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)
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
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
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)
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])
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)
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
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)
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
Not evaluated (Not evaluated)
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
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
No change (No change)
CL Item
Unknown (Unknown)
CL Item
Progression (Progression)
Response Specification
Item
If previous treatment, specify response: If other, specify:
text
C1704632 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])
Item
Additional Pre-HSCT treatment
text
C1706712 (UMLS CUI [1,1])
C2709094 (UMLS CUI [1,2])
Code List
Additional Pre-HSCT treatment
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
No change (No change)
CL Item
Unknown (Unknown)
CL Item
Progression (Progression)
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])
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
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
Not evaluated (Not evaluated)
Item
Cytogenetics
text
C0010802 (UMLS CUI [1])
CL Item
Not done or failed (Not done or failed)
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
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
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])
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)
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
Lymphadenopathy
text
C0497156 (UMLS CUI [1])
Code List
Lymphadenopathy
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
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
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
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
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
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
Unknown (Unknown)
Item
Additional Disease Treatment
text
C1706712 (UMLS CUI [1])
Code List
Additional Disease Treatment
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
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
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
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
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])
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
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])