ID

13884

Description

ODM derived from HSCT forms on http://www.ebmt.org/

Link

http://www.ebmt.org/

Keywords

  1. 3/13/16 3/13/16 -
Uploaded on

March 13, 2016

DOI

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License

Creative Commons BY-NC-ND 3.0

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Specification of the disease EBMT CLL

Specification of the disease EBMT CLL

Initial Diagnosis
Description

Initial Diagnosis

Has the information requested in this section been submittedwith a previous HSCT registration?
Description

Registration

Data type

text

Alias
UMLS CUI [1]
C1514821
Subclassification
Description

Subclassification

Data type

text

Alias
UMLS CUI [1]
C0008902
If Richter's syndrome and CLL previously known, specify date of CLL diagnosis
Description

Date of diagnosis

Data type

date

Alias
UMLS CUI [1,1]
C2316983
UMLS CUI [1,2]
C0023434
If other, specify:
Description

Other Subclassification

Data type

text

Alias
UMLS CUI [1,1]
C0008902
UMLS CUI [1,2]
C2348235
Biological Risk Factor Assessment: Cytogenetics
Description

Cytogenetics

Data type

text

Alias
UMLS CUI [1]
C0010802
Biological Risk Factor Assessment: Technique:
Description

Laboratory Procedures

Data type

text

Alias
UMLS CUI [1]
C0022885
Biological Risk Factor Assessment: Abnormalities (if present)
Description

Chromosomal Abnormalities

Data type

text

Alias
UMLS CUI [1]
C0008625
Biological Risk Factor Assessment: Abnormalities (if present) If other, specify:
Description

Chromosomal abnormalities specification

Data type

text

Alias
UMLS CUI [1,1]
C0008625
UMLS CUI [1,2]
C2348235
VH gene status
Description

VH gene

Data type

text

Alias
UMLS CUI [1]
C0017353
VH gene status: If evaluated, specify VH3-21 status:
Description

VH gene specification

Data type

text

Alias
UMLS CUI [1,1]
C0017353
UMLS CUI [1,2]
C2348235
Biological Risk Factor Assessment: Markers: Molecular or other type of markers:
Description

Markers

Data type

text

Alias
UMLS CUI [1]
C0005516
Biological Risk Factor Assessment: Markers: Molecular or other type of markers: If present, specify:
Description

Markers Specification

Data type

text

Alias
UMLS CUI [1,1]
C0005516
UMLS CUI [1,2]
C2348235
Biological Risk Factor Assessment: Markers Molecular or other type of markers: If present and ZAP-70 (Expression cut-off used), specify: (%)
Description

ZAP-70

Data type

float

Measurement units
  • %
Alias
UMLS CUI [1]
C1421567
%
Biological Risk Factor Assessment: Markers: Molecular or other type of markers: If present and other, specify:
Description

Marker Specification

Data type

text

Alias
UMLS CUI [1,1]
C0005516
UMLS CUI [1,2]
C2348235
Clinical status at diagnosis: Lymphocyte doubling time
Description

Lymphocyte doubling time

Data type

text

Alias
UMLS CUI [1]
C2986483
Clinical Status at diagnosis: Binet stage
Description

Binet stage

Data type

text

Alias
UMLS CUI [1]
C1511118
If this registration pertains to a second or subsequent HSCT the therapy number should be counted since last reported HSCT
Description

If this registration pertains to a second or subsequent HSCT the therapy number should be counted since last reported HSCT

Was the patient treated before the HSCT procedure?
Description

Previous treatment

Data type

text

Alias
UMLS CUI [1]
C0087111
If previous treatment, specify Start Date:
Description

Start Date

Data type

date

Alias
UMLS CUI [1]
C0808070
If previous treatment, specify sequential number of this treatment (Counted from diagnosis, or last HSCT if applicable)
Description

Sequential Number

Data type

float

Alias
UMLS CUI [1]
C2348184
If previous treatment, specify the modality: Chemo/ drug/ agent (including MoAB, vaccination, etc.)
Description

Pharmacotherapy

Data type

boolean

Alias
UMLS CUI [1]
C0013216
If Chemotherapy, specify the regimen:
Description

Chemotherapy Regimen

Data type

text

Alias
UMLS CUI [1]
C0392920
If Chemotherapy, specify the number of cycles:
Description

Number of cycles

Data type

float

Alias
UMLS CUI [1]
C0750480
If previous treatment, specify the modality: Radiotherapy
Description

Radiotherapy

Data type

boolean

Alias
UMLS CUI [1]
C1522449
If previous treatment, specify response:
Description

Response

Data type

text

Alias
UMLS CUI [1]
C1704632
If previous treatment, specify response: If other, specify:
Description

Response Specification

Data type

text

Alias
UMLS CUI [1,1]
C1704632
UMLS CUI [1,2]
C2348235
If this registration pertains to a second or subsequent HSCT the therapy number should be counted since last reported HSCT
Description

If this registration pertains to a second or subsequent HSCT the therapy number should be counted since last reported HSCT

Additional Pre-HSCT treatment
Description

Additional Pre-HSCT treatment

Data type

text

Alias
UMLS CUI [1,1]
C1706712
UMLS CUI [1,2]
C2709094
If additional Pre-HSCT treatment performed, specify start date:
Description

Start Date

Data type

date

Alias
UMLS CUI [1]
C0808070
If additional Pre-HSCT treatment performed, specify sequential number of this treatment: (counted from diagnosis, or last HSCT if applicable)
Description

Sequential number

Data type

float

Alias
UMLS CUI [1]
C2348184
If additional Pre-HSCT treatment performed, specify modality: Chemo/ drug/ agent (including MoAB, vaccination, etc.)
Description

Pharmacotherapy

Data type

boolean

Alias
UMLS CUI [1]
C0013216
If additional chemo/ drug/ agent treatment performed, specify chemotherapy regimen:
Description

Chemotherapy Regimen

Data type

text

Alias
UMLS CUI [1]
C0392920
If additional chemo/ drug/ agent treatment performed, specify chemotherapy cycle:
Description

Chemotherapy cycle

Data type

float

Alias
UMLS CUI [1]
C1302181
If additional Pre-HSCT treatment performed, specify modality: Radiotherapy
Description

Radiotherapy

Data type

boolean

Alias
UMLS CUI [1]
C1522449
If additional Pre-HSCT treatment performed, specify disease response:
Description

Disease Response

Data type

text

Alias
UMLS CUI [1]
C1704632
If additional Pre-HSCT treatment performed, specify disease response If other, specify:
Description

Disease Response

Data type

text

Alias
UMLS CUI [1,1]
C1704632
UMLS CUI [1,2]
C2348235
To be evaluated just before starting conditioning
Description

To be evaluated just before starting conditioning

Date of HSCT
Description

Date of HSCT

Data type

date

Alias
UMLS CUI [1]
C2584899
Splenectomy
Description

Splenectomy

Data type

boolean

Alias
UMLS CUI [1]
C0037995
If Splenectomy performed, specify date:
Description

Date of Splenectomy

Data type

date

Alias
UMLS CUI [1,1]
C0037995
UMLS CUI [1,2]
C2584899
Disease Status:
Description

Disease Status

Data type

text

Alias
UMLS CUI [1]
C1704632
Residual disease status (only to be completed when patient in Haematological CR): Minimal residual disease investigated by: Immunophenotyping
Description

Immunophenotyping

Data type

text

Alias
UMLS CUI [1]
C0079611
Residual disease status (only to be completed when patient in Haematological CR): Minimal residual disease investigated by: Molecular Biology
Description

Molecular Biology

Data type

text

Alias
UMLS CUI [1]
C0026376
Residual disease status (only to be completed when patient in Haematological CR): Sensitivity of minimal residual disease (MRD) assay: Known?
Description

Minimal residual disease

Data type

boolean

Alias
UMLS CUI [1]
C1511791
Residual disease status (only to be completed when patient in Haematological CR): Sensitivity of minimal residual disease (MRD) assay If known, specify:
Description

Minimal residual disease specification

Data type

text

Alias
UMLS CUI [1,1]
C1511791
UMLS CUI [1,2]
C2348235
Worst Binet stage up to and including this date:
Description

Binet stage

Data type

text

Alias
UMLS CUI [1]
C1511118
Disease Status at HSCT - Biological Risk Factor Assessment
Description

Disease Status at HSCT - Biological Risk Factor Assessment

Cytogenetics
Description

Cytogenetics

Data type

text

Alias
UMLS CUI [1]
C0010802
Laboratory Technique
Description

Laboratory Technique

Data type

text

Alias
UMLS CUI [1]
C0376583
Chromosomal Abnormalities
Description

Chromosomal Abnormalities

Data type

text

Alias
UMLS CUI [1]
C0008625
Chromosomal Abnormalities: If other, specify:
Description

Chromosomal Abnormalities Specification

Data type

text

Alias
UMLS CUI [1,1]
C0008625
UMLS CUI [1,2]
C2348235
VH gene status
Description

VH gene status

Data type

text

Alias
UMLS CUI [1]
C0017353
If evaluated: VH3-21 status:
Description

VH gene status specification

Data type

text

Alias
UMLS CUI [1,1]
C0017353
UMLS CUI [1,2]
C2348235
Disease Status at HSCT - Haematological values
Description

Disease Status at HSCT - Haematological values

Hb Evaluated?
Description

Hb

Data type

boolean

Alias
UMLS CUI [1]
C0518015
If Hb evaluated, specify:
Description

Hb value

Data type

float

Measurement units
  • g/dL
Alias
UMLS CUI [1,1]
C0518015
UMLS CUI [1,2]
C1522609
g/dL
Platelets Evaluated?
Description

Platelets

Data type

boolean

Alias
UMLS CUI [1]
C0005821
If platelets evaluated, specify:
Description

Platelets value

Data type

float

Measurement units
  • 10^9/L
Alias
UMLS CUI [1,1]
C0005821
UMLS CUI [1,2]
C1522609
10^9/L
White Blood Count Evaluated?
Description

White Blood Count

Data type

boolean

Alias
UMLS CUI [1]
C0023508
If White Blood Count evaluated, specify:
Description

White Blood Count value

Data type

float

Measurement units
  • 10^9/L
Alias
UMLS CUI [1,1]
C0023508
UMLS CUI [1,2]
C1522609
10^9/L
Lymphocytes Evaluated?
Description

Lymphocytes

Data type

boolean

Alias
UMLS CUI [1]
C0200635
If Lymphocytes evaluated, specify:
Description

Lymphocytes percentage

Data type

float

Measurement units
  • %
Alias
UMLS CUI [1,1]
C0200635
UMLS CUI [1,2]
C0439165
%
BM aspirate: lymphocytes Evaluated?
Description

BM aspirate: lymphocytes

Data type

boolean

Alias
UMLS CUI [1,1]
C0857285
UMLS CUI [1,2]
C0200635
If BM aspirate: lymphocytes evaluated, specify:
Description

BM aspirate: lymphocytes percentage

Data type

float

Measurement units
  • %
Alias
UMLS CUI [1,1]
C0857285
UMLS CUI [1,2]
C0200635
UMLS CUI [1,3]
C0439165
%
BM trephine: lymphocytes Evaluated?
Description

BM trephine: lymphocytes

Data type

boolean

Alias
UMLS CUI [1,1]
C0184925
UMLS CUI [1,2]
C0200635
If BM trephine: lymphocytes evaluated, specify:
Description

BM trephine: lymphocytes percentage

Data type

float

Measurement units
  • %
Alias
UMLS CUI [1,1]
C0184925
UMLS CUI [1,2]
C0200635
UMLS CUI [1,3]
C0439165
%
Disease Status at HSCT - Clinical data
Description

Disease Status at HSCT - Clinical data

Lymphadenopathy
Description

Lymphadenopathy

Data type

text

Alias
UMLS CUI [1]
C0497156
If yes, number of lymph node sites
Description

Number of lymph node site

Data type

text

Alias
UMLS CUI [1,1]
C0024204
UMLS CUI [1,2]
C0237753
Thoraco abdominal CT scan
Description

Thoraco abdominal CT scan

Data type

text

Alias
UMLS CUI [1]
C0202823
UMLS CUI [2]
C0412620
Palpable Splenomegaly
Description

Palpable Splenomegaly

Data type

text

Alias
UMLS CUI [1]
C0038002
Palpable Splenomegaly: Physical examination: evaluated?
Description

Physical examination: Splenomegaly

Data type

boolean

Alias
UMLS CUI [1,1]
C0038002
UMLS CUI [1,2]
C0031809
Palpable Splenomegaly: Physical examination: If evaluated, specify: cm (below costal margin)
Description

Physical Examination: Splenomegaly value

Data type

float

Measurement units
  • cm
Alias
UMLS CUI [1,1]
C0038002
UMLS CUI [1,2]
C0031809
UMLS CUI [1,3]
C1522609
cm
Palpable Splenomegaly: Spleen span in ultrasound or CT scan: evaluated?
Description

Imaging: Splenomegaly

Data type

boolean

Alias
UMLS CUI [1,1]
C0038002
UMLS CUI [1,2]
C0011923
Palpable Splenomegaly: Spleen span in ultrasound or CT scan: If evaluated, specify: cm (maximum diameter)
Description

Imaging: Splenomegaly value

Data type

float

Measurement units
  • cm
Alias
UMLS CUI [1,1]
C0038002
UMLS CUI [1,2]
C0011923
UMLS CUI [1,3]
C1522609
cm
Palpable Hepatomegaly
Description

Palpable Hepatomegaly

Data type

text

Alias
UMLS CUI [1]
C0019209
Palpable Hepatomegaly: Physical examination: evaluated?
Description

Physical examination: Hepatomegaly

Data type

boolean

Alias
UMLS CUI [1,1]
C0019209
UMLS CUI [1,2]
C0031809
Palpable Hepatomegaly: Physical examination: If evaluated, specify: cm (below costal margin)
Description

Physical Examination: Hepatomegaly value

Data type

float

Measurement units
  • cm
Alias
UMLS CUI [1,1]
C0019209
UMLS CUI [1,2]
C0031809
UMLS CUI [1,3]
C1522609
cm
Palpable Hepatomegaly: Liver span in ultrasound or CT scan: evaluated?
Description

Imaging: Hepatomegaly

Data type

boolean

Alias
UMLS CUI [1,1]
C0019209
UMLS CUI [1,2]
C0011923
Palpable Hepatomegaly: Liver span in ultrasound or CT scan: If evaluated, specify: cm (maximum diameter)
Description

Imaging: Hepatomegaly value

Data type

float

Measurement units
  • cm
Alias
UMLS CUI [1,1]
C0019209
UMLS CUI [1,2]
C0011923
UMLS CUI [1,3]
C1522609
cm
If patient has not been treated before skip this section and go to additional treatment Post-HSCT. Purine analogue-refractory? (non response or relapse within 6 months after completion of purine analogue- containing chemotherapy)
Description

Purine analogue-refractory

Data type

text

Alias
UMLS CUI [1,1]
C3653380
UMLS CUI [1,2]
C0205269
If patient has not been treated before skip this section and go to additional treatment Post-HSCT. Early relapse after intensive therapy? (within 24 months after completion of purine analogue-containing combination therapy or autologous SCT)
Description

Early relapse after intensive therapy

Data type

text

Alias
UMLS CUI [1,1]
C0277556
UMLS CUI [1,2]
C0392920
Additional-Treatment Post-HSCT
Description

Additional-Treatment Post-HSCT

Additional Disease Treatment
Description

Additional Disease Treatment

Data type

text

Alias
UMLS CUI [1]
C1706712
If Additional Disease Treatment performed, specify:
Description

Additional Disease Treatment Specification

Data type

text

Alias
UMLS CUI [1,1]
C1706712
UMLS CUI [1,2]
C2348235
If Additional Disease Treatment performed, specify start date:
Description

Start Date

Data type

date

Alias
UMLS CUI [1]
C0808070
If Additonal Disease Treatment performed, specify: Chemo/drug/agent (including MoAB, vaccination, etc.) Known?
Description

Pharmacotherapy

Data type

boolean

Alias
UMLS CUI [1]
C0013216
If Additonal Disease Treatment performed, specify: Chemo/drug/agent (including MoAB, vaccination, etc.) If performed, specify:
Description

Chemotherapy Regimen

Data type

text

Alias
UMLS CUI [1]
C0392920
If Additional Disease Treatment performed, specify: Radiotherapy
Description

Radiotherapy

Data type

text

Alias
UMLS CUI [1]
C1522449
If Additional Disease Treatment performed, specify: Other treatment
Description

Additional Disease Treatment Specification

Data type

text

Alias
UMLS CUI [1,1]
C1706712
UMLS CUI [1,2]
C2348235
If Additional Disease Treatment performed, specify: Other treatment If Yes, specify:
Description

Additional Disease Treatment Specification

Data type

text

Alias
UMLS CUI [1,1]
C1706712
UMLS CUI [1,2]
C2348235
BM trephine: lymphocytes percentage
Description

BM trephine: lymphocytes percentage

Data type

text

Best Disease Response at 100 days post-HSCT
Description

Best Disease Response at 100 days post-HSCT

Best Disease Response at 100 days post-HSCT
Description

Best Disease Response

Data type

text

Alias
UMLS CUI [1]
C1704632
Date of evaluation
Description

Date of evaluation

Data type

date

Alias
UMLS CUI [1]
C2985720
Residual Disease Status (Only to be completed when patient in Haematological Complete Remission) Minimal residual disease investigated by: Immunophenotyping
Description

Immunophenotyping

Data type

text

Alias
UMLS CUI [1]
C0079611
Residual Disease Status (Only to be completed when patient in Haematological Complete Remission) Minimal residual disease investigated by: Molecular Biology
Description

Molecular Biology

Data type

text

Alias
UMLS CUI [1]
C0026376
Residual disease status (only to be completed when patient in Haematological CR): Sensitivity of minimal residual disease (MRD) assay: Known?
Description

Minimal Residual Disease

Data type

boolean

Alias
UMLS CUI [1]
C1511791
Residual disease status (only to be completed when patient in Haematological CR): Sensitivity of minimal residual disease (MRD) assay If known, specify:
Description

Minimal residual disease specification

Data type

text

Alias
UMLS CUI [1,1]
C1511791
UMLS CUI [1,2]
C2348235
Best Disease Response at 100 days post-HSCT - Haematological values
Description

Best Disease Response at 100 days post-HSCT - Haematological values

Hb Evaluated?
Description

Hb

Data type

boolean

Alias
UMLS CUI [1]
C0518015
If Hb evaluated, specify:
Description

Hb value

Data type

float

Measurement units
  • g/dL
Alias
UMLS CUI [1]
C0019046
g/dL
Platelets Evaluated?
Description

Platelets

Data type

boolean

Alias
UMLS CUI [1]
C0005821
If platelets evaluated, specify:
Description

Platelets value

Data type

float

Measurement units
  • 10^9/L
Alias
UMLS CUI [1,1]
C0005821
UMLS CUI [1,2]
C1522609
10^9/L
White Blood Count Evaluated?
Description

White Blood Count

Data type

boolean

Alias
UMLS CUI [1]
C0023508
If White Blood Count evaluated, specify:
Description

White Blood Count value

Data type

float

Measurement units
  • 10^9/L
Alias
UMLS CUI [1,1]
C0023508
UMLS CUI [1,2]
C1522609
10^9/L
Lymphocyts Evaluated?
Description

Lymphocytes

Data type

boolean

Alias
UMLS CUI [1]
C0200635
If Lymphocyte evaluated, specify:
Description

Lymphocytes percentage

Data type

float

Measurement units
  • %
Alias
UMLS CUI [1,1]
C0200635
UMLS CUI [1,2]
C0439165
%
BM aspirate: lymphocytes Evaluated?
Description

BM aspirate: lymphocytes

Data type

boolean

Alias
UMLS CUI [1,1]
C0857285
UMLS CUI [1,2]
C0200635
If BM aspirate: lymphocytes evaluated, specify:
Description

BM aspirate: lymphocytes percentage

Data type

float

Measurement units
  • %
Alias
UMLS CUI [1,1]
C0857285
UMLS CUI [1,2]
C0200635
UMLS CUI [1,3]
C0439165
%
BM trephine: lymphocytes Evaluated?
Description

BM trephine: lymphocytes

Data type

boolean

Alias
UMLS CUI [1,1]
C0184925
UMLS CUI [1,2]
C0200635
If BM trephine: lymphocytes evaluated, specify:
Description

BM trephine: lymphocytes percentage

Data type

float

Measurement units
  • %
Alias
UMLS CUI [1,1]
C0184925
UMLS CUI [1,2]
C0200635
UMLS CUI [1,3]
C0439165
%
Forms to be filled in
Description

Forms to be filled in

Type of Transplant
Description

Type of Transplant

Data type

text

Alias
UMLS CUI [1,1]
C0559189
UMLS CUI [1,2]
C0040739
If Other, specify:
Description

Type of Transplant Specifcation

Data type

text

Alias
UMLS CUI [1,1]
C0559189
UMLS CUI [1,2]
C0040739
UMLS CUI [1,3]
C2348235

Similar models

Specification of the disease EBMT CLL

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Initial Diagnosis
Item
Has the information requested in this section been submittedwith a previous HSCT registration?
text
C1514821 (UMLS CUI [1])
Code List
Has the information requested in this section been submittedwith a previous HSCT registration?
CL Item
Yes: go to "Pre-HSCT treatment" (Yes: go to "Pre-HSCT treatment")
CL Item
No: proceed with this section (No: proceed with this section)
Item
Subclassification
text
C0008902 (UMLS CUI [1])
Code List
Subclassification
CL Item
Chronic Lymphocytic Leukaemia (CLL)/ Small Lymphocytic Lymphoma (SLL) (Chronic Lymphocytic Leukaemia (CLL)/ Small Lymphocytic Lymphoma (SLL))
CL Item
Prolymphocytic Leukaemia (PLL) (Prolymphocytic Leukaemia (PLL))
CL Item
PLL, B type (PLL, B type)
CL Item
PLL, T type (PLL, T type)
CL Item
Richter's syndrome: (Richter's syndrome:)
CL Item
CLL previously known (CLL previously known)
CL Item
Primary Richter (wihtout previous known diagnosis of CLL) (Primary Richter (wihtout previous known diagnosis of CLL))
CL Item
Hairy Cell Leukaemia (HCL) (Hairy Cell Leukaemia (HCL))
CL Item
Atypical Hairy Cell Leukaemia (Atypical Hairy Cell Leukaemia)
CL Item
Other (Other)
Date of diagnosis
Item
If Richter's syndrome and CLL previously known, specify date of CLL diagnosis
date
C2316983 (UMLS CUI [1,1])
C0023434 (UMLS CUI [1,2])
Other Subclassification
Item
If other, specify:
text
C0008902 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
Biological Risk Factor Assessment: Cytogenetics
text
C0010802 (UMLS CUI [1])
Code List
Biological Risk Factor Assessment: Cytogenetics
CL Item
Not done or failed (Not done or failed)
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
CL Item
Unknown (Unknown)
Item
Biological Risk Factor Assessment: Technique:
text
C0022885 (UMLS CUI [1])
Code List
Biological Risk Factor Assessment: Technique:
CL Item
Conventional (Conventional)
CL Item
FISH (FISH)
CL Item
Both (Both)
CL Item
Unknown (Unknown)
Item
Biological Risk Factor Assessment: Abnormalities (if present)
text
C0008625 (UMLS CUI [1])
Code List
Biological Risk Factor Assessment: Abnormalities (if present)
CL Item
Trisomy 12 (Trisomy 12)
CL Item
Del 13q14 (Del 13q14)
CL Item
t(11;14) (t(11;14))
CL Item
Del 11q22-23 (Del 11q22-23)
CL Item
Del 17p13 (Del 17p13)
CL Item
Other (Other)
Chromosomal abnormalities specification
Item
Biological Risk Factor Assessment: Abnormalities (if present) If other, specify:
text
C0008625 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
VH gene status
text
C0017353 (UMLS CUI [1])
Code List
VH gene status
CL Item
Not mutated (Not mutated)
CL Item
Mutated (Mutated)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
VH gene status: If evaluated, specify VH3-21 status:
text
C0017353 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Code List
VH gene status: If evaluated, specify VH3-21 status:
CL Item
Not used (Not used)
CL Item
Used (Used)
Item
Biological Risk Factor Assessment: Markers: Molecular or other type of markers:
text
C0005516 (UMLS CUI [1])
Code List
Biological Risk Factor Assessment: Markers: Molecular or other type of markers:
CL Item
Absent (Absent)
CL Item
Present (Present)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
Biological Risk Factor Assessment: Markers: Molecular or other type of markers: If present, specify:
text
C0005516 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Code List
Biological Risk Factor Assessment: Markers: Molecular or other type of markers: If present, specify:
CL Item
ZAP-70: Expression cut off used (ZAP-70: Expression cut off used)
CL Item
Other (Other)
ZAP-70
Item
Biological Risk Factor Assessment: Markers Molecular or other type of markers: If present and ZAP-70 (Expression cut-off used), specify: (%)
float
C1421567 (UMLS CUI [1])
Marker Specification
Item
Biological Risk Factor Assessment: Markers: Molecular or other type of markers: If present and other, specify:
text
C0005516 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
Clinical status at diagnosis: Lymphocyte doubling time
text
C2986483 (UMLS CUI [1])
Code List
Clinical status at diagnosis: Lymphocyte doubling time
CL Item
< 12 months (< 12 months)
CL Item
> 12 months (> 12 months)
CL Item
Unknown (Unknown)
Item
Clinical Status at diagnosis: Binet stage
text
C1511118 (UMLS CUI [1])
Code List
Clinical Status at diagnosis: Binet stage
CL Item
A (A)
CL Item
B (B)
CL Item
C (C)
CL Item
Not evaluated (Not evaluated)
Item Group
If this registration pertains to a second or subsequent HSCT the therapy number should be counted since last reported HSCT
Item
Was the patient treated before the HSCT procedure?
text
C0087111 (UMLS CUI [1])
Code List
Was the patient treated before the HSCT procedure?
CL Item
No (proceed to "Date of HSCT") (No (proceed to "Date of HSCT"))
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Start Date
Item
If previous treatment, specify Start Date:
date
C0808070 (UMLS CUI [1])
Sequential Number
Item
If previous treatment, specify sequential number of this treatment (Counted from diagnosis, or last HSCT if applicable)
float
C2348184 (UMLS CUI [1])
Pharmacotherapy
Item
If previous treatment, specify the modality: Chemo/ drug/ agent (including MoAB, vaccination, etc.)
boolean
C0013216 (UMLS CUI [1])
Chemotherapy Regimen
Item
If Chemotherapy, specify the regimen:
text
C0392920 (UMLS CUI [1])
Number of cycles
Item
If Chemotherapy, specify the number of cycles:
float
C0750480 (UMLS CUI [1])
Radiotherapy
Item
If previous treatment, specify the modality: Radiotherapy
boolean
C1522449 (UMLS CUI [1])
Item
If previous treatment, specify response:
text
C1704632 (UMLS CUI [1])
Code List
If previous treatment, specify response:
CL Item
CR (CR)
CL Item
No change (No change)
CL Item
Unknown (Unknown)
CL Item
PR (PR)
CL Item
Progression (Progression)
CL Item
Other (Other)
Response Specification
Item
If previous treatment, specify response: If other, specify:
text
C1704632 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item Group
If this registration pertains to a second or subsequent HSCT the therapy number should be counted since last reported HSCT
Item
Additional Pre-HSCT treatment
text
C1706712 (UMLS CUI [1,1])
C2709094 (UMLS CUI [1,2])
Code List
Additional Pre-HSCT treatment
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Start Date
Item
If additional Pre-HSCT treatment performed, specify start date:
date
C0808070 (UMLS CUI [1])
Sequential number
Item
If additional Pre-HSCT treatment performed, specify sequential number of this treatment: (counted from diagnosis, or last HSCT if applicable)
float
C2348184 (UMLS CUI [1])
Pharmacotherapy
Item
If additional Pre-HSCT treatment performed, specify modality: Chemo/ drug/ agent (including MoAB, vaccination, etc.)
boolean
C0013216 (UMLS CUI [1])
Chemotherapy Regimen
Item
If additional chemo/ drug/ agent treatment performed, specify chemotherapy regimen:
text
C0392920 (UMLS CUI [1])
Chemotherapy cycle
Item
If additional chemo/ drug/ agent treatment performed, specify chemotherapy cycle:
float
C1302181 (UMLS CUI [1])
Radiotherapy
Item
If additional Pre-HSCT treatment performed, specify modality: Radiotherapy
boolean
C1522449 (UMLS CUI [1])
Item
If additional Pre-HSCT treatment performed, specify disease response:
text
C1704632 (UMLS CUI [1])
Code List
If additional Pre-HSCT treatment performed, specify disease response:
CL Item
CR (CR)
CL Item
No change (No change)
CL Item
Unknown (Unknown)
CL Item
PR (PR)
CL Item
Progression (Progression)
CL Item
Other (Other)
Disease Response
Item
If additional Pre-HSCT treatment performed, specify disease response If other, specify:
text
C1704632 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item Group
To be evaluated just before starting conditioning
Date of HSCT
Item
Date of HSCT
date
C2584899 (UMLS CUI [1])
Splenectomy
Item
Splenectomy
boolean
C0037995 (UMLS CUI [1])
Date of Splenectomy
Item
If Splenectomy performed, specify date:
date
C0037995 (UMLS CUI [1,1])
C2584899 (UMLS CUI [1,2])
Item
Disease Status:
text
C1704632 (UMLS CUI [1])
Code List
Disease Status:
CL Item
Never treated (Never treated)
CL Item
CR (CR)
CL Item
PR (PR)
CL Item
Nodular PR (nPR) (Nodular PR (nPR))
CL Item
No response (No response)
CL Item
Unknown (Unknown)
CL Item
Progression: (Progression:)
CL Item
Sensitive to last regimen (Sensitive to last regimen)
CL Item
Resistant to last regimen (Resistant to last regimen)
Item
Residual disease status (only to be completed when patient in Haematological CR): Minimal residual disease investigated by: Immunophenotyping
text
C0079611 (UMLS CUI [1])
Code List
Residual disease status (only to be completed when patient in Haematological CR): Minimal residual disease investigated by: Immunophenotyping
CL Item
Negative (Negative)
CL Item
Positive (Positive)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
Residual disease status (only to be completed when patient in Haematological CR): Minimal residual disease investigated by: Molecular Biology
text
C0026376 (UMLS CUI [1])
Code List
Residual disease status (only to be completed when patient in Haematological CR): Minimal residual disease investigated by: Molecular Biology
CL Item
Negative (Negative)
CL Item
Positive (Positive)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Minimal residual disease
Item
Residual disease status (only to be completed when patient in Haematological CR): Sensitivity of minimal residual disease (MRD) assay: Known?
boolean
C1511791 (UMLS CUI [1])
Minimal residual disease specification
Item
Residual disease status (only to be completed when patient in Haematological CR): Sensitivity of minimal residual disease (MRD) assay If known, specify:
text
C1511791 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
Worst Binet stage up to and including this date:
text
C1511118 (UMLS CUI [1])
Code List
Worst Binet stage up to and including this date:
CL Item
A (A)
CL Item
B (B)
CL Item
C (C)
CL Item
Not evaluated (Not evaluated)
Item Group
Disease Status at HSCT - Biological Risk Factor Assessment
Item
Cytogenetics
text
C0010802 (UMLS CUI [1])
Code List
Cytogenetics
CL Item
Not done or failed (Not done or failed)
CL Item
Normal (Normal)
CL Item
Abnomal (Abnomal)
CL Item
Unknown (Unknown)
Item
Laboratory Technique
text
C0376583 (UMLS CUI [1])
Code List
Laboratory Technique
CL Item
Convential (Convential)
CL Item
FISH (FISH)
CL Item
Both (Both)
CL Item
Unknown (Unknown)
Item
Chromosomal Abnormalities
text
C0008625 (UMLS CUI [1])
Code List
Chromosomal Abnormalities
CL Item
Trisomy 12 (Trisomy 12)
CL Item
Del 13q14 (Del 13q14)
CL Item
t(11;14) (t(11;14))
CL Item
Del 11q22-23 (Del 11q22-23)
CL Item
Other (Other)
CL Item
DEL 17p13 (Del 17p13)
Chromosomal Abnormalities Specification
Item
Chromosomal Abnormalities: If other, specify:
text
C0008625 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
VH gene status
text
C0017353 (UMLS CUI [1])
Code List
VH gene status
CL Item
Not mutated (Not mutated)
CL Item
Mutated (Mutated)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
If evaluated: VH3-21 status:
text
C0017353 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Code List
If evaluated: VH3-21 status:
CL Item
Not used (Not used)
CL Item
Used (Used)
Item Group
Disease Status at HSCT - Haematological values
Hb
Item
Hb Evaluated?
boolean
C0518015 (UMLS CUI [1])
Hb value
Item
If Hb evaluated, specify:
float
C0518015 (UMLS CUI [1,1])
C1522609 (UMLS CUI [1,2])
Platelets
Item
Platelets Evaluated?
boolean
C0005821 (UMLS CUI [1])
Platelets value
Item
If platelets evaluated, specify:
float
C0005821 (UMLS CUI [1,1])
C1522609 (UMLS CUI [1,2])
White Blood Count
Item
White Blood Count Evaluated?
boolean
C0023508 (UMLS CUI [1])
White Blood Count value
Item
If White Blood Count evaluated, specify:
float
C0023508 (UMLS CUI [1,1])
C1522609 (UMLS CUI [1,2])
Lymphocytes
Item
Lymphocytes Evaluated?
boolean
C0200635 (UMLS CUI [1])
Lymphocytes percentage
Item
If Lymphocytes evaluated, specify:
float
C0200635 (UMLS CUI [1,1])
C0439165 (UMLS CUI [1,2])
BM aspirate: lymphocytes
Item
BM aspirate: lymphocytes Evaluated?
boolean
C0857285 (UMLS CUI [1,1])
C0200635 (UMLS CUI [1,2])
BM aspirate: lymphocytes percentage
Item
If BM aspirate: lymphocytes evaluated, specify:
float
C0857285 (UMLS CUI [1,1])
C0200635 (UMLS CUI [1,2])
C0439165 (UMLS CUI [1,3])
BM trephine: lymphocytes
Item
BM trephine: lymphocytes Evaluated?
boolean
C0184925 (UMLS CUI [1,1])
C0200635 (UMLS CUI [1,2])
BM trephine: lymphocytes percentage
Item
If BM trephine: lymphocytes evaluated, specify:
float
C0184925 (UMLS CUI [1,1])
C0200635 (UMLS CUI [1,2])
C0439165 (UMLS CUI [1,3])
Item Group
Disease Status at HSCT - Clinical data
Item
Lymphadenopathy
text
C0497156 (UMLS CUI [1])
Code List
Lymphadenopathy
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
If yes, number of lymph node sites
text
C0024204 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Code List
If yes, number of lymph node sites
CL Item
< 3 (< 3)
CL Item
3- 5 (3- 5)
CL Item
> 5  (> 5 )
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
Thoraco abdominal CT scan
text
C0202823 (UMLS CUI [1])
C0412620 (UMLS CUI [2])
Code List
Thoraco abdominal CT scan
CL Item
Normal (Normal)
CL Item
Abnormal (Abnormal)
CL Item
Not done (Not done)
CL Item
Unknown (Unknown)
Item
Palpable Splenomegaly
text
C0038002 (UMLS CUI [1])
Code List
Palpable Splenomegaly
CL Item
Absent  (Absent)
CL Item
Present  (Present)
CL Item
Not evaluated  (Not evaluated)
CL Item
Unknown (Unknown)
Physical examination: Splenomegaly
Item
Palpable Splenomegaly: Physical examination: evaluated?
boolean
C0038002 (UMLS CUI [1,1])
C0031809 (UMLS CUI [1,2])
Physical Examination: Splenomegaly value
Item
Palpable Splenomegaly: Physical examination: If evaluated, specify: cm (below costal margin)
float
C0038002 (UMLS CUI [1,1])
C0031809 (UMLS CUI [1,2])
C1522609 (UMLS CUI [1,3])
Imaging: Splenomegaly
Item
Palpable Splenomegaly: Spleen span in ultrasound or CT scan: evaluated?
boolean
C0038002 (UMLS CUI [1,1])
C0011923 (UMLS CUI [1,2])
Imaging: Splenomegaly value
Item
Palpable Splenomegaly: Spleen span in ultrasound or CT scan: If evaluated, specify: cm (maximum diameter)
float
C0038002 (UMLS CUI [1,1])
C0011923 (UMLS CUI [1,2])
C1522609 (UMLS CUI [1,3])
Item
Palpable Hepatomegaly
text
C0019209 (UMLS CUI [1])
Code List
Palpable Hepatomegaly
CL Item
Absent  (Absent)
CL Item
Present  (Present)
CL Item
Not evaluated  (Not evaluated)
CL Item
Unknown (Unknown)
Physical examination: Hepatomegaly
Item
Palpable Hepatomegaly: Physical examination: evaluated?
boolean
C0019209 (UMLS CUI [1,1])
C0031809 (UMLS CUI [1,2])
Physical Examination: Hepatomegaly value
Item
Palpable Hepatomegaly: Physical examination: If evaluated, specify: cm (below costal margin)
float
C0019209 (UMLS CUI [1,1])
C0031809 (UMLS CUI [1,2])
C1522609 (UMLS CUI [1,3])
Imaging: Hepatomegaly
Item
Palpable Hepatomegaly: Liver span in ultrasound or CT scan: evaluated?
boolean
C0019209 (UMLS CUI [1,1])
C0011923 (UMLS CUI [1,2])
Imaging: Hepatomegaly value
Item
Palpable Hepatomegaly: Liver span in ultrasound or CT scan: If evaluated, specify: cm (maximum diameter)
float
C0019209 (UMLS CUI [1,1])
C0011923 (UMLS CUI [1,2])
C1522609 (UMLS CUI [1,3])
Item
If patient has not been treated before skip this section and go to additional treatment Post-HSCT. Purine analogue-refractory? (non response or relapse within 6 months after completion of purine analogue- containing chemotherapy)
text
C3653380 (UMLS CUI [1,1])
C0205269 (UMLS CUI [1,2])
Code List
If patient has not been treated before skip this section and go to additional treatment Post-HSCT. Purine analogue-refractory? (non response or relapse within 6 months after completion of purine analogue- containing chemotherapy)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Item
If patient has not been treated before skip this section and go to additional treatment Post-HSCT. Early relapse after intensive therapy? (within 24 months after completion of purine analogue-containing combination therapy or autologous SCT)
text
C0277556 (UMLS CUI [1,1])
C0392920 (UMLS CUI [1,2])
Code List
If patient has not been treated before skip this section and go to additional treatment Post-HSCT. Early relapse after intensive therapy? (within 24 months after completion of purine analogue-containing combination therapy or autologous SCT)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Item Group
Additional-Treatment Post-HSCT
Item
Additional Disease Treatment
text
C1706712 (UMLS CUI [1])
Code List
Additional Disease Treatment
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Item
If Additional Disease Treatment performed, specify:
text
C1706712 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Code List
If Additional Disease Treatment performed, 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))
Start Date
Item
If Additional Disease Treatment performed, specify start date:
date
C0808070 (UMLS CUI [1])
Pharmacotherapy
Item
If Additonal Disease Treatment performed, specify: Chemo/drug/agent (including MoAB, vaccination, etc.) Known?
boolean
C0013216 (UMLS CUI [1])
Chemotherapy Regimen
Item
If Additonal Disease Treatment performed, specify: Chemo/drug/agent (including MoAB, vaccination, etc.) If performed, specify:
text
C0392920 (UMLS CUI [1])
Item
If Additional Disease Treatment performed, specify: Radiotherapy
text
C1522449 (UMLS CUI [1])
Code List
If Additional Disease Treatment performed, specify: Radiotherapy
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Item
If Additional Disease Treatment performed, specify: Other treatment
text
C1706712 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Code List
If Additional Disease Treatment performed, specify: Other treatment
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Additional Disease Treatment Specification
Item
If Additional Disease Treatment performed, specify: Other treatment If Yes, specify:
text
C1706712 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
BM trephine: lymphocytes percentage
Item
text
Item Group
Best Disease Response at 100 days post-HSCT
Item
Best Disease Response at 100 days post-HSCT
text
C1704632 (UMLS CUI [1])
Code List
Best Disease Response at 100 days post-HSCT
CL Item
CR  (CR )
CL Item
PR (PR)
CL Item
No response (No response)
CL Item
Progression (Progression)
CL Item
Unknown (Unknown)
Date of evaluation
Item
Date of evaluation
date
C2985720 (UMLS CUI [1])
Item
Residual Disease Status (Only to be completed when patient in Haematological Complete Remission) Minimal residual disease investigated by: Immunophenotyping
text
C0079611 (UMLS CUI [1])
Code List
Residual Disease Status (Only to be completed when patient in Haematological Complete Remission) Minimal residual disease investigated by: Immunophenotyping
CL Item
Negative (Negative)
CL Item
Positive (Positive)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
Residual Disease Status (Only to be completed when patient in Haematological Complete Remission) Minimal residual disease investigated by: Molecular Biology
text
C0026376 (UMLS CUI [1])
Code List
Residual Disease Status (Only to be completed when patient in Haematological Complete Remission) Minimal residual disease investigated by: Molecular Biology
CL Item
Negative (Negative)
CL Item
Positive (Positive)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Minimal Residual Disease
Item
Residual disease status (only to be completed when patient in Haematological CR): Sensitivity of minimal residual disease (MRD) assay: Known?
boolean
C1511791 (UMLS CUI [1])
Minimal residual disease specification
Item
Residual disease status (only to be completed when patient in Haematological CR): Sensitivity of minimal residual disease (MRD) assay If known, specify:
text
C1511791 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item Group
Best Disease Response at 100 days post-HSCT - Haematological values
Hb
Item
Hb Evaluated?
boolean
C0518015 (UMLS CUI [1])
Hb value
Item
If Hb evaluated, specify:
float
C0019046 (UMLS CUI [1])
Platelets
Item
Platelets Evaluated?
boolean
C0005821 (UMLS CUI [1])
Platelets value
Item
If platelets evaluated, specify:
float
C0005821 (UMLS CUI [1,1])
C1522609 (UMLS CUI [1,2])
White Blood Count
Item
White Blood Count Evaluated?
boolean
C0023508 (UMLS CUI [1])
White Blood Count value
Item
If White Blood Count evaluated, specify:
float
C0023508 (UMLS CUI [1,1])
C1522609 (UMLS CUI [1,2])
Lymphocytes
Item
Lymphocyts Evaluated?
boolean
C0200635 (UMLS CUI [1])
Lymphocytes percentage
Item
If Lymphocyte evaluated, specify:
float
C0200635 (UMLS CUI [1,1])
C0439165 (UMLS CUI [1,2])
BM aspirate: lymphocytes
Item
BM aspirate: lymphocytes Evaluated?
boolean
C0857285 (UMLS CUI [1,1])
C0200635 (UMLS CUI [1,2])
BM aspirate: lymphocytes percentage
Item
If BM aspirate: lymphocytes evaluated, specify:
float
C0857285 (UMLS CUI [1,1])
C0200635 (UMLS CUI [1,2])
C0439165 (UMLS CUI [1,3])
BM trephine: lymphocytes
Item
BM trephine: lymphocytes Evaluated?
boolean
C0184925 (UMLS CUI [1,1])
C0200635 (UMLS CUI [1,2])
BM trephine: lymphocytes percentage
Item
If BM trephine: lymphocytes evaluated, specify:
float
C0184925 (UMLS CUI [1,1])
C0200635 (UMLS CUI [1,2])
C0439165 (UMLS CUI [1,3])
Item Group
Forms to be filled in
Item
Type of Transplant
text
C0559189 (UMLS CUI [1,1])
C0040739 (UMLS CUI [1,2])
Code List
Type of Transplant
CL Item
AUTOgraft (proceed to Autograft form) (AUTOgraft (proceed to Autograft form))
CL Item
ALLOgraft or Syngeneic graft (proceed to Allograft form) (ALLOgraft or Syngeneic graft (proceed to Allograft form))
CL Item
Other (contact the EBMT Central Registry for instructions) (Other (contact the EBMT Central Registry for instructions))
Type of Transplant Specifcation
Item
If Other, specify:
text
C0559189 (UMLS CUI [1,1])
C0040739 (UMLS CUI [1,2])
C2348235 (UMLS CUI [1,3])

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