follow up)
Date of diagnosis
Item
If yes, specify date of diagnosis
date
C2316983 (UMLS CUI [1])
Item
If yes, specify the diagnosis
text
C0011900 (UMLS CUI [1])
Code List
If yes, specify the diagnosis
CL Item
Lymphoproliferative disorder (Lymphoproliferative disorder)
Specification of other diagnosis
Item
If other, specify:
text
C0011900 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
If additional treatment is given, specify for cellular therapy:
text
C1706712 (UMLS CUI [1,1])
C0302189 (UMLS CUI [1,2])
Code List
If additional treatment is given, specify for cellular therapy:
CL Item
Unknown (Unknown)
Item
If yes, specify the disease status before this cellular therapy
text
C0699749 (UMLS CUI [1])
Code List
If yes, specify the disease status before this cellular therapy
CL Item
Not in CR (Not in CR)
CL Item
Not evaluated (Not evaluated)
Item
If yes, specify the cell type
text
C0449475 (UMLS CUI [1])
Code List
If yes, specify the cell type
CL Item
Donor lymphocyte infusion (DLI) (Donor lymphocyte infusion (DLI))
CL Item
Mesenchymal cells (Mesenchymal cells)
CL Item
Unknown (Unknown)
Specification: other cell type
Item
If yes, specify the cell type: If cell type other, specify:
text
C0449475 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
If DLI, specify the number of cells infused by type: Nucleated cells
text
C1180059 (UMLS CUI [1])
Code List
If DLI, specify the number of cells infused by type: Nucleated cells
CL Item
Evaluated (Evaluated)
CL Item
Not evaluated (Not evaluated)
CL Item
unknown (unknown)
Number of infused Nucleated cells
Item
If DLI, specify the number of cells infused by type: Nucleated cells (10^8/kg)
float
C1180059 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Item
If DLI, specify the number of cells infused by type: CD 34+
text
C3538723 (UMLS CUI [1])
Code List
If DLI, specify the number of cells infused by type: CD 34+
CL Item
Evaluated (Evaluated)
CL Item
Not Evaluated (Not Evaluated)
CL Item
Unknown (Unknown)
Number of infused CD34+ cells
Item
Number of infused CD34+ cells
float
C3538723 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Item
If DLI, specify the number of cells infused by type: CD 3+
text
C3542405 (UMLS CUI [1])
Code List
If DLI, specify the number of cells infused by type: CD 3+
CL Item
Evaluated (Evaluated )
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Number of infused CD3+ cells
Item
Number of infused CD3+ cells
float
C3542405 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Item
If non DLI, specify total number of cells infused:
text
C0007584 (UMLS CUI [1])
Code List
If non DLI, specify total number of cells infused:
CL Item
Evaluated (Evaluated)
CL Item
Not Evaluated (Not Evaluated)
CL Item
Unknown (Unknown)
Total number of cells infused
Item
If non DLI, specify the total number of cells infused (10^6/kg)
float
C0007584 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Chronological number
Item
Chronological number of this cell therapy for this patient
float
C2348184 (UMLS CUI [1])
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
Planned/ protocol (Planned/ protocol)
CL Item
Treatment for disease (Treatment for disease)
CL Item
Prophylactic (Prophylactic)
CL Item
Mixed chimaerism (Mixed chimaerism)
CL Item
Treatment of GvHD (Treatment of GvHD)
CL Item
Treatment viral infection (Treatment viral infection)
CL Item
Loss/decreased chimaerism (Loss/decreased chimaerism)
CL Item
Treatment PTLD, EBV, lymphoma (Treatment PTLD, EBV, lymphoma)
Specification of other indication
Item
Indication: If other, specify:
text
C3146298 (UMLS CUI [1,1])
C0302189 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Number of Infusions
Item
Number of Infusions (within 10 weeks) (count only infusions that are part of same regimen and given for the same indication)
float
C2348184 (UMLS CUI [1,1])
C1289919 (UMLS CUI [1,2])
Item
Acute Graft versus Host Disease (after this infusion but before any further infusion/ transplant) Maximum grade:
text
C0856825 (UMLS CUI [1])
Code List
Acute Graft versus Host Disease (after this infusion but before any further infusion/ transplant) Maximum grade:
CL Item
grade 0 (absent) (grade 0 (absent))
CL Item
grade 1 (grade 1)
CL Item
grade 2 (grade 2)
CL Item
grade 3 (grade 3)
CL Item
grade 4 (grade 4)
CL Item
present, grade unknown (present, grade unknown)
Item
Disease treatment
text
C0087111 (UMLS CUI [1])
Code List
Disease treatment
CL Item
Unknown (Unknown)
Item
If yes, specify:
text
C2348235 (UMLS CUI [1])
Code List
If yes, specify:
CL Item
Planned (planned before HSCT took place) (Planned (planned before HSCT took place))
CL Item
Not planned (for relapse/ progression or persistent disease) (Not planned (for relapse/ progression or persistent disease))
Item
Imatinib (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
text
C0935989 (UMLS CUI [1])
Code List
Imatinib (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
CL Item
Ongoing (Ongoing)
Imatinib duration
Item
Imatinib: If yes, specify duration: (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
durationDatetime
C0935989 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
Item
Dasatinib (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
text
C1455147 (UMLS CUI [1])
Code List
Dasatinib (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
CL Item
Ongoing (Ongoing)
Dasatinib duration
Item
Dasatinib, If yes, specify duration: (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
durationDatetime
C1455147 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
Item
Nilotinib (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
text
C1721377 (UMLS CUI [1])
Code List
Nilotinib (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
CL Item
Ongoing (Ongoing)
Nilotinib duration
Item
Nilotinib If yes, specify duration: (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
durationDatetime
C1721377 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
Item
Interferon alpha (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
text
C0002199 (UMLS CUI [1])
Code List
Interferon alpha (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
CL Item
Ongoing (Ongoing)
Interferon alpha duration
Item
Interferon alpha If yes, specify duration: (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
durationDatetime
C0002199 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
Other chemo/ drug
Item
Other chemo/ drug (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
text
C0392920 (UMLS CUI [1])
Other chemo/ drug duration
Item
Other chemo/ drug If yes, specify duration: (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
datetime
C0392920 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
Item
Immunosuppressive therapy (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
text
C0021079 (UMLS CUI [1])
Code List
Immunosuppressive therapy (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
CL Item
No (therapy stopped) (No (therapy stopped))
CL Item
Yes (with tapering) (Yes (with tapering))
CL Item
Yes, tapering off (Yes, tapering off)
CL Item
Unknown (Unknown)
Item
Other treatment (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
text
C1706712 (UMLS CUI [1])
Code List
Other treatment (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
CL Item
Unknown (Unknown)
Other treatment specification
Item
Other treatment If yes, specify: (Please report every treatment given - please replicate these items as often as necessary in order to provide the history of all assessments since last report)
text
C1706712 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
Relapse or Progression
text
C0277556 (UMLS CUI [1])
C0242656 (UMLS CUI [2])
Code List
Relapse or Progression
CL Item
Previously reported (Previously reported)
CL Item
Continous progression since transplant (Continous progression since transplant)
CL Item
Unknown (Unknown)
Date of diagnosis
Item
If yes, specify date of diagnosis
date
C2316983 (UMLS CUI [1])
Item
Clinical/ haematological relapse or progression
text
C0205210 (UMLS CUI [1,1])
C0277556 (UMLS CUI [1,2])
C0205210 (UMLS CUI [2,1])
C0242656 (UMLS CUI [2,2])
C0018943 (UMLS CUI [3,1])
C0277556 (UMLS CUI [3,2])
C0018943 (UMLS CUI [4,1])
C0242656 (UMLS CUI [4,2])
Code List
Clinical/ haematological relapse or progression
CL Item
Not evaluated (Not evaluated)
Date of assessment
Item
If No, specify Date of assessment:
date
C2985720 (UMLS CUI [1])
Date of initial diagnosis
Item
If Yes, specify date first seen:
date
C2316983 (UMLS CUI [1,1])
C0205265 (UMLS CUI [1,2])
Item
If Yes, specify affected site:
text
C1515974 (UMLS CUI [1])
Code List
If Yes, specify affected site:
CL Item
extramedullary (extramedullary)
Item
If Haematological relapse yes, specify:
text
C0699749 (UMLS CUI [1])
Code List
If Haematological relapse yes, specify:
CL Item
Chronic phase (Chronic phase)
CL Item
Accelerated phase (Accelerated phase)
CL Item
Blast crisis (Blast crisis)
Item
Cytogenetic relapse or progression
text
C0277556 (UMLS CUI [1,1])
C0010802 (UMLS CUI [1,2])
C0242656 (UMLS CUI [2,1])
C0010802 (UMLS CUI [2,2])
Code List
Cytogenetic relapse or progression
CL Item
Not evaluated (Not evaluated)
Date of assessment
Item
If No, specify Date of assessment:
date
C2985720 (UMLS CUI [1])
Date of initial diagnosis
Item
If Yes, specify date first seen:
date
C2316983 (UMLS CUI [1,1])
C0205265 (UMLS CUI [1,2])
Item
If Yes, specify affected site:
text
C1515974 (UMLS CUI [1])
Code List
If Yes, specify affected site:
CL Item
extramedullary (extramedullary)
Item
Molecular relapse or progression
text
C0277556 (UMLS CUI [1,1])
C0026376 (UMLS CUI [1,2])
C0242656 (UMLS CUI [2,1])
C0026376 (UMLS CUI [2,2])
Code List
Molecular relapse or progression
CL Item
Not evaluated (Not evaluated)
Date of assessment
Item
If No, specify Date of assessment:
date
C2985720 (UMLS CUI [1])
Date of initial diagnosis
Item
If Yes, specify date first seen:
date
C2316983 (UMLS CUI [1,1])
C0205265 (UMLS CUI [1,2])
Item
If Yes, specify affected site:
text
C1515974 (UMLS CUI [1])
Code List
If Yes, specify affected site:
CL Item
extramedullary (extramedullary)
Item
Clinical/ haematological disease stage: (record the ost recent status and date for each method)
text
C0205210 (UMLS CUI [1,1])
C0699749 (UMLS CUI [1,2])
C0018943 (UMLS CUI [2,1])
C0699749 (UMLS CUI [2,2])
Code List
Clinical/ haematological disease stage: (record the ost recent status and date for each method)
CL Item
Not evaluated (Not evaluated)
Date of assessment
Item
If Yes, specify last date of evaluation:
date
C2985720 (UMLS CUI [1])
Item
If Disease detected by Clinical/ Haematological Method "yes", specify:
text
C0699749 (UMLS CUI [1])
Code List
If Disease detected by Clinical/ Haematological Method "yes", specify:
CL Item
Chronic phase (Chronic phase)
CL Item
Accelerated phase (Accelerated phase)
CL Item
Blast crisis (Blast crisis)
Item
Cytogenetic/ FISH
text
C0010802 (UMLS CUI [1])
C0162789 (UMLS CUI [2])
Code List
Cytogenetic/ FISH
CL Item
Not evaluated (Not evaluated)
Relapse/ progesseion
Item
If Yes, considered disease relapse/ progression
boolean
C0277556 (UMLS CUI [1])
C0242656 (UMLS CUI [2])
t(9;22) + metaphases
Item
If Yes, specify t(p;22) + metaphases (%)
float
C3897138 (UMLS CUI [1])
C1621812 (UMLS CUI [2])
t(9;22) + cells by FISH
Item
If Yes, specify t(9;22) + cells by FISH (%)
float
C3897138 (UMLS CUI [1])
C0162789 (UMLS CUI [2])
Date of assessment
Item
If Yes, specify last date of evaluation:
date
C2985720 (UMLS CUI [1])
Item
Molecular
text
C0026376 (UMLS CUI [1])
CL Item
Not Evaluated (Not Evaluated)
Relapse/ Progression
Item
If Yes, considered disease relapse/ progression
boolean
C0277556 (UMLS CUI [1])
C0242656 (UMLS CUI [2])
Date of assessment
Item
If Yes, specify last date of evaluation:
date
C2985720 (UMLS CUI [1])
Item
Survival status
text
C1148433 (UMLS CUI [1])
Code List
Survival status
Item
If alive: Type of score used:
text
C1518965 (UMLS CUI [1])
Code List
If alive: Type of score used:
CL Item
Karnofsky (Karnofsky)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
If alive and performance score evaluated, specify:
text
C1518965 (UMLS CUI [1,1])
C1522609 (UMLS CUI [1,2])
Code List
If alive and performance score evaluated, specify:
CL Item
100 (Normal, NED) (100 (Normal, NED))
CL Item
90 (Normal activity) (90 (Normal activity))
CL Item
80 (Normal with effort) (80 (Normal with effort))
CL Item
70 (Cares for self) (70 (Cares for self))
CL Item
60 (Requires occasional assistance) (60 (Requires occasional assistance))
CL Item
50 (Requires assistance) (50 (Requires assistance))
CL Item
40 (Disabled) (40 (Disabled))
CL Item
30 (Severely disabled) (30 (Severely disabled))
CL Item
20 (Very sick) (20 (Very sick))
CL Item
10 (Moribund) (10 (Moribund))
Item
If dead, specify cause of death:
text
C0007465 (UMLS CUI [1])
Code List
If dead, specify cause of death:
CL Item
Relapse or progression (Relapse or progression)
CL Item
Secondary malignancy (including lymphoproliferative disease) (Secondary malignancy (including lymphoproliferative disease))
CL Item
HSCT related cause (HSCT related cause )
CL Item
Unknown (Unknown )
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): GvHD
text
C0007465 (UMLS CUI [1,1])
C0018133 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): GvHD
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Interstitial Pneumonitis
text
C0007465 (UMLS CUI [1,1])
C0206061 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Interstitial Pneumonitis
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Pulmonary toxicity
text
C0007465 (UMLS CUI [1,1])
C0919924 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Pulmonary toxicity
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Infection
text
C0007465 (UMLS CUI [1,1])
C0009450 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Infection
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): If Infection, specify:
text
C0007465 (UMLS CUI [1,1])
C0009450 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): If Infection, specify:
CL Item
Bacterial (Bacterial)
CL Item
Parasitic (Parasitic)
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Rejection/ Poor graft function
text
C0007465 (UMLS CUI [1,1])
C0018129 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Rejection/ Poor graft function
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Veno-Occlusive disease (VOD)
text
C0007465 (UMLS CUI [1,1])
C0948441 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Veno-Occlusive disease (VOD)
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Haemorrhage
text
C0007465 (UMLS CUI [1,1])
C0019080 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Haemorrhage
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Cardiac toxicity
text
C0007465 (UMLS CUI [1,1])
C0876994 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Cardiac toxicity
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Central nervous system toxicity
text
C0007465 (UMLS CUI [1,1])
C3160947 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Central nervous system toxicity
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Gastro intestinal toxicity
text
C0007465 (UMLS CUI [1,1])
C1142499 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Gastro intestinal toxicity
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Skin toxicity
text
C0007465 (UMLS CUI [1,1])
C1167791 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Skin toxicity
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Renal failure
text
C0007465 (UMLS CUI [1,1])
C0035078 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Renal failure
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Multiple organ failure
text
C0007465 (UMLS CUI [1,1])
C0026766 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Multiple organ failure
CL Item
Unknown (Unknown)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Other
text
C0007465 (UMLS CUI [1])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Other
CL Item
Unknown (Unknown)
Specification of other Cause of Death
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): If other, specify:
text
C0007465 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Other Cause of Death
Item
If other, specify:
text
C0007465 (UMLS CUI [1])