ID

15657

Beskrivning

DOCUMENTED PATHOGENS (Use this table for guidance on the pathogens of interest) Bacteria: S. pneumoniae, Other gram positive (i.e.: other streptococci, staphylococci, listeria …),Haemophilus influenzae, Other gram negative (i.e.: E. coli klebsiella, proteus, serratia, pseudomonas …), Legionella sp, Mycobacteria sp, Other Fungi: Candida sp, Aspergillus sp, Pneumocystis carinii, Other Parasites: Toxoplasma gondii, Other Viruses: HSV, VZV, EBV, CMV, HHV-6, RSV. Other respiratory virus (influenza, parainfluenza, rhinovirus), Adenovirus, HBV, HCV, HIV,Papovavirus, Parvovirus, Other

Nyckelord

  1. 2016-06-07 2016-06-07 -
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7 juni 2016

DOI

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18pp EBMT Amyloidosis

18pp EBMT Amyloidosis

  1. StudyEvent: ODM
    1. 18pp EBMT Amyloidosis
GENERAL INFORMATION TEAM
Beskrivning

GENERAL INFORMATION TEAM

EBMT Centre Identification Code (CIC)
Beskrivning

EBMT Centre Identification Code (CIC)

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Name of the hospital
Beskrivning

Hospital

Datatyp

text

Alias
UMLS CUI [1]
C0019994
Unit
Beskrivning

Unit

Datatyp

text

Name of contact person
Beskrivning

Contact person

Datatyp

text

Alias
UMLS CUI [1]
C0337611
Telephone number
Beskrivning

Telephone

Datatyp

integer

Alias
UMLS CUI [1]
C1515258
Fax
Beskrivning

Fax

Datatyp

text

Alias
UMLS CUI [1,1]
C1549619
UMLS CUI [1,2]
C0337611
UMLS CUI [1,3]
C0030664
E-Mail
Beskrivning

E-Mail

Datatyp

text

Alias
UMLS CUI [1,1]
C1705961
UMLS CUI [1,2]
C0337611
UMLS CUI [1,3]
C0030664
Date of this report
Beskrivning

Date of this report

Datatyp

date

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

Patient in Trial

Datatyp

integer

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

Name of study / trial

Datatyp

text

Alias
UMLS CUI [1]
C0008976
GENERAL INFORMATION PATIENT
Beskrivning

GENERAL INFORMATION PATIENT

To be entered only if patient previously reported
Beskrivning

Unique Identification Code (UIC)

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number or Code
Beskrivning

Hospital Unique Patient Number or Code

Datatyp

text

Alias
UMLS CUI [1]
C1827636
First name(s)_surname(s)
Beskrivning

Initials

Datatyp

text

Alias
UMLS CUI [1]
C2986440
Date of birth
Beskrivning

Date of birth

Datatyp

date

Alias
UMLS CUI [1]
C0421451
Sex
Beskrivning

Sex

Datatyp

text

Alias
UMLS CUI [1]
C0079399
ABO Group
Beskrivning

ABO Group

Datatyp

text

Rh factor Donor a
Beskrivning

Rh factor

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0035403
UMLS CUI [1,2]
C0013018
DISEASE
Beskrivning

DISEASE

Date of diagnosis
Beskrivning

Date of diagnosis

Datatyp

text

Alias
UMLS CUI [1]
C2316983
Check the disease for which this transplant was performed
Beskrivning

Primary Disease Diagnosis

Datatyp

text

Alias
UMLS CUI [1]
C0277554
AL AMYLOIDOSIS INITIAL DIAGNOSIS
Beskrivning

AL AMYLOIDOSIS INITIAL DIAGNOSIS

Has the information requested in this section been submitted with a previous HSCT registration for this patient?
Beskrivning

SubmittedPreviously

Datatyp

integer

EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
Beskrivning

EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

Datatyp

boolean

if yes
Beskrivning

EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

Datatyp

text

If Other B-cell malignancy, specify
Beskrivning

EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

Datatyp

text

Select one as applicable
Beskrivning

EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

Datatyp

integer

Select one as applicable
Beskrivning

EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

Datatyp

integer

If Multiple myeloma
Beskrivning

Stage at diagnosis (Salmon and Durie) A

Datatyp

integer

If Multiple myeloma
Beskrivning

Stage at diagnosis (Salmon and Durie) B

Datatyp

boolean

DIAGNOSIS OF AMYLOIDOSIS
Beskrivning

Methods Hereditary Amyloidosis

Datatyp

integer

DIAGNOSIS OF AMYLOIDOSIS
Beskrivning

Methods Immunohistochemistry

Datatyp

text

Hb (g/dl) CLINICAL AND LABORATORY DATA
Beskrivning

HbLab

Datatyp

float

Hb (g/dl) CLINICAL AND LABORATORY DATA
Beskrivning

Hb (g/dL)

Datatyp

integer

CLINICAL AND LABORATORY DATA
Beskrivning

Serum creatinine

Datatyp

float

CLINICAL AND LABORATORY DATA Serum creatinine
Beskrivning

Serum creatinine

Datatyp

text

CLINICAL AND LABORATORY DATA Serum creatinine
Beskrivning

Serum creatinine

Datatyp

integer

CLINICAL AND LABORATORY DATA Creatinine clearance (mL/min)
Beskrivning

Creatinine clearance (mL/min)

Datatyp

float

Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
Beskrivning

Creatinine clearance (mL/min)

Datatyp

integer

Total urinary protein excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary protein excretion (mg/24 h)

Datatyp

float

CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
Beskrivning

Total urinary protein excretion (mg/24 h)

Datatyp

integer

Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary albumin excretion (mg/24 h)

Datatyp

float

Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary albumin excretion (mg/24 h)

Datatyp

integer

Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum calcium (mmol/L)

Datatyp

float

Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum calcium (mmol/L)

Datatyp

integer

Serum albumin (g/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum albumin (g/L)

Datatyp

float

Serum albumin (g/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum albumin (g/L)

Datatyp

integer

Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum alkaline phosphatase (IU/L)

Datatyp

float

Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum alkaline phosphatase (IU/L)

Datatyp

integer

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

integer

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

float

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

integer

Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum NT-pro-BNP (ng/L)

Datatyp

float

CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
Beskrivning

Serum NT-pro-BNP (ng/L)

Datatyp

integer

Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum c-Troponin T (μg/L)

Datatyp

float

Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum c-Troponin T (μg/L)

Datatyp

integer

BM aspirate: % plasmacytosis
Beskrivning

BM aspirate

Datatyp

float

BM aspirate % plasmacytosis
Beskrivning

BM aspirate

Datatyp

integer

BM trephine % plasmacytosis
Beskrivning

BM trephine

Datatyp

float

BM trephine: % plasmacytosis
Beskrivning

BM trephine

Datatyp

integer

Monoclonal Ig in serum
Beskrivning

Monoclonal Ig in serum

Datatyp

float

Måttenheter
  • g/L
g/L
Immunofixation of serum
Beskrivning

Immunofixation of serum

Datatyp

integer

Free light chains in serum Kappa light chains
Beskrivning

Kappa light chains

Datatyp

float

Måttenheter
  • mg/L
mg/L
Kappa light chains Not evaluated
Beskrivning

Kappa light chains

Datatyp

boolean

Lambda light chains
Beskrivning

Lambda light chains

Datatyp

float

Måttenheter
  • mg/L
mg/L
Lambda light chains Not evaluated
Beskrivning

Lambda light chains

Datatyp

boolean

Immunofixation of urine
Beskrivning

Immunofixation of urine

Datatyp

integer

Monoclonal light chains in urine
Beskrivning

Monoclonal light chains in urine

Datatyp

float

Måttenheter
  • g/24h
g/24h
Serum Beta2 microglobulin
Beskrivning

Serum Beta2 microglobulin

Datatyp

float

Måttenheter
  • mg/L
mg/L
Bone structure (X-ray)
Beskrivning

Bone structure (X-ray)

Datatyp

integer

Macroglossy Typical clinical symptoms
Beskrivning

Macroglossy

Datatyp

integer

Periorbital bleeding Typical clinical symptoms
Beskrivning

Periorbital bleeding

Datatyp

integer

Shoulder pad sign Typical clinical symptoms
Beskrivning

Shoulder pad sign

Datatyp

integer

ORGAN INVOLVEMENT AT DIAGNOSIS
Beskrivning

ORGAN INVOLVEMENT AT DIAGNOSIS

Soft Tissues
Beskrivning

Soft Tissues

Datatyp

text

Gastrointestinal Tract
Beskrivning

Gastrointestinal Tract

Datatyp

integer

Heart
Beskrivning

Heart

Datatyp

integer

Liver
Beskrivning

Liver

Datatyp

integer

Kidney
Beskrivning

Kidney

Datatyp

integer

Peripheral nerves
Beskrivning

Peripheral nerves

Datatyp

integer

Autonomic nerves
Beskrivning

Autonomic nerves

Datatyp

integer

if other, please specify
Beskrivning

ORGAN INVOLVEMENT AT DIAGNOSIS

Datatyp

text

Liver span in ultrasound or CT scan (cm craniocaudal diameter)
Beskrivning

Liver span in ultrasound or CT scan

Datatyp

float

Liver span in ultrasound or CT scan (cm craniocaudal diameter) Not evaluated
Beskrivning

Liver span in ultrasound or CT scan

Datatyp

boolean

NYHA class
Beskrivning

NYHA class

Datatyp

integer

Alias
UMLS CUI [1]
C1275491
Left Ventricular Ejection Fraction
Beskrivning

LVEF

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0428772
%
Left ventricular ejection fraction Not evaluated
Beskrivning

Left ventricular ejection fraction

Datatyp

boolean

Interventricular septal wall thickness (mean # mm in echocardiogram)
Beskrivning

Interventricular septal wall thickness

Datatyp

float

Interventricular septal wall thickness (mean # mm in echocardiogram) Not evaluated
Beskrivning

Interventricular septal wall thickness

Datatyp

boolean

Weight loss
Beskrivning

Weight loss

Datatyp

integer

Malabsorption
Beskrivning

Malabsorption

Datatyp

integer

GI bleeding
Beskrivning

GI Bleeding

Datatyp

integer

If other evidence of gastrointestinal involvement, please specify
Beskrivning

Other evidence of gastrointestinal involvement

Datatyp

text

Neurological exam
Beskrivning

Neurological exam

Datatyp

text

If abnormal: Specify abnormality
Beskrivning

Neurological exam

Datatyp

text

PNP severity
Beskrivning

PNP severity

Datatyp

integer

Orthostatic hypotension
Beskrivning

Orthostatic hypotension

Datatyp

integer

Intractable diarrhoea
Beskrivning

Intractable diarrhoea

Datatyp

integer

Inflexible pulse rate
Beskrivning

Inflexible pulse rate

Datatyp

integer

Clinical evidence for involvement of other sites
Beskrivning

Other sites

Datatyp

text

PRE-HSCT TREATMENT
Beskrivning

PRE-HSCT TREATMENT

WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?
Beskrivning

WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?

Datatyp

integer

Chemotherapy Modality
Beskrivning

Chemotherapy

Datatyp

boolean

Modality, if Chemotherapy
Beskrivning

Chemotherapy

Datatyp

text

If Other, please specify
Beskrivning

Modality

Datatyp

text

HSCT
Beskrivning

HSCT

DATE OF HSCT
Beskrivning

DATE OF HSCT

Datatyp

date

HSCT TYPE Allogeneic: proceed to “Status at Start of Conditioning” on page 4
Beskrivning

HSCT TYPE

Datatyp

boolean

Autologous: Date of 1st collection or pheresis
Beskrivning

Autologous: Date of 1st collection or pheresis

Datatyp

date

STATUS OF DISEASE AT COLLECTION (AUTOGRAFTS ONLY)
Beskrivning

STATUS OF DISEASE AT COLLECTION (AUTOGRAFTS ONLY)

Haematological status
Beskrivning

Haematological status

Datatyp

text

Organ status
Beskrivning

Organ status

Datatyp

integer

STATUS OF DISEASE AT START OF CONDITIONING FOR BMT
Beskrivning

STATUS OF DISEASE AT START OF CONDITIONING FOR BMT

Haematological status
Beskrivning

Haematological status

Datatyp

integer

Organ status
Beskrivning

Organ status

Datatyp

integer

Hb (g/dl) CLINICAL AND LABORATORY DATA
Beskrivning

HbLab

Datatyp

float

Hb (g/dl) CLINICAL AND LABORATORY DATA
Beskrivning

Hb (g/dL)

Datatyp

integer

CLINICAL AND LABORATORY DATA
Beskrivning

Serum creatinine

Datatyp

float

CLINICAL AND LABORATORY DATA Serum creatinine
Beskrivning

Serum creatinine

Datatyp

text

CLINICAL AND LABORATORY DATA Serum creatinine
Beskrivning

Serum creatinine

Datatyp

integer

CLINICAL AND LABORATORY DATA Creatinine clearance (mL/min)
Beskrivning

Creatinine clearance (mL/min)

Datatyp

float

Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
Beskrivning

Creatinine clearance (mL/min)

Datatyp

integer

Total urinary protein excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary protein excretion (mg/24 h)

Datatyp

float

CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
Beskrivning

Total urinary protein excretion (mg/24 h)

Datatyp

integer

Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary albumin excretion (mg/24 h)

Datatyp

float

Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary albumin excretion (mg/24 h)

Datatyp

integer

Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum calcium (mmol/L)

Datatyp

float

Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum calcium (mmol/L)

Datatyp

integer

Serum albumin (g/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum albumin (g/L)

Datatyp

float

Serum albumin (g/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum albumin (g/L)

Datatyp

integer

Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum alkaline phosphatase (IU/L)

Datatyp

float

Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum alkaline phosphatase (IU/L)

Datatyp

integer

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

integer

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

float

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

integer

Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum NT-pro-BNP (ng/L)

Datatyp

float

CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
Beskrivning

Serum NT-pro-BNP (ng/L)

Datatyp

integer

Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum c-Troponin T (μg/L)

Datatyp

float

Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum c-Troponin T (μg/L)

Datatyp

integer

BM aspirate: % plasmacytosis
Beskrivning

BM aspirate

Datatyp

float

BM aspirate % plasmacytosis
Beskrivning

BM aspirate

Datatyp

integer

BM trephine % plasmacytosis
Beskrivning

BM trephine

Datatyp

float

BM trephine: % plasmacytosis
Beskrivning

BM trephine

Datatyp

integer

Monoclonal Ig in serum
Beskrivning

Monoclonal Ig in serum

Datatyp

float

Måttenheter
  • g/L
g/L
Immunofixation of serum
Beskrivning

Immunofixation of serum

Datatyp

integer

Free light chains in serum Kappa light chains
Beskrivning

Kappa light chains

Datatyp

float

Måttenheter
  • mg/L
mg/L
Kappa light chains Not evaluated
Beskrivning

Kappa light chains

Datatyp

boolean

Lambda light chains
Beskrivning

Lambda light chains

Datatyp

float

Måttenheter
  • mg/L
mg/L
Lambda light chains Not evaluated
Beskrivning

Lambda light chains

Datatyp

boolean

Immunofixation of urine
Beskrivning

Immunofixation of urine

Datatyp

integer

Monoclonal light chains in urine
Beskrivning

Monoclonal light chains in urine

Datatyp

float

Måttenheter
  • g/24h
g/24h
Serum Beta2 microglobulin
Beskrivning

Serum Beta2 microglobulin

Datatyp

float

Måttenheter
  • mg/L
mg/L
Soft Tissues
Beskrivning

Soft Tissues

Datatyp

text

Gastrointestinal Tract
Beskrivning

Gastrointestinal Tract

Datatyp

integer

Heart
Beskrivning

Heart

Datatyp

integer

Liver
Beskrivning

Liver

Datatyp

integer

Kidney
Beskrivning

Kidney

Datatyp

integer

Peripheral nerves
Beskrivning

Peripheral nerves

Datatyp

integer

Autonomic nerves
Beskrivning

Autonomic nerves

Datatyp

integer

Liver span in ultrasound or CT scan (cm craniocaudal diameter)
Beskrivning

Liver span in ultrasound or CT scan

Datatyp

float

Liver span in ultrasound or CT scan (cm craniocaudal diameter) Not evaluated
Beskrivning

Liver span in ultrasound or CT scan

Datatyp

boolean

NYHA class
Beskrivning

NYHA class

Datatyp

integer

Alias
UMLS CUI [1]
C1275491
Left Ventricular Ejection Fraction
Beskrivning

LVEF

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0428772
%
Left ventricular ejection fraction Not evaluated
Beskrivning

Left ventricular ejection fraction

Datatyp

boolean

Interventricular septal wall thickness (mean # mm in echocardiogram)
Beskrivning

Interventricular septal wall thickness

Datatyp

float

Interventricular septal wall thickness (mean # mm in echocardiogram) Not evaluated
Beskrivning

Interventricular septal wall thickness

Datatyp

boolean

Weight loss
Beskrivning

Weight loss

Datatyp

integer

Malabsorption
Beskrivning

Malabsorption

Datatyp

integer

GI bleeding
Beskrivning

GI Bleeding

Datatyp

integer

If other evidence of gastrointestinal involvement, please specify
Beskrivning

Other evidence of gastrointestinal involvement

Datatyp

text

Neurological exam
Beskrivning

Neurological exam

Datatyp

text

If abnormal: Specify abnormality
Beskrivning

Neurological exam

Datatyp

text

PNP severity
Beskrivning

PNP severity

Datatyp

integer

Orthostatic hypotension
Beskrivning

Orthostatic hypotension

Datatyp

integer

Intractable diarrhoea
Beskrivning

Intractable diarrhoea

Datatyp

integer

Inflexible pulse rate
Beskrivning

Inflexible pulse rate

Datatyp

integer

Clinical evidence for involvement of other sites
Beskrivning

Other sites

Datatyp

text

STATUS OF DISEASE AT 100 DAYS AFTER HSCT
Beskrivning

STATUS OF DISEASE AT 100 DAYS AFTER HSCT

BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS
Beskrivning

BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS

Datatyp

text

DATE RESPONSE ACHIEVED OR ASSESSED
Beskrivning

DATE RESPONSE ACHIEVED OR ASSESSED

Datatyp

date

Hb (g/dl) CLINICAL AND LABORATORY DATA
Beskrivning

Hb (g/dL)

Datatyp

integer

CLINICAL AND LABORATORY DATA
Beskrivning

Serum creatinine

Datatyp

float

CLINICAL AND LABORATORY DATA Serum creatinine
Beskrivning

Serum creatinine

Datatyp

text

CLINICAL AND LABORATORY DATA Serum creatinine
Beskrivning

Serum creatinine

Datatyp

integer

CLINICAL AND LABORATORY DATA Creatinine clearance (mL/min)
Beskrivning

Creatinine clearance (mL/min)

Datatyp

float

Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
Beskrivning

Creatinine clearance (mL/min)

Datatyp

integer

Total urinary protein excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary protein excretion (mg/24 h)

Datatyp

float

CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
Beskrivning

Total urinary protein excretion (mg/24 h)

Datatyp

integer

Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary albumin excretion (mg/24 h)

Datatyp

float

Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary albumin excretion (mg/24 h)

Datatyp

integer

Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum calcium (mmol/L)

Datatyp

float

Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum calcium (mmol/L)

Datatyp

integer

Serum albumin (g/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum albumin (g/L)

Datatyp

float

Serum albumin (g/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum albumin (g/L)

Datatyp

integer

Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum alkaline phosphatase (IU/L)

Datatyp

float

Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum alkaline phosphatase (IU/L)

Datatyp

integer

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

integer

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

float

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

integer

Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum NT-pro-BNP (ng/L)

Datatyp

float

CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
Beskrivning

Serum NT-pro-BNP (ng/L)

Datatyp

integer

Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum c-Troponin T (μg/L)

Datatyp

float

Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum c-Troponin T (μg/L)

Datatyp

integer

BM aspirate: % plasmacytosis
Beskrivning

BM aspirate

Datatyp

float

BM aspirate % plasmacytosis
Beskrivning

BM aspirate

Datatyp

integer

BM trephine % plasmacytosis
Beskrivning

BM trephine

Datatyp

float

BM trephine: % plasmacytosis
Beskrivning

BM trephine

Datatyp

integer

Monoclonal Ig in serum
Beskrivning

Monoclonal Ig in serum

Datatyp

float

Måttenheter
  • g/L
g/L
Immunofixation of serum
Beskrivning

Immunofixation of serum

Datatyp

integer

Free light chains in serum Kappa light chains
Beskrivning

Kappa light chains

Datatyp

float

Måttenheter
  • mg/L
mg/L
Kappa light chains Not evaluated
Beskrivning

Kappa light chains

Datatyp

boolean

Lambda light chains
Beskrivning

Lambda light chains

Datatyp

float

Måttenheter
  • mg/L
mg/L
Lambda light chains Not evaluated
Beskrivning

Lambda light chains

Datatyp

boolean

Immunofixation of urine
Beskrivning

Immunofixation of urine

Datatyp

integer

Monoclonal light chains in urine
Beskrivning

Monoclonal light chains in urine

Datatyp

float

Måttenheter
  • g/24h
g/24h
Serum Beta2 microglobulin
Beskrivning

Serum Beta2 microglobulin

Datatyp

float

Måttenheter
  • mg/L
mg/L
ORGAN-SPECIFIC RESPONSES AT 100 DAYS AFTER HSCT
Beskrivning

ORGAN-SPECIFIC RESPONSES AT 100 DAYS AFTER HSCT

Kidney
Beskrivning

Renal response

Datatyp

integer

Liver Liver span in ultrasound or CT scan (cm craniocaudal diameter)
Beskrivning

Liver span in ultrasound or CT scan

Datatyp

float

Liver Not evaluated Liver span in ultrasound or CT scan (cm craniocaudal diameter)
Beskrivning

Liver span in ultrasound or CT scan

Datatyp

boolean

Hepatic response
Beskrivning

Hepatic response

Datatyp

integer

Heart NYHA class
Beskrivning

NYHA class

Datatyp

integer

Left ventricular ejection fraction
Beskrivning

Left ventricular ejection fraction

Datatyp

float

Måttenheter
  • %
%
Left ventricular ejection fraction
Beskrivning

Left ventricular ejection fraction

Datatyp

integer

Interventricular septal wall thickness (mean # mm in echocardiogram)
Beskrivning

Interventricular septal wall thickness

Datatyp

float

Interventricular septal wall thickness (mean # mm in echocardiogram)
Beskrivning

Interventricular septal wall thickness

Datatyp

integer

Cardiac response
Beskrivning

Cardiac response

Datatyp

text

Weight loss
Beskrivning

Weight loss

Datatyp

integer

Malabsorption
Beskrivning

Malabsorption

Datatyp

integer

GI bleeding
Beskrivning

GI Bleeding

Datatyp

integer

GI response
Beskrivning

GI response

Datatyp

integer

Neurological exam Peripheral neuropathy (Compare current situation to situation before HSCT)
Beskrivning

Neurological exam

Datatyp

integer

PNP severity Peripheral neuropathy (Compare current situation to situation before HSCT)
Beskrivning

PNP severity

Datatyp

integer

PN response Peripheral neuropathy (Compare current situation to situation before HSCT)
Beskrivning

PN response

Datatyp

integer

AN response Autonomic neuropathy
Beskrivning

AN response

Datatyp

integer

Clinical evidence for involvement of new sites Evidence of new organ involvement
Beskrivning

Clinical evidence for involvement of new sites

Datatyp

text

KARNOFSKY
Beskrivning

KARNOFSKY

Datatyp

text

FORMS TO BE FILLED IN
Beskrivning

FORMS TO BE FILLED IN

Type of Transplant
Beskrivning

Type of Transplant

Datatyp

text

Alias
UMLS CUI [1,1]
C0559189
UMLS CUI [1,2]
C0040739
FOLLOW UP AL AMYLOIDOSIS
Beskrivning

FOLLOW UP AL AMYLOIDOSIS

Unique Identification Code (UIC) (if known)
Beskrivning

Unique Identification Code (UIC)

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number
Beskrivning

Hospital Unique Patient Number

Datatyp

text

Alias
UMLS CUI [1]
C2348585
Initials
Beskrivning

Initialen

Datatyp

text

Alias
UMLS CUI [1]
C2986440
Date of birth
Beskrivning

Date of birth

Datatyp

date

Alias
UMLS CUI [1]
C0421451
Date of HSCT
Beskrivning

Date of HSCT

Datatyp

date

Alias
UMLS CUI [1]
C2584899
PATIENT LAST SEEN
Beskrivning

PATIENT LAST SEEN

Date of Last Contact or Death
Beskrivning

Date last contact

Datatyp

date

Alias
UMLS CUI [1]
C0805839
Complete haematological remission obtained after the HSCT in the absence of additional disease treatment
Beskrivning

Complete haematological remission obtained after the HSCT in the absence of additional disease treatment

Datatyp

integer

GRAFT VERSUS HOST DISEASE (GvHD) SINCE LAST REPORT
Beskrivning

GRAFT VERSUS HOST DISEASE (GvHD) SINCE LAST REPORT

Maximum Grade of Acute GVHD
Beskrivning

AcuteGraftVersusHostDiseaseMaximumOverallGrade

Datatyp

integer

Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C0806909
UMLS CUI [1,3]
C0441800
UMLS CUI [1,4]
C1561607
UMLS CUI [1,5]
C0856825
UMLS CUI [1,6]
C0441800
If present
Beskrivning

Maximum grade

Datatyp

integer

Reason if present
Beskrivning

Maximum grade

Datatyp

text

Date onset of this episode (if new or recurrent)
Beskrivning

Date onset of this episode

Datatyp

date

Måttenheter
  • yyyy/mm/dd
Alias
UMLS CUI [1]
C0574845
yyyy/mm/dd
Date onset of this episode Not applicable
Beskrivning

Date onset of this episode

Datatyp

boolean

Stage skin
Beskrivning

aGvHD Stage Skin

Datatyp

integer

Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C1306673
UMLS CUI [1,3]
C1306673
Stage liver
Beskrivning

aGvHD Stage liver

Datatyp

integer

Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C1306673
UMLS CUI [1,3]
C0023884
Stage gut
Beskrivning

aGvHD stage gut

Datatyp

integer

Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C1306673
UMLS CUI [1,3]
C0021853
Resolution
Beskrivning

aGvHD Resolution

Datatyp

integer

Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C1514893
Date of resolution
Beskrivning

aGvHD Date of resolution

Datatyp

date

Måttenheter
  • yyyy/mm/dd
Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C1514893
UMLS CUI [1,3]
C0011008
yyyy/mm/dd
Presence of cGvHD
Beskrivning

Chronic Graft versus Host Disease

Datatyp

text

Alias
UMLS CUI [1]
C0867389
Presence of cGVHD if yes
Beskrivning

Presence of cGVHD

Datatyp

integer

Date of onset
Beskrivning

cGvHD Date of onset

Datatyp

date

Måttenheter
  • yyyy/mm/dd
Alias
UMLS CUI [1,1]
C0867389
UMLS CUI [1,2]
C0011008
yyyy/mm/dd
cGvHD grade
Beskrivning

cGvHD grade

Datatyp

integer

Alias
UMLS CUI [1,1]
C0867389
UMLS CUI [1,2]
C0441800
Organs affected
Beskrivning

Organs affected

Datatyp

integer

Alias
UMLS CUI [1]
C0449642
If resolved, specify the date of resolution:
Beskrivning

Date of Resolution

Datatyp

date

Alias
UMLS CUI [1,1]
C1514893
UMLS CUI [1,2]
C0011008
OTHER COMPLICATIONS SINCE LAST REPORT
Beskrivning

OTHER COMPLICATIONS SINCE LAST REPORT

Infection related complications
Beskrivning

Infection related complications

Datatyp

boolean

Alias
UMLS CUI [1,1]
C0009450
UMLS CUI [1,2]
C0009566
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary
Beskrivning

Bacteraemia / fungemia / viremia / parasites

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

Bacteraemia / fungemia / viremia / parasites

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
Beskrivning

Septic shock

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

Septic shock

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
Beskrivning

ARDS

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

ARDS

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
Beskrivning

Multiorgan failure due to infection

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

Multiorgan failure due to infection

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
Beskrivning

Pneumonia

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

Pneumonia

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
Beskrivning

Hepatitis

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

Hepatitis

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
Beskrivning

CNS infection

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

CNS infection

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary
Beskrivning

Gut infection

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

Gut infection

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
Beskrivning

Skin infection

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

Skin infection

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
Beskrivning

Cystitis

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

Cystitis

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
Beskrivning

Retinitis

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable
Beskrivning

Retinitis

Datatyp

text

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary
Beskrivning

Other

Datatyp

text

Date Provide different dates for different episodes of the same complication if applicable.
Beskrivning

Other

Datatyp

text

Non infection related complications
Beskrivning

Non infection related complications

Datatyp

boolean

Alias
UMLS CUI [1]
C0009566
CTC grade Cardiovascular
Beskrivning

CTC grade Cardiovascular

Datatyp

integer

Date Cardiovascular
Beskrivning

Date Cardiovascular

Datatyp

date

Comments
Beskrivning

Cardiovascular

Datatyp

text

CTC grade Dermatologic
Beskrivning

CTC grade Dermatologic

Datatyp

integer

Date Dermatologic
Beskrivning

Date Dermatologic

Datatyp

date

Comments
Beskrivning

Dermatologic

Datatyp

text

CTC grade Gastrointestinal
Beskrivning

CTC grade Gastrointestinal

Datatyp

integer

Date Gastrointestinal
Beskrivning

Date Gastrointestinal

Datatyp

date

Comments
Beskrivning

Gastrointestinal

Datatyp

text

CTC grade Haemorrhage
Beskrivning

CTC grade Haemorrhage

Datatyp

integer

Date Haemorrhage
Beskrivning

Date Haemorrhage

Datatyp

date

Haemorrhage Comments
Beskrivning

Haemorrhage Comments

Datatyp

text

CTC grade Hepatic
Beskrivning

CTC grade Hepatic

Datatyp

integer

Date Hepatic
Beskrivning

Date Hepatic

Datatyp

date

Comments
Beskrivning

Hepatic Comments

Datatyp

text

CTC grade Neurologic
Beskrivning

CTC grade Neurologic

Datatyp

integer

Date Neurologic
Beskrivning

Date Neurologic

Datatyp

date

Neurologic Comments
Beskrivning

Neurologic Comments

Datatyp

text

CTC grade Pulmonary
Beskrivning

CTC grade Pulmonary

Datatyp

integer

Pulmonary Date
Beskrivning

Pulmonary Date

Datatyp

date

Pulmonary Comments
Beskrivning

Pulmonary Comments

Datatyp

text

CTC grade Renal
Beskrivning

CTC grade Renal

Datatyp

integer

Renal Date
Beskrivning

Renal Date

Datatyp

date

Renal Comments
Beskrivning

Renal Comments

Datatyp

text

Other CTC grade
Beskrivning

Other CTC grade

Datatyp

integer

Date of other Typte
Beskrivning

Date of other Typte

Datatyp

date

Comments of Other type
Beskrivning

Comments of Other type

Datatyp

text

Graft loss
Beskrivning

Graft loss

Datatyp

text

Alias
UMLS CUI [1]
C0877042
Overall chimaerism
Beskrivning

Overall chimaerism

Datatyp

integer

GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM
Beskrivning

GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM

Date of Test
Beskrivning

Date of Test

Datatyp

date

Alias
UMLS CUI [1,1]
C0024671
UMLS CUI [1,2]
C0011008
Identification of donor or Cord Blood Unit given by the centre
Beskrivning

Identification

Datatyp

text

Alias
UMLS CUI [1]
C1718162
Number in the infusion order (if applicable)
Beskrivning

Number in the infusion order

Datatyp

text

Alias
UMLS CUI [1]
C0237753
Number in the infusion order
Beskrivning

Number in the infusion order

Datatyp

integer

Cell type on which test was performed (% Donor Cells): BM
Beskrivning

Bone marrow

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0005953
%
Cell type on which test was performed (% Donor cells): PB mononuclear cells (PBMC)
Beskrivning

PB mononuclear cells (PBMC)

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C1321301
%
Cell type on which test was performed (% Donor cells): T-Cells
Beskrivning

T-Cells

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0039194
%
Cell type on which test was performed (% Donor cells): B-Cells
Beskrivning

B-Cells

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0004561
%
Cell type on which test was performed (% Donor cells): Red blood cells
Beskrivning

Red blood cells

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0014772
%
Cell type on which test was performed (% Donor cells): Monocytes
Beskrivning

Monocytes

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0026473
%
Cell type on which test was performed (% Donor cells): PMNs (neutrophils)
Beskrivning

PMNs (neutrophils)

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0200633
%
Cell type on which test was performed (% Donor cells): Lymphocytes, NOS
Beskrivning

Lymphocytes, NOS

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0024264
%
Cell type on which test was performed (% Donor cells): Myeloid cells, NOS
Beskrivning

Myeloid cells, NOS

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0887899
%
Cell type on which test was performed (% Donor cells):
Beskrivning

Other

Datatyp

float

Måttenheter
  • %
%
Test used:
Beskrivning

Laboratory tests

Datatyp

text

Alias
UMLS CUI [1]
C0022885
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
Beskrivning

SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED

Datatyp

integer

Date of diagnosis
Beskrivning

Diagnose-Datum

Datatyp

date

Alias
UMLS CUI [1,1]
C2316983
UMLS CUI [1,2]
C1274082
Diagnosis
Beskrivning

Diagnosis

Datatyp

integer

If other diagnosis, please specify
Beskrivning

Diagnosis

Datatyp

text

ADDITIONAL THERAPIES SINCE LAST FOLLOW UP
Beskrivning

ADDITIONAL THERAPIES SINCE LAST FOLLOW UP

Treatment given since last report
Beskrivning

Additional treatment

Datatyp

text

Alias
UMLS CUI [1]
C1706712
Date started
Beskrivning

Datestarted

Datatyp

date

If yes: CELLULAR THERAPY One cell therapy regimen is defined as any number of infusions given within 10 weeks for the same indication. If more than one regimen of cell therapy has been given since last report, copy this section and complete it as many times as necessary.
Beskrivning

ADDITIONAL TREATMENT

Datatyp

integer

Disease status before this cellular therapy
Beskrivning

Disease status before this cellular therapy

Datatyp

integer

If yes: Type of cells
Beskrivning

Type of cells

Datatyp

integer

Alias
UMLS CUI [1]
C0302189
If DLI, specify the number of cells infused by type: Nucleated cells
Beskrivning

Nucleated cells

Datatyp

text

Alias
UMLS CUI [1]
C1180059
Number of Nucleated cells infused (DLI only)
Beskrivning

Nucleated cells

Datatyp

text

Måttenheter
  • 10^8/kg
Alias
UMLS CUI [1]
C1180059
10^8/kg
If DLI, specify the number of cells infused by type: CD 34+
Beskrivning

CD 34+

Datatyp

text

Alias
UMLS CUI [1]
C3538723
specify the number of cells infused by type: CD 34+
Beskrivning

CD 34+

Datatyp

text

Alias
UMLS CUI [1]
C3538723
If DLI, specify the number of cells infused by type: CD 3+
Beskrivning

CD 3+

Datatyp

text

Alias
UMLS CUI [1]
C3542405
specify the number of cells infused by type: CD 3+
Beskrivning

CD 3+

Datatyp

float

Alias
UMLS CUI [1]
C3542405
Total number of cells infused (non DLI only)
Beskrivning

All cells

Datatyp

float

Måttenheter
  • x10^6/kg
Alias
UMLS CUI [1]
C0007584
x10^6/kg
All cells
Beskrivning

All cells

Datatyp

text

Alias
UMLS CUI [1]
C0007584
Chronological number of this cell therapy for this patient
Beskrivning

Chronological number

Datatyp

float

Alias
UMLS CUI [1]
C2348184
Indication (check all that apply)
Beskrivning

Indication

Datatyp

text

Alias
UMLS CUI [1,1]
C3146298
UMLS CUI [1,2]
C0302189
Number of infusions within 10 weeks (count only infusions that are part of same regimen and given for the same indication)
Beskrivning

Infusion count

Datatyp

float

Alias
UMLS CUI [1,1]
C0574032
UMLS CUI [1,2]
C0750480
Maximum Grade of Acute GVHD
Beskrivning

AcuteGraftVersusHostDiseaseMaximumOverallGrade

Datatyp

text

Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C0806909
UMLS CUI [1,3]
C0441800
UMLS CUI [1,4]
C1561607
UMLS CUI [1,5]
C0856825
UMLS CUI [1,6]
C0441800
Disease treatment (apart from donor cell infusion or other type of cell therapy)
Beskrivning

Disease treatment

Datatyp

integer

Alias
UMLS CUI [1]
C0087111
FIRST EVIDENCE OF DISEASE WORSENING SINCE LAST HSCT
Beskrivning

FIRST EVIDENCE OF DISEASE WORSENING SINCE LAST HSCT

EVIDENCE OF DISEASE ACTIVITY
Beskrivning

EVIDENCE OF DISEASE ACTIVITY

Datatyp

text

If yes, date first noted
Beskrivning

EVIDENCE OF DISEASE ACTIVITY

Datatyp

date

LAST DISEASE AND PATIENT STATUS
Beskrivning

LAST DISEASE AND PATIENT STATUS

HAEMATOLOGICAL DISEASE STATUS
Beskrivning

HAEMATOLOGICAL DISEASE STATUS

Datatyp

integer

Organ Response
Beskrivning

ORGAN RESPONSE

Datatyp

integer

Hb (g/dl) CLINICAL AND LABORATORY DATA
Beskrivning

Hb (g/dL)

Datatyp

integer

CLINICAL AND LABORATORY DATA
Beskrivning

Serum creatinine

Datatyp

float

CLINICAL AND LABORATORY DATA Serum creatinine
Beskrivning

Serum creatinine

Datatyp

text

CLINICAL AND LABORATORY DATA Serum creatinine
Beskrivning

Serum creatinine

Datatyp

integer

CLINICAL AND LABORATORY DATA Creatinine clearance (mL/min)
Beskrivning

Creatinine clearance (mL/min)

Datatyp

float

Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
Beskrivning

Creatinine clearance (mL/min)

Datatyp

integer

Total urinary protein excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary protein excretion (mg/24 h)

Datatyp

float

CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
Beskrivning

Total urinary protein excretion (mg/24 h)

Datatyp

integer

Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary albumin excretion (mg/24 h)

Datatyp

float

Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
Beskrivning

Total urinary albumin excretion (mg/24 h)

Datatyp

integer

Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum calcium (mmol/L)

Datatyp

float

Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum calcium (mmol/L)

Datatyp

integer

Serum albumin (g/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum albumin (g/L)

Datatyp

float

Serum albumin (g/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum albumin (g/L)

Datatyp

integer

Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum alkaline phosphatase (IU/L)

Datatyp

float

Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum alkaline phosphatase (IU/L)

Datatyp

integer

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

integer

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

float

Serum bilirubin CLINICAL AND LABORATORY DATA
Beskrivning

Serum bilirubin

Datatyp

integer

Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum NT-pro-BNP (ng/L)

Datatyp

float

CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
Beskrivning

Serum NT-pro-BNP (ng/L)

Datatyp

integer

Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum c-Troponin T (μg/L)

Datatyp

float

Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
Beskrivning

Serum c-Troponin T (μg/L)

Datatyp

integer

BM aspirate: % plasmacytosis
Beskrivning

BM aspirate

Datatyp

float

BM aspirate % plasmacytosis
Beskrivning

BM aspirate

Datatyp

integer

BM trephine % plasmacytosis
Beskrivning

BM trephine

Datatyp

float

BM trephine: % plasmacytosis
Beskrivning

BM trephine

Datatyp

integer

Monoclonal Ig in serum
Beskrivning

Monoclonal Ig in serum

Datatyp

float

Måttenheter
  • g/L
g/L
Immunofixation of serum
Beskrivning

Immunofixation of serum

Datatyp

integer

Free light chains in serum Kappa light chains
Beskrivning

Kappa light chains

Datatyp

float

Måttenheter
  • mg/L
mg/L
Kappa light chains Not evaluated
Beskrivning

Kappa light chains

Datatyp

boolean

Lambda light chains
Beskrivning

Lambda light chains

Datatyp

float

Måttenheter
  • mg/L
mg/L
Lambda light chains Not evaluated
Beskrivning

Lambda light chains

Datatyp

boolean

Immunofixation of urine
Beskrivning

Immunofixation of urine

Datatyp

integer

Monoclonal light chains in urine
Beskrivning

Monoclonal light chains in urine

Datatyp

float

Måttenheter
  • g/24h
g/24h
Serum Beta2 microglobulin
Beskrivning

Serum Beta2 microglobulin

Datatyp

float

Måttenheter
  • mg/L
mg/L
Renal response ORGAN-SPECIFIC RESPONSES AT THIS FOLLOW UP
Beskrivning

Renal response

Datatyp

integer

Liver (cm craniocaudal diameter)
Beskrivning

Liver span in ultrasound or CT scan

Datatyp

float

Liver (cm craniocaudal diameter)
Beskrivning

Liver span in ultrasound or CT scan

Datatyp

integer

Hepatic response
Beskrivning

Hepatic response

Datatyp

text

NYHA class
Beskrivning

NYHA class

Datatyp

integer

Alias
UMLS CUI [1]
C1275491
Left Ventricular Ejection Fraction
Beskrivning

LVEF

Datatyp

float

Måttenheter
  • %
Alias
UMLS CUI [1]
C0428772
%
Left Ventricular Ejection Fraction
Beskrivning

LVEF

Datatyp

integer

Interventricular septal wall thickness (mean # mm in echocardiogram)
Beskrivning

Interventricular septal wall thickness

Datatyp

float

Interventricular septal wall thickness (mean # mm in echocardiogram)
Beskrivning

Interventricular septal wall thickness

Datatyp

integer

Cardiac response
Beskrivning

Cardiac response

Datatyp

integer

Weight loss
Beskrivning

Weight loss

Datatyp

integer

Malabsorption
Beskrivning

Malabsorption

Datatyp

integer

GI bleeding
Beskrivning

GI bleeding

Datatyp

integer

GI response
Beskrivning

GI response

Datatyp

integer

Neurological exam
Beskrivning

Neurological exam

Datatyp

integer

PNP severity
Beskrivning

PNP severity

Datatyp

integer

PN response
Beskrivning

PN response

Datatyp

integer

AN response
Beskrivning

AN response

Datatyp

integer

Evidence of new organ involvement Clinical evidence for involvement of new sites
Beskrivning

Evidence of new organ involvement

Datatyp

text

Has patient or partner become pregnant after this HSCT?
Beskrivning

Has patient or partner become pregnant after this HSCT?

Datatyp

integer

Survival Status
Beskrivning

Survival Status

Datatyp

integer

Alias
UMLS CUI [1]
C1148433
Type of score used PERFORMANCE SCORE (if alive)
Beskrivning

Type of score used

Datatyp

integer

Score
Beskrivning

Performance score

Datatyp

integer

Alias
UMLS CUI [1]
C1518965
CAUSE OF DEATH (check only one main cause)
Beskrivning

CAUSE OF DEATH

Datatyp

integer

cGvHD
Beskrivning

cGvHD cause

Datatyp

integer

Interstitial pneumonitis Cause
Beskrivning

Interstitial pneumonitis

Datatyp

integer

Pulmonary toxicity Cause
Beskrivning

Pulmonary toxicity

Datatyp

integer

Infection
Beskrivning

Infection

Datatyp

integer

Infection:
Beskrivning

Infection

Datatyp

integer

Rejection / poor graft function
Beskrivning

Rejection / poor graft function

Datatyp

integer

Veno-Occlusive disease (VOD)
Beskrivning

Veno-Occlusive disease (VOD)

Datatyp

integer

Haemorrhage
Beskrivning

Haemorrhage

Datatyp

integer

Cardiac toxicity
Beskrivning

Cardiac toxicity

Datatyp

integer

Central nervous system toxicity
Beskrivning

Central nervous system toxicity

Datatyp

integer

Gastro intestinal toxicity
Beskrivning

Gastro intestinal toxicity

Datatyp

integer

Skin toxicity
Beskrivning

Skin toxicity

Datatyp

integer

Renal failure
Beskrivning

Renal failure

Datatyp

integer

Multiple organ failure
Beskrivning

Multiple organ failure

Datatyp

integer

If other HSCT related cause, please specify
Beskrivning

Other

Datatyp

text

ADDITIONAL NOTES IF APPLICABLE
Beskrivning

ADDITIONAL NOTES IF APPLICABLE

Comments
Beskrivning

Comments

Datatyp

text

IDENTIFICATION & SIGNATURE
Beskrivning

IDENTIFICATION & SIGNATURE

Datatyp

text

Similar models

18pp EBMT Amyloidosis

  1. StudyEvent: ODM
    1. 18pp EBMT Amyloidosis
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
GENERAL INFORMATION TEAM
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
text
C2348585 (UMLS CUI [1])
Hospital
Item
Name of the hospital
text
C0019994 (UMLS CUI [1])
Unit
Item
Unit
text
Contact person
Item
Name of contact person
text
C0337611 (UMLS CUI [1])
Telephone
Item
Telephone number
integer
C1515258 (UMLS CUI [1])
Fax
Item
Fax
text
C1549619 (UMLS CUI [1,1])
C0337611 (UMLS CUI [1,2])
C0030664 (UMLS CUI [1,3])
E-Mail
Item
E-Mail
text
C1705961 (UMLS CUI [1,1])
C0337611 (UMLS CUI [1,2])
C0030664 (UMLS CUI [1,3])
Date of this report
Item
Date of this report
date
C1302584 (UMLS CUI [1])
Item
Patient following national / international study / trial
integer
C1997894 (UMLS CUI [1])
Code List
Patient following national / international study / trial
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Name of study / trial
Item
Name of study / trial
text
C0008976 (UMLS CUI [1])
Item Group
GENERAL INFORMATION PATIENT
Unique Identification Code (UIC)
Item
To be entered only if patient previously reported
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number or Code
Item
Hospital Unique Patient Number or Code
text
C1827636 (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])
Item
Sex
text
C0079399 (UMLS CUI [1])
Code List
Sex
CL Item
Male (1)
CL Item
Female (2)
ABO Group
Item
ABO Group
text
Rh factor
Item
Rh factor Donor a
boolean
C0035403 (UMLS CUI [1,1])
C0013018 (UMLS CUI [1,2])
Item Group
DISEASE
Date of diagnosis
Item
Date of diagnosis
text
C2316983 (UMLS CUI [1])
Item
Check the disease for which this transplant was performed
text
C0277554 (UMLS CUI [1])
Code List
Check the disease for which this transplant was performed
CL Item
Acute Leukaemia (Acute Leukaemia)
CL Item
Acute Myelogenous Leukaemia (AML) (Acute Myelogenous Leukaemia (AML))
CL Item
Acute Lymphoblastic Leukaemia (ALL) (Acute Lymphoblastic Leukaemia (ALL))
CL Item
Secondary Acute Leukaemia (do not use if transformed from MDS/MPN) (Secondary Acute Leukaemia (do not use if transformed from MDS/MPN))
CL Item
Chronic Leukaemia (Chronic Leukaemia)
CL Item
Chronic Myeloid Leukaemia (CML) (Chronic Myeloid Leukaemia (CML))
CL Item
Chronic Lymphocytic Leukaemia (Chronic Lymphocytic Leukaemia)
CL Item
Lymphoma (Lymphoma)
CL Item
Non Hodgkin (Non Hodgkin)
CL Item
Hodgkin´s Disease (Hodgkin´s Disease)
CL Item
Myeloma/ Plasma cell disorder (Myeloma/ Plasma cell disorder)
CL Item
Solid Tumour (Solid Tumour)
CL Item
Myelodysplastic syndromes (Myelodysplastic syndromes)
CL Item
MDS (MDS)
CL Item
MD/ MPN (MD/ MPN)
CL Item
Myeloproliferative neoplasm (Myeloproliferative neoplasm)
CL Item
Bone marrow failure including Aplastic anaemia (Bone marrow failure including Aplastic anaemia)
CL Item
Inherited disorders (Inherited disorders)
CL Item
Primary immune deficiencies (Primary immune deficiencies)
CL Item
Metabolic disorders (Metabolic disorders)
CL Item
Histiocytic disorders (Histiocytic disorders)
CL Item
Autoimmune disease (Autoimmune disease)
CL Item
Juvenile Idiopathic Arthritis (Juvenile Idiopathic Arthritis)
CL Item
Multiple Sclerosis (Multiple Sclerosis)
CL Item
Systemic Lupus (Systemic Lupus)
CL Item
Systemic Sclerosis (Systemic Sclerosis)
CL Item
Haemoglobinopathiy (Haemoglobinopathiy)
CL Item
Other diagnosis (Other diagnosis)
Item Group
AL AMYLOIDOSIS INITIAL DIAGNOSIS
Item
Has the information requested in this section been submitted with a previous HSCT registration for this patient?
integer
Code List
Has the information requested in this section been submitted with a previous HSCT registration for this patient?
CL Item
Yes: go to page 3, Pre-HSCT Treatment (1)
CL Item
No: proceed with this section (2)
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
Item
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
boolean
CL Item
Monoclonal Gammopathy (Monoclonal Gammopathy)
CL Item
Multiple Myeloma (Multiple Myeloma)
CL Item
Other B-cell malignancy (Other B-cell malignancy)
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
Item
If Other B-cell malignancy, specify
text
Item
Select one as applicable
integer
Code List
Select one as applicable
CL Item
IgG (1)
CL Item
IgA (2)
CL Item
IgD (3)
CL Item
IgE (4)
CL Item
IgM (5)
CL Item
Absent (6)
CL Item
Not evaluated (7)
Item
Select one as applicable
integer
Code List
Select one as applicable
CL Item
Kappa (1)
CL Item
Lambda (2)
CL Item
Absent (3)
CL Item
Not evaluated (4)
Item
If Multiple myeloma
integer
Code List
If Multiple myeloma
CL Item
I (I)
CL Item
II (II)
CL Item
III (III)
Stage at diagnosis (Salmon and Durie) B
Item
If Multiple myeloma
boolean
Item
DIAGNOSIS OF AMYLOIDOSIS
integer
Code List
DIAGNOSIS OF AMYLOIDOSIS
CL Item
Excluded (1)
CL Item
Not evaluated (2)
Item
DIAGNOSIS OF AMYLOIDOSIS
text
Code List
DIAGNOSIS OF AMYLOIDOSIS
CL Item
Done (Done)
CL Item
Not evaluated (Not evaluated)
HbLab
Item
Hb (g/dl) CLINICAL AND LABORATORY DATA
float
Item
Hb (g/dl) CLINICAL AND LABORATORY DATA
integer
Code List
Hb (g/dl) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum creatinine
Item
CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Serum creatinine
text
Code List
CLINICAL AND LABORATORY DATA Serum creatinine
CL Item
μmol/L (μmol/L)
CL Item
mg/dL (mg/dL)
Item
CLINICAL AND LABORATORY DATA Serum creatinine
integer
Code List
CLINICAL AND LABORATORY DATA Serum creatinine
CL Item
Not evaluated (1)
Creatinine clearance (mL/min)
Item
CLINICAL AND LABORATORY DATA Creatinine clearance (mL/min)
float
Item
Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
integer
Code List
Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Total urinary protein excretion (mg/24 h)
Item
Total urinary protein excretion (mg/24 h) CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
integer
Code List
CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
CL Item
Not evaluated (1)
Total urinary albumin excretion (mg/24 h)
Item
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
float
Item
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
integer
Code List
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum calcium (mmol/L)
Item
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
float
Item
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum albumin (g/L)
Item
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
float
Item
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum alkaline phosphatase (IU/L)
Item
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
float
Item
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
integer
Code List
Serum bilirubin CLINICAL AND LABORATORY DATA
CL Item
μmol/L  (1)
CL Item
mg/dL (2)
Serum bilirubin
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
float
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
integer
Code List
Serum bilirubin CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum NT-pro-BNP (ng/L)
Item
Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
integer
Code List
CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
CL Item
Not evaluated (1)
Serum c-Troponin T (μg/L)
Item
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
float
Item
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
BM aspirate
Item
BM aspirate: % plasmacytosis
float
Item
BM aspirate % plasmacytosis
integer
Code List
BM aspirate % plasmacytosis
CL Item
Not evaluated (1)
BM trephine
Item
BM trephine % plasmacytosis
float
Item
BM trephine: % plasmacytosis
integer
Code List
BM trephine: % plasmacytosis
CL Item
Not evaluated (1)
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
Item
Immunofixation of serum
integer
Code List
Immunofixation of serum
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Kappa light chains
Item
Free light chains in serum Kappa light chains
float
Kappa light chains
Item
Kappa light chains Not evaluated
boolean
Lambda light chains
Item
Lambda light chains
float
Lambda light chains
Item
Lambda light chains Not evaluated
boolean
Item
Immunofixation of urine
integer
Code List
Immunofixation of urine
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
float
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
Item
Bone structure (X-ray)
integer
Code List
Bone structure (X-ray)
CL Item
Normal  (1)
CL Item
Lytic lesion present  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Macroglossy Typical clinical symptoms
integer
Code List
Macroglossy Typical clinical symptoms
CL Item
Absent  (1)
CL Item
Present  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Periorbital bleeding Typical clinical symptoms
integer
Code List
Periorbital bleeding Typical clinical symptoms
CL Item
Absent  (1)
CL Item
Present  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Shoulder pad sign Typical clinical symptoms
integer
Code List
Shoulder pad sign Typical clinical symptoms
CL Item
Absent  (1)
CL Item
Present  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item Group
ORGAN INVOLVEMENT AT DIAGNOSIS
Item
Soft Tissues
text
Code List
Soft Tissues
CL Item
Dominant organ(s) involved (Dominant organ(s) involved)
CL Item
Additional organ involvement (Additional organ involvement)
CL Item
Biopsy (Biopsy)
CL Item
No involvement (No involvement)
Item
Gastrointestinal Tract
integer
Code List
Gastrointestinal Tract
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Heart
integer
Code List
Heart
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Liver
integer
Code List
Liver
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Kidney
integer
Code List
Kidney
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Peripheral nerves
integer
Code List
Peripheral nerves
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Autonomic nerves
integer
Code List
Autonomic nerves
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
if other, please specify
text
Code List
if other, please specify
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Liver span in ultrasound or CT scan
Item
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
float
Liver span in ultrasound or CT scan
Item
Liver span in ultrasound or CT scan (cm craniocaudal diameter) Not evaluated
boolean
Item
NYHA class
integer
C1275491 (UMLS CUI [1])
Code List
NYHA class
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
CL Item
not done (99)
LVEF
Item
Left Ventricular Ejection Fraction
float
C0428772 (UMLS CUI [1])
Left ventricular ejection fraction
Item
Left ventricular ejection fraction Not evaluated
boolean
Interventricular septal wall thickness
Item
Interventricular septal wall thickness (mean # mm in echocardiogram)
float
Interventricular septal wall thickness
Item
Interventricular septal wall thickness (mean # mm in echocardiogram) Not evaluated
boolean
Item
Weight loss
integer
Code List
Weight loss
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Malabsorption
integer
Code List
Malabsorption
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI bleeding
integer
Code List
GI bleeding
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Other evidence of gastrointestinal involvement
Item
If other evidence of gastrointestinal involvement, please specify
text
Item
Neurological exam
text
Code List
Neurological exam
CL Item
Normal  (Normal )
CL Item
Abnormal  ( Abnormal )
CL Item
Not evaluated or failed  ( Not evaluated or failed )
CL Item
Unknown ( Unknown)
Neurological exam
Item
If abnormal: Specify abnormality
text
Item
PNP severity
integer
Code List
PNP severity
CL Item
grade I  (1)
CL Item
grade II  (2)
CL Item
grade III  (3)
CL Item
grade IV (4)
Item
Orthostatic hypotension
integer
Code List
Orthostatic hypotension
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Intractable diarrhoea
integer
Code List
Intractable diarrhoea
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Inflexible pulse rate
integer
Code List
Inflexible pulse rate
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Other sites
Item
Clinical evidence for involvement of other sites
text
Item Group
PRE-HSCT TREATMENT
Item
WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?
integer
Code List
WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?
CL Item
No  (1)
CL Item
Yes, Date started (2)
Chemotherapy
Item
Chemotherapy Modality
boolean
Item
Modality, if Chemotherapy
text
Code List
Modality, if Chemotherapy
CL Item
Chemotherapy regimen (Chemotherapy regimen)
CL Item
Number of cycles (Number of cycles)
Modality
Item
If Other, please specify
text
Item Group
HSCT
DATE OF HSCT
Item
DATE OF HSCT
date
HSCT TYPE
Item
HSCT TYPE Allogeneic: proceed to “Status at Start of Conditioning” on page 4
boolean
Autologous: Date of 1st collection or pheresis
Item
Autologous: Date of 1st collection or pheresis
date
Item Group
STATUS OF DISEASE AT COLLECTION (AUTOGRAFTS ONLY)
Item
Haematological status
text
Code List
Haematological status
CL Item
At diagnosis  (At diagnosis )
CL Item
CR1  ( CR1 )
CL Item
CR2  ( CR2 )
CL Item
>CR2 VNUMSTM ( >CR2 VNUMSTM)
CL Item
PR1  ( PR1 )
CL Item
PR2  (PR2 )
CL Item
>PR2  ( >PR2 )
CL Item
MR (MR)
CL Item
No change  ( No change )
CL Item
Progression  ( Progression )
CL Item
Unknown ( Unknown)
Item
Organ status
integer
Code List
Organ status
CL Item
At diagnosis  (1)
CL Item
Response  (2)
CL Item
No change  (3)
CL Item
Progression  (4)
CL Item
Unknown (5)
Item Group
STATUS OF DISEASE AT START OF CONDITIONING FOR BMT
Item
Haematological status
integer
Code List
Haematological status
CL Item
At diagnosis  (At diagnosis )
CL Item
CR1  (CR1 )
CL Item
CR2  ( CR2 )
CL Item
>CR2  ( >CR2 )
CL Item
PR1  ( PR1 )
CL Item
PR2  ( PR2 )
CL Item
>PR2  ( >PR2 )
CL Item
MR ( MR)
CL Item
No change  ( No change )
CL Item
Progression  (Progression )
CL Item
Unknown (Unknown)
Item
Organ status
integer
Code List
Organ status
CL Item
At diagnosis  (1)
CL Item
Response  (2)
CL Item
No change  (3)
CL Item
Progression  (4)
CL Item
Unknown (5)
HbLab
Item
Hb (g/dl) CLINICAL AND LABORATORY DATA
float
Item
Hb (g/dl) CLINICAL AND LABORATORY DATA
integer
Code List
Hb (g/dl) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum creatinine
Item
CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Serum creatinine
text
Code List
CLINICAL AND LABORATORY DATA Serum creatinine
CL Item
μmol/L (μmol/L)
CL Item
mg/dL (mg/dL)
Item
CLINICAL AND LABORATORY DATA Serum creatinine
integer
Code List
CLINICAL AND LABORATORY DATA Serum creatinine
CL Item
Not evaluated (1)
Creatinine clearance (mL/min)
Item
CLINICAL AND LABORATORY DATA Creatinine clearance (mL/min)
float
Item
Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
integer
Code List
Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Total urinary protein excretion (mg/24 h)
Item
Total urinary protein excretion (mg/24 h) CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
integer
Code List
CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
CL Item
Not evaluated (1)
Total urinary albumin excretion (mg/24 h)
Item
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
float
Item
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
integer
Code List
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum calcium (mmol/L)
Item
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
float
Item
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum albumin (g/L)
Item
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
float
Item
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum alkaline phosphatase (IU/L)
Item
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
float
Item
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
integer
Code List
Serum bilirubin CLINICAL AND LABORATORY DATA
CL Item
μmol/L  (1)
CL Item
mg/dL (2)
Serum bilirubin
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
float
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
integer
Code List
Serum bilirubin CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum NT-pro-BNP (ng/L)
Item
Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
integer
Code List
CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
CL Item
Not evaluated (1)
Serum c-Troponin T (μg/L)
Item
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
float
Item
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
BM aspirate
Item
BM aspirate: % plasmacytosis
float
Item
BM aspirate % plasmacytosis
integer
Code List
BM aspirate % plasmacytosis
CL Item
Not evaluated (1)
BM trephine
Item
BM trephine % plasmacytosis
float
Item
BM trephine: % plasmacytosis
integer
Code List
BM trephine: % plasmacytosis
CL Item
Not evaluated (1)
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
Item
Immunofixation of serum
integer
Code List
Immunofixation of serum
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Kappa light chains
Item
Free light chains in serum Kappa light chains
float
Kappa light chains
Item
Kappa light chains Not evaluated
boolean
Lambda light chains
Item
Lambda light chains
float
Lambda light chains
Item
Lambda light chains Not evaluated
boolean
Item
Immunofixation of urine
integer
Code List
Immunofixation of urine
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
float
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
Item
Soft Tissues
text
Code List
Soft Tissues
CL Item
Dominant organ(s) involved (Dominant organ(s) involved)
CL Item
Additional organ involvement (Additional organ involvement)
CL Item
Biopsy (Biopsy)
CL Item
No involvement (No involvement)
Item
Gastrointestinal Tract
integer
Code List
Gastrointestinal Tract
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Heart
integer
Code List
Heart
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Liver
integer
Code List
Liver
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Kidney
integer
Code List
Kidney
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Peripheral nerves
integer
Code List
Peripheral nerves
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Autonomic nerves
integer
Code List
Autonomic nerves
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Liver span in ultrasound or CT scan
Item
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
float
Liver span in ultrasound or CT scan
Item
Liver span in ultrasound or CT scan (cm craniocaudal diameter) Not evaluated
boolean
Item
NYHA class
integer
C1275491 (UMLS CUI [1])
Code List
NYHA class
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
CL Item
not done (99)
LVEF
Item
Left Ventricular Ejection Fraction
float
C0428772 (UMLS CUI [1])
Left ventricular ejection fraction
Item
Left ventricular ejection fraction Not evaluated
boolean
Interventricular septal wall thickness
Item
Interventricular septal wall thickness (mean # mm in echocardiogram)
float
Interventricular septal wall thickness
Item
Interventricular septal wall thickness (mean # mm in echocardiogram) Not evaluated
boolean
Item
Weight loss
integer
Code List
Weight loss
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Malabsorption
integer
Code List
Malabsorption
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI bleeding
integer
Code List
GI bleeding
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Other evidence of gastrointestinal involvement
Item
If other evidence of gastrointestinal involvement, please specify
text
Item
Neurological exam
text
Code List
Neurological exam
CL Item
Normal  (Normal )
CL Item
Abnormal  ( Abnormal )
CL Item
Not evaluated or failed  ( Not evaluated or failed )
CL Item
Unknown ( Unknown)
Neurological exam
Item
If abnormal: Specify abnormality
text
Item
PNP severity
integer
Code List
PNP severity
CL Item
grade I  (1)
CL Item
grade II  (2)
CL Item
grade III  (3)
CL Item
grade IV (4)
Item
Orthostatic hypotension
integer
Code List
Orthostatic hypotension
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Intractable diarrhoea
integer
Code List
Intractable diarrhoea
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Inflexible pulse rate
integer
Code List
Inflexible pulse rate
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Other sites
Item
Clinical evidence for involvement of other sites
text
Item Group
STATUS OF DISEASE AT 100 DAYS AFTER HSCT
Item
BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS
text
Code List
BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS
CL Item
CR1  (CR1 )
CL Item
CR2  ( CR2 )
CL Item
>CR2 ( >CR2)
CL Item
PR1  (PR1 )
CL Item
PR2  (PR2 )
CL Item
>PR2  ( >PR2 )
CL Item
MR ( MR)
CL Item
No change  (No change )
CL Item
Progression  ( Progression )
CL Item
Not evaluable  (Not evaluable )
CL Item
Unknown ( Unknown)
DATE RESPONSE ACHIEVED OR ASSESSED
Item
DATE RESPONSE ACHIEVED OR ASSESSED
date
Item
Hb (g/dl) CLINICAL AND LABORATORY DATA
integer
Code List
Hb (g/dl) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum creatinine
Item
CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Serum creatinine
text
Code List
CLINICAL AND LABORATORY DATA Serum creatinine
CL Item
μmol/L (μmol/L)
CL Item
mg/dL (mg/dL)
Item
CLINICAL AND LABORATORY DATA Serum creatinine
integer
Code List
CLINICAL AND LABORATORY DATA Serum creatinine
CL Item
Not evaluated (1)
Creatinine clearance (mL/min)
Item
CLINICAL AND LABORATORY DATA Creatinine clearance (mL/min)
float
Item
Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
integer
Code List
Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Total urinary protein excretion (mg/24 h)
Item
Total urinary protein excretion (mg/24 h) CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
integer
Code List
CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
CL Item
Not evaluated (1)
Total urinary albumin excretion (mg/24 h)
Item
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
float
Item
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
integer
Code List
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum calcium (mmol/L)
Item
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
float
Item
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum albumin (g/L)
Item
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
float
Item
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum alkaline phosphatase (IU/L)
Item
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
float
Item
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
integer
Code List
Serum bilirubin CLINICAL AND LABORATORY DATA
CL Item
μmol/L  (1)
CL Item
mg/dL (2)
Serum bilirubin
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
float
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
integer
Code List
Serum bilirubin CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum NT-pro-BNP (ng/L)
Item
Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
integer
Code List
CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
CL Item
Not evaluated (1)
Serum c-Troponin T (μg/L)
Item
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
float
Item
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
BM aspirate
Item
BM aspirate: % plasmacytosis
float
Item
BM aspirate % plasmacytosis
integer
Code List
BM aspirate % plasmacytosis
CL Item
Not evaluated (1)
BM trephine
Item
BM trephine % plasmacytosis
float
Item
BM trephine: % plasmacytosis
integer
Code List
BM trephine: % plasmacytosis
CL Item
Not evaluated (1)
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
Item
Immunofixation of serum
integer
Code List
Immunofixation of serum
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Kappa light chains
Item
Free light chains in serum Kappa light chains
float
Kappa light chains
Item
Kappa light chains Not evaluated
boolean
Lambda light chains
Item
Lambda light chains
float
Lambda light chains
Item
Lambda light chains Not evaluated
boolean
Item
Immunofixation of urine
integer
Code List
Immunofixation of urine
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
float
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
Item Group
ORGAN-SPECIFIC RESPONSES AT 100 DAYS AFTER HSCT
Item
Kidney
integer
Code List
Kidney
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Liver span in ultrasound or CT scan
Item
Liver Liver span in ultrasound or CT scan (cm craniocaudal diameter)
float
Liver span in ultrasound or CT scan
Item
Liver Not evaluated Liver span in ultrasound or CT scan (cm craniocaudal diameter)
boolean
Item
Hepatic response
integer
Code List
Hepatic response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Item
Heart NYHA class
integer
Code List
Heart NYHA class
CL Item
I (I)
CL Item
II (II)
CL Item
III (III)
CL Item
IV (IV)
CL Item
Unknown (Unknown)
Left ventricular ejection fraction
Item
Left ventricular ejection fraction
float
Item
Left ventricular ejection fraction
integer
Code List
Left ventricular ejection fraction
CL Item
Not evaluated (1)
CL Item
evaluated (2)
Interventricular septal wall thickness
Item
Interventricular septal wall thickness (mean # mm in echocardiogram)
float
Item
Interventricular septal wall thickness (mean # mm in echocardiogram)
integer
Code List
Interventricular septal wall thickness (mean # mm in echocardiogram)
CL Item
Not evaluated (1)
CL Item
evaluated (2)
Item
Cardiac response
text
Code List
Cardiac response
CL Item
Response  (Response )
CL Item
No response/stable disease  ( No response/stable disease )
CL Item
Progressive disease ( Progressive disease)
CL Item
Not evaluable  ( Not evaluable )
CL Item
Not evaluated/not applicable  ( Not evaluated/not applicable )
CL Item
Unknown ( Unknown)
Item
Weight loss
integer
Code List
Weight loss
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Malabsorption
integer
Code List
Malabsorption
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI bleeding
integer
Code List
GI bleeding
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI response
integer
Code List
GI response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Item
Neurological exam Peripheral neuropathy (Compare current situation to situation before HSCT)
integer
Code List
Neurological exam Peripheral neuropathy (Compare current situation to situation before HSCT)
CL Item
Improved  (1)
CL Item
Worsened  (2)
CL Item
Unchanged  (3)
CL Item
Unknown (4)
Item
PNP severity Peripheral neuropathy (Compare current situation to situation before HSCT)
integer
Code List
PNP severity Peripheral neuropathy (Compare current situation to situation before HSCT)
CL Item
grade I  (1)
CL Item
grade II  (2)
CL Item
grade III  (3)
CL Item
grade IV (4)
Item
PN response Peripheral neuropathy (Compare current situation to situation before HSCT)
integer
Code List
PN response Peripheral neuropathy (Compare current situation to situation before HSCT)
CL Item
Response  (Response )
CL Item
Unknown (Unknown)
CL Item
No response/stable disease  (No response/stable disease )
CL Item
Progressive disease (Progressive disease)
CL Item
Not evaluable  (Not evaluable )
CL Item
Not evaluated/not applicable  (Not evaluated/not applicable )
Item
AN response Autonomic neuropathy
integer
Code List
AN response Autonomic neuropathy
CL Item
Response  (Response )
CL Item
No response/stable disease  (No response/stable disease )
CL Item
Progressive disease (Progressive disease)
CL Item
Not evaluable  (Not evaluable )
CL Item
Not evaluated/not applicable  (Not evaluated/not applicable )
CL Item
Unknown (Unknown)
Clinical evidence for involvement of new sites
Item
Clinical evidence for involvement of new sites Evidence of new organ involvement
text
KARNOFSKY
Item
KARNOFSKY
text
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))
Item Group
FOLLOW UP AL AMYLOIDOSIS
Unique Identification Code (UIC)
Item
Unique Identification Code (UIC) (if known)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number
Item
Hospital Unique Patient Number
text
C2348585 (UMLS CUI [1])
Initialen
Item
Initials
text
C2986440 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Date of HSCT
Item
Date of HSCT
date
C2584899 (UMLS CUI [1])
Item Group
PATIENT LAST SEEN
Date last contact
Item
Date of Last Contact or Death
date
C0805839 (UMLS CUI [1])
Item
Complete haematological remission obtained after the HSCT in the absence of additional disease treatment
integer
Code List
Complete haematological remission obtained after the HSCT in the absence of additional disease treatment
CL Item
Previously reported (1)
CL Item
Yes, date (2)
CL Item
No (3)
CL Item
Unknown (4)
Item Group
GRAFT VERSUS HOST DISEASE (GvHD) SINCE LAST REPORT
Item
Maximum Grade of Acute GVHD
integer
C0856825 (UMLS CUI [1,1])
C0806909 (UMLS CUI [1,2])
C0441800 (UMLS CUI [1,3])
C1561607 (UMLS CUI [1,4])
C0856825 (UMLS CUI [1,5])
C0441800 (UMLS CUI [1,6])
Code List
Maximum Grade of Acute GVHD
CL Item
Agvhd Grade 0 (0)
CL Item
Agvhd Grade I (I)
CL Item
Agvhd Grade Ii (II)
CL Item
Agvhd Grade Iii (III)
CL Item
Agvhd Grade Iv (IV)
CL Item
Agvhd Present, Grade Unknown (Present, grade unknown)
Item
If present
integer
Code List
If present
CL Item
New onset  (1)
CL Item
Recurrent  (2)
CL Item
Persistent (3)
Item
Reason if present
text
Code List
Reason if present
CL Item
Tapering  (Tapering )
CL Item
DLI  (DLI )
CL Item
Unexplained (Unexplained)
Date onset of this episode
Item
Date onset of this episode (if new or recurrent)
date
C0574845 (UMLS CUI [1])
Date onset of this episode
Item
Date onset of this episode Not applicable
boolean
Item
Stage skin
integer
C0856825 (UMLS CUI [1,1])
C1306673 (UMLS CUI [1,2])
C1306673 (UMLS CUI [1,3])
Code List
Stage skin
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
Not evaluated (6)
CL Item
unknown (7)
Item
Stage liver
integer
C0856825 (UMLS CUI [1,1])
C1306673 (UMLS CUI [1,2])
C0023884 (UMLS CUI [1,3])
Code List
Stage liver
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
Not evaluated (6)
CL Item
unknown (7)
Item
Stage gut
integer
C0856825 (UMLS CUI [1,1])
C1306673 (UMLS CUI [1,2])
C0021853 (UMLS CUI [1,3])
Code List
Stage gut
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
Not evaluated (6)
CL Item
unknown (7)
Item
Resolution
integer
C0856825 (UMLS CUI [1,1])
C1514893 (UMLS CUI [1,2])
Code List
Resolution
CL Item
No  (1)
CL Item
Yes (2)
aGvHD Date of resolution
Item
Date of resolution
date
C0856825 (UMLS CUI [1,1])
C1514893 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item
Presence of cGvHD
text
C0867389 (UMLS CUI [1])
Code List
Presence of cGvHD
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Present continously since last reported episode (Present continously since last reported episode)
CL Item
Resolved (Resolved)
Item
Presence of cGVHD if yes
integer
Code List
Presence of cGVHD if yes
CL Item
First episode (1)
CL Item
Recurrence (2)
cGvHD Date of onset
Item
Date of onset
date
C0867389 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
cGvHD grade
integer
C0867389 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
Code List
cGvHD grade
CL Item
limited (1)
CL Item
Extensive (2)
Item
Organs affected
integer
C0449642 (UMLS CUI [1])
Code List
Organs affected
CL Item
Skin (1)
CL Item
Gut (2)
CL Item
Liver (3)
CL Item
Mouth (4)
CL Item
Eyes (5)
CL Item
Lung (6)
CL Item
Other, specify (7)
CL Item
Unknown (8)
Date of Resolution
Item
If resolved, specify the date of resolution:
date
C1514893 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
OTHER COMPLICATIONS SINCE LAST REPORT
Infection related complications
Item
Infection related complications
boolean
C0009450 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])
Bacteraemia / fungemia / viremia / parasites
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary
text
Bacteraemia / fungemia / viremia / parasites
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
Septic shock
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
text
Septic shock
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
ARDS
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
text
ARDS
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
Multiorgan failure due to infection
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
text
Multiorgan failure due to infection
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
Pneumonia
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
text
Pneumonia
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
Hepatitis
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
text
Hepatitis
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
CNS infection
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
text
CNS infection
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
Gut infection
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary
text
Gut infection
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
Skin infection
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
text
Skin infection
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
Cystitis
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
text
Cystitis
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
Retinitis
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.
text
Retinitis
Item
Date Provide different dates for different episodes of the same complication if applicable
text
Other
Item
Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary
text
Other
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
Non infection related complications
Item
Non infection related complications
boolean
C0009566 (UMLS CUI [1])
Item
CTC grade Cardiovascular
integer
Code List
CTC grade Cardiovascular
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Cardiovascular
Item
Date Cardiovascular
date
Cardiovascular
Item
Comments
text
Item
CTC grade Dermatologic
integer
Code List
CTC grade Dermatologic
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Dermatologic
Item
Date Dermatologic
date
Dermatologic
Item
Comments
text
Item
CTC grade Gastrointestinal
integer
Code List
CTC grade Gastrointestinal
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Gastrointestinal
Item
Date Gastrointestinal
date
Gastrointestinal
Item
Comments
text
Item
CTC grade Haemorrhage
integer
Code List
CTC grade Haemorrhage
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Haemorrhage
Item
Date Haemorrhage
date
Haemorrhage Comments
Item
Haemorrhage Comments
text
Item
CTC grade Hepatic
integer
Code List
CTC grade Hepatic
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Hepatic
Item
Date Hepatic
date
Hepatic Comments
Item
Comments
text
Item
CTC grade Neurologic
integer
Code List
CTC grade Neurologic
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Neurologic
Item
Date Neurologic
date
Neurologic Comments
Item
Neurologic Comments
text
Item
CTC grade Pulmonary
integer
Code List
CTC grade Pulmonary
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Pulmonary Date
Item
Pulmonary Date
date
Pulmonary Comments
Item
Pulmonary Comments
text
Item
CTC grade Renal
integer
Code List
CTC grade Renal
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Renal Date
Item
Renal Date
date
Renal Comments
Item
Renal Comments
text
Item
Other CTC grade
integer
Code List
Other CTC grade
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date of other Typte
Item
Date of other Typte
date
Comments of Other type
Item
Comments of Other type
text
Item
Graft loss
text
C0877042 (UMLS CUI [1])
Code List
Graft loss
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
Item
Overall chimaerism
integer
Code List
Overall chimaerism
CL Item
Full (donor >95 %)  (1)
CL Item
Mixed (partial) (2)
CL Item
Autologous reconstitution (recipient >95 %)  (3)
CL Item
Aplasia (4)
CL Item
Not evaluated (5)
Item Group
GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM
Date of Test
Item
Date of Test
date
C0024671 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
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])
Item
Number in the infusion order
integer
Code List
Number in the infusion order
CL Item
N/A (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])
Other
Item
Cell type on which test was performed (% Donor cells):
float
Item
Test used:
text
C0022885 (UMLS CUI [1])
Code List
Test used:
CL Item
FISH (FISH)
CL Item
Molecular (Molecular)
CL Item
Cytogenetic (Cytogenetic)
CL Item
ABO group (ABO group)
CL Item
Other (Other)
CL Item
unknown (unknown)
Item
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
integer
Code List
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
CL Item
Previously reported (1)
CL Item
Yes (2)
CL Item
No at date of this follow-up (3)
Diagnose-Datum
Item
Date of diagnosis
date
C2316983 (UMLS CUI [1,1])
C1274082 (UMLS CUI [1,2])
Item
integer
Code List
Diagnosis
CL Item
AML  (1)
CL Item
MDS  (2)
CL Item
Lymphoproliferative disorder  (3)
CL Item
Other (4)
Diagnosis
Item
If other diagnosis, please specify
text
Item Group
ADDITIONAL THERAPIES SINCE LAST FOLLOW UP
Item
Treatment given since last report
text
C1706712 (UMLS CUI [1])
Code List
Treatment given since last report
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Datestarted
Item
Date started
date
Item
If yes: CELLULAR THERAPY One cell therapy regimen is defined as any number of infusions given within 10 weeks for the same indication. If more than one regimen of cell therapy has been given since last report, copy this section and complete it as many times as necessary.
integer
Code List
If yes: CELLULAR THERAPY One cell therapy regimen is defined as any number of infusions given within 10 weeks for the same indication. If more than one regimen of cell therapy has been given since last report, copy this section and complete it as many times as necessary.
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
Disease status before this cellular therapy
integer
Code List
Disease status before this cellular therapy
CL Item
CR  (1)
CL Item
Not in CR  (2)
CL Item
Not evaluated (3)
Item
If yes: Type of cells
integer
C0302189 (UMLS CUI [1])
Code List
If yes: Type of cells
CL Item
Donor lymphocyte infusion (DLI) (1)
CL Item
Mesenchymal cells (2)
CL Item
Other (3)
CL Item
Unknown (4)
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)
Nucleated cells
Item
Number of Nucleated cells infused (DLI only)
text
C1180059 (UMLS CUI [1])
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)
CD 34+
Item
specify the number of cells infused by type: CD 34+
text
C3538723 (UMLS CUI [1])
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)
CD 3+
Item
specify the number of cells infused by type: CD 3+
float
C3542405 (UMLS CUI [1])
All cells
Item
Total number of cells infused (non DLI only)
float
C0007584 (UMLS CUI [1])
Item
text
C0007584 (UMLS CUI [1])
Code List
All cells
CL Item
Evaluated (Evaluated)
CL Item
Not Evaluated (Not Evaluated)
CL Item
Unknown (Unknown)
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)
CL Item
Other (Other)
Infusion count
Item
Number of infusions within 10 weeks (count only infusions that are part of same regimen and given for the same indication)
float
C0574032 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
Item
Maximum Grade of Acute GVHD
text
C0856825 (UMLS CUI [1,1])
C0806909 (UMLS CUI [1,2])
C0441800 (UMLS CUI [1,3])
C1561607 (UMLS CUI [1,4])
C0856825 (UMLS CUI [1,5])
C0441800 (UMLS CUI [1,6])
Code List
Maximum Grade of Acute GVHD
CL Item
Agvhd Grade 0 (0)
CL Item
Agvhd Grade I (I)
CL Item
Agvhd Grade Ii (II)
CL Item
Agvhd Grade Iii (III)
CL Item
Agvhd Grade Iv (IV)
CL Item
Agvhd Present, Grade Unknown (Present, grade unknown)
Item
Disease treatment (apart from donor cell infusion or other type of cell therapy)
integer
C0087111 (UMLS CUI [1])
Code List
Disease treatment (apart from donor cell infusion or other type of cell therapy)
CL Item
No (1)
CL Item
Yes: Planned (planned before HSCT took place) (2)
CL Item
Yes: Not planned (for relapse/progression or persistent disease) (3)
Item Group
FIRST EVIDENCE OF DISEASE WORSENING SINCE LAST HSCT
Item
EVIDENCE OF DISEASE ACTIVITY
text
Code List
EVIDENCE OF DISEASE ACTIVITY
CL Item
Previously reported (Previously reported)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Continuous worsening since HSCT (Continuous worsening since HSCT)
CL Item
Unknown (Unknown)
EVIDENCE OF DISEASE ACTIVITY
Item
If yes, date first noted
date
Item Group
LAST DISEASE AND PATIENT STATUS
Item
HAEMATOLOGICAL DISEASE STATUS
integer
Code List
HAEMATOLOGICAL DISEASE STATUS
CL Item
Complete remission (Complete remission)
CL Item
Partial remission (Partial remission)
CL Item
Stable disease (Stable disease)
CL Item
Progression (Progression)
CL Item
Not evaluable (Not evaluable)
CL Item
Unknown (Unknown)
Item
Organ Response
integer
Code List
Organ Response
CL Item
Response (1)
CL Item
Non Response (2)
CL Item
Progression (3)
CL Item
Not evaluable (4)
CL Item
Unknown (5)
Item
Hb (g/dl) CLINICAL AND LABORATORY DATA
integer
Code List
Hb (g/dl) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum creatinine
Item
CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Serum creatinine
text
Code List
CLINICAL AND LABORATORY DATA Serum creatinine
CL Item
μmol/L (μmol/L)
CL Item
mg/dL (mg/dL)
Item
CLINICAL AND LABORATORY DATA Serum creatinine
integer
Code List
CLINICAL AND LABORATORY DATA Serum creatinine
CL Item
Not evaluated (1)
Creatinine clearance (mL/min)
Item
CLINICAL AND LABORATORY DATA Creatinine clearance (mL/min)
float
Item
Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
integer
Code List
Creatinine clearance (mL/min) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Total urinary protein excretion (mg/24 h)
Item
Total urinary protein excretion (mg/24 h) CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
integer
Code List
CLINICAL AND LABORATORY DATA Total urinary protein excretion (mg/24 h)
CL Item
Not evaluated (1)
Total urinary albumin excretion (mg/24 h)
Item
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
float
Item
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
integer
Code List
Total urinary albumin excretion (mg/24 h) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum calcium (mmol/L)
Item
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
float
Item
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum calcium (mmol/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum albumin (g/L)
Item
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
float
Item
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum albumin (g/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum alkaline phosphatase (IU/L)
Item
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
float
Item
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum alkaline phosphatase (IU/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
integer
Code List
Serum bilirubin CLINICAL AND LABORATORY DATA
CL Item
μmol/L  (1)
CL Item
mg/dL (2)
Serum bilirubin
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
float
Item
Serum bilirubin CLINICAL AND LABORATORY DATA
integer
Code List
Serum bilirubin CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
Serum NT-pro-BNP (ng/L)
Item
Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
float
Item
CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
integer
Code List
CLINICAL AND LABORATORY DATA Serum NT-pro-BNP (ng/L)
CL Item
Not evaluated (1)
Serum c-Troponin T (μg/L)
Item
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
float
Item
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
integer
Code List
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
CL Item
Not evaluated (1)
BM aspirate
Item
BM aspirate: % plasmacytosis
float
Item
BM aspirate % plasmacytosis
integer
Code List
BM aspirate % plasmacytosis
CL Item
Not evaluated (1)
BM trephine
Item
BM trephine % plasmacytosis
float
Item
BM trephine: % plasmacytosis
integer
Code List
BM trephine: % plasmacytosis
CL Item
Not evaluated (1)
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
Item
Immunofixation of serum
integer
Code List
Immunofixation of serum
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Kappa light chains
Item
Free light chains in serum Kappa light chains
float
Kappa light chains
Item
Kappa light chains Not evaluated
boolean
Lambda light chains
Item
Lambda light chains
float
Lambda light chains
Item
Lambda light chains Not evaluated
boolean
Item
Immunofixation of urine
integer
Code List
Immunofixation of urine
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
float
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
Item
Renal response ORGAN-SPECIFIC RESPONSES AT THIS FOLLOW UP
integer
Code List
Renal response ORGAN-SPECIFIC RESPONSES AT THIS FOLLOW UP
CL Item
Response (1)
CL Item
No response/stable disease (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable (4)
CL Item
Not evaluated/not applicable (5)
CL Item
Unknown (6)
Liver span in ultrasound or CT scan
Item
Liver (cm craniocaudal diameter)
float
Item
Liver (cm craniocaudal diameter)
integer
Code List
Liver (cm craniocaudal diameter)
CL Item
Not evaluated (1)
Item
Hepatic response
text
Code List
Hepatic response
CL Item
Response (Response)
CL Item
No response/stable disease (No response/stable disease)
CL Item
Progressive disease (Progressive disease)
CL Item
Not evaluable (Not evaluable)
CL Item
Not evaluated/not applicable (Not evaluated/not applicable)
CL Item
Unknown (Unknown)
Item
NYHA class
integer
C1275491 (UMLS CUI [1])
Code List
NYHA class
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
CL Item
unknown (5)
LVEF
Item
Left Ventricular Ejection Fraction
float
C0428772 (UMLS CUI [1])
Item
Left Ventricular Ejection Fraction
integer
Code List
Left Ventricular Ejection Fraction
CL Item
Not evaluated (1)
Interventricular septal wall thickness
Item
Interventricular septal wall thickness (mean # mm in echocardiogram)
float
Item
Interventricular septal wall thickness (mean # mm in echocardiogram)
integer
Code List
Interventricular septal wall thickness (mean # mm in echocardiogram)
CL Item
Not evaluated (1)
Item
Cardiac response
integer
Code List
Cardiac response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Item
Weight loss
integer
Code List
Weight loss
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Malabsorption
integer
Code List
Malabsorption
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI bleeding
integer
Code List
GI bleeding
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI response
integer
Code List
GI response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Item
Neurological exam
integer
Code List
Neurological exam
CL Item
Improved  (1)
CL Item
Worsened  (2)
CL Item
Unchanged  (3)
CL Item
Unknown (4)
Item
PNP severity
integer
Code List
PNP severity
CL Item
grade I  (1)
CL Item
grade II  (2)
CL Item
grade III  (3)
CL Item
grade IV (4)
Item
PN response
integer
Code List
PN response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Item
AN response
integer
Code List
AN response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Evidence of new organ involvement
Item
Evidence of new organ involvement Clinical evidence for involvement of new sites
text
Item
Has patient or partner become pregnant after this HSCT?
integer
Code List
Has patient or partner become pregnant after this HSCT?
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Unknown (3)
Item
Survival Status
integer
C1148433 (UMLS CUI [1])
Code List
Survival Status
CL Item
alive (0)
CL Item
dead (1)
Item
Type of score used PERFORMANCE SCORE (if alive)
integer
Code List
Type of score used PERFORMANCE SCORE (if alive)
CL Item
Karnofsky (1)
CL Item
Lansky (2)
Item
Score
integer
C1518965 (UMLS CUI [1])
Code List
Score
CL Item
100 (Normal, NED) (1)
CL Item
90 (Normal activity)  (2)
CL Item
80 (Normal with effort) (3)
CL Item
70 (Cares for self) (4)
CL Item
60 (Requires occasional assistance) (5)
CL Item
50 (Requires assistance) (6)
CL Item
40 (Disabled) (7)
CL Item
30 (Severely disabled) (8)
CL Item
20 (Very sick) (9)
CL Item
10 (Moribund) (10)
CL Item
Not evaluated (11)
CL Item
Unknown (12)
Item
CAUSE OF DEATH (check only one main cause)
integer
Code List
CAUSE OF DEATH (check only one main cause)
CL Item
Due to amyloidosis (progression of disease) (1)
CL Item
Secondary malignancy (including lymphoproliferative disease) (2)
CL Item
HSCT related cause (3)
CL Item
unknown (4)
CL Item
other (5)
Item
cGvHD
integer
Code List
cGvHD
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Unknown (3)
Item
Interstitial pneumonitis Cause
integer
Code List
Interstitial pneumonitis Cause
CL Item
No  (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
Pulmonary toxicity Cause
integer
Code List
Pulmonary toxicity Cause
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Infection
integer
Code List
Infection
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Infection:
integer
Code List
Infection:
CL Item
bacterial  (1)
CL Item
viral  (2)
CL Item
fungal  (3)
CL Item
parasitic  (4)
CL Item
unknown (5)
Item
Rejection / poor graft function
integer
Code List
Rejection / poor graft function
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Veno-Occlusive disease (VOD)
integer
Code List
Veno-Occlusive disease (VOD)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Haemorrhage
integer
Code List
Haemorrhage
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Cardiac toxicity
integer
Code List
Cardiac toxicity
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Central nervous system toxicity
integer
Code List
Central nervous system toxicity
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Gastro intestinal toxicity
integer
Code List
Gastro intestinal toxicity
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Skin toxicity
integer
Code List
Skin toxicity
CL Item
Yes  (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Renal failure
integer
Code List
Renal failure
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Multiple organ failure
integer
Code List
Multiple organ failure
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other
Item
If other HSCT related cause, please specify
text
Item Group
ADDITIONAL NOTES IF APPLICABLE
Comments
Item
Comments
text
IDENTIFICATION & SIGNATURE
Item
IDENTIFICATION & SIGNATURE
text

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