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ID

15657

Beschrijving

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

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  1. 07-06-16 07-06-16 -
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7 juni 2016

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Creative Commons BY-NC 3.0

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    18pp EBMT Amyloidosis

    18pp EBMT Amyloidosis

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

    GENERAL INFORMATION TEAM

    EBMT Centre Identification Code (CIC)
    Beschrijving

    EBMT Centre Identification Code (CIC)

    Datatype

    text

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

    Hospital

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0019994
    Unit
    Beschrijving

    Unit

    Datatype

    text

    Name of contact person
    Beschrijving

    Contact person

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0337611
    Telephone number
    Beschrijving

    Telephone

    Datatype

    integer

    Alias
    UMLS CUI [1]
    C1515258
    Fax
    Beschrijving

    Fax

    Datatype

    text

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

    E-Mail

    Datatype

    text

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

    Date of this report

    Datatype

    date

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

    Patient in Trial

    Datatype

    integer

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

    Name of study / trial

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0008976
    GENERAL INFORMATION PATIENT
    Beschrijving

    GENERAL INFORMATION PATIENT

    To be entered only if patient previously reported
    Beschrijving

    Unique Identification Code (UIC)

    Datatype

    text

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

    Hospital Unique Patient Number or Code

    Datatype

    text

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

    Initials

    Datatype

    text

    Alias
    UMLS CUI [1]
    C2986440
    Date of birth
    Beschrijving

    Date of birth

    Datatype

    date

    Alias
    UMLS CUI [1]
    C0421451
    Sex
    Beschrijving

    Sex

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0079399
    ABO Group
    Beschrijving

    ABO Group

    Datatype

    text

    Rh factor Donor a
    Beschrijving

    Rh factor

    Datatype

    boolean

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

    DISEASE

    Date of diagnosis
    Beschrijving

    Date of diagnosis

    Datatype

    text

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

    Primary Disease Diagnosis

    Datatype

    text

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

    AL AMYLOIDOSIS INITIAL DIAGNOSIS

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

    SubmittedPreviously

    Datatype

    integer

    EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
    Beschrijving

    EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

    Datatype

    boolean

    if yes
    Beschrijving

    EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

    Datatype

    text

    If Other B-cell malignancy, specify
    Beschrijving

    EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

    Datatype

    text

    Select one as applicable
    Beschrijving

    EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

    Datatype

    integer

    Select one as applicable
    Beschrijving

    EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

    Datatype

    integer

    If Multiple myeloma
    Beschrijving

    Stage at diagnosis (Salmon and Durie) A

    Datatype

    integer

    If Multiple myeloma
    Beschrijving

    Stage at diagnosis (Salmon and Durie) B

    Datatype

    boolean

    DIAGNOSIS OF AMYLOIDOSIS
    Beschrijving

    Methods Hereditary Amyloidosis

    Datatype

    integer

    DIAGNOSIS OF AMYLOIDOSIS
    Beschrijving

    Methods Immunohistochemistry

    Datatype

    text

    Hb (g/dl) CLINICAL AND LABORATORY DATA
    Beschrijving

    HbLab

    Datatype

    float

    Hb (g/dl) CLINICAL AND LABORATORY DATA
    Beschrijving

    Hb (g/dL)

    Datatype

    integer

    CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum creatinine

    Datatype

    float

    CLINICAL AND LABORATORY DATA Serum creatinine
    Beschrijving

    Serum creatinine

    Datatype

    text

    CLINICAL AND LABORATORY DATA Serum creatinine
    Beschrijving

    Serum creatinine

    Datatype

    integer

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

    Creatinine clearance (mL/min)

    Datatype

    float

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

    Creatinine clearance (mL/min)

    Datatype

    integer

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

    Total urinary protein excretion (mg/24 h)

    Datatype

    float

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

    Total urinary protein excretion (mg/24 h)

    Datatype

    integer

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

    Total urinary albumin excretion (mg/24 h)

    Datatype

    float

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

    Total urinary albumin excretion (mg/24 h)

    Datatype

    integer

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

    Serum calcium (mmol/L)

    Datatype

    float

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

    Serum calcium (mmol/L)

    Datatype

    integer

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

    Serum albumin (g/L)

    Datatype

    float

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

    Serum albumin (g/L)

    Datatype

    integer

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

    Serum alkaline phosphatase (IU/L)

    Datatype

    float

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

    Serum alkaline phosphatase (IU/L)

    Datatype

    integer

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    integer

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    float

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    integer

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

    Serum NT-pro-BNP (ng/L)

    Datatype

    float

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

    Serum NT-pro-BNP (ng/L)

    Datatype

    integer

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

    Serum c-Troponin T (μg/L)

    Datatype

    float

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

    Serum c-Troponin T (μg/L)

    Datatype

    integer

    BM aspirate: % plasmacytosis
    Beschrijving

    BM aspirate

    Datatype

    float

    BM aspirate % plasmacytosis
    Beschrijving

    BM aspirate

    Datatype

    integer

    BM trephine % plasmacytosis
    Beschrijving

    BM trephine

    Datatype

    float

    BM trephine: % plasmacytosis
    Beschrijving

    BM trephine

    Datatype

    integer

    Monoclonal Ig in serum
    Beschrijving

    Monoclonal Ig in serum

    Datatype

    float

    Maateenheden
    • g/L
    g/L
    Immunofixation of serum
    Beschrijving

    Immunofixation of serum

    Datatype

    integer

    Free light chains in serum Kappa light chains
    Beschrijving

    Kappa light chains

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Kappa light chains Not evaluated
    Beschrijving

    Kappa light chains

    Datatype

    boolean

    Lambda light chains
    Beschrijving

    Lambda light chains

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Lambda light chains Not evaluated
    Beschrijving

    Lambda light chains

    Datatype

    boolean

    Immunofixation of urine
    Beschrijving

    Immunofixation of urine

    Datatype

    integer

    Monoclonal light chains in urine
    Beschrijving

    Monoclonal light chains in urine

    Datatype

    float

    Maateenheden
    • g/24h
    g/24h
    Serum Beta2 microglobulin
    Beschrijving

    Serum Beta2 microglobulin

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Bone structure (X-ray)
    Beschrijving

    Bone structure (X-ray)

    Datatype

    integer

    Macroglossy Typical clinical symptoms
    Beschrijving

    Macroglossy

    Datatype

    integer

    Periorbital bleeding Typical clinical symptoms
    Beschrijving

    Periorbital bleeding

    Datatype

    integer

    Shoulder pad sign Typical clinical symptoms
    Beschrijving

    Shoulder pad sign

    Datatype

    integer

    ORGAN INVOLVEMENT AT DIAGNOSIS
    Beschrijving

    ORGAN INVOLVEMENT AT DIAGNOSIS

    Soft Tissues
    Beschrijving

    Soft Tissues

    Datatype

    text

    Gastrointestinal Tract
    Beschrijving

    Gastrointestinal Tract

    Datatype

    integer

    Heart
    Beschrijving

    Heart

    Datatype

    integer

    Liver
    Beschrijving

    Liver

    Datatype

    integer

    Kidney
    Beschrijving

    Kidney

    Datatype

    integer

    Peripheral nerves
    Beschrijving

    Peripheral nerves

    Datatype

    integer

    Autonomic nerves
    Beschrijving

    Autonomic nerves

    Datatype

    integer

    if other, please specify
    Beschrijving

    ORGAN INVOLVEMENT AT DIAGNOSIS

    Datatype

    text

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

    Liver span in ultrasound or CT scan

    Datatype

    float

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

    Liver span in ultrasound or CT scan

    Datatype

    boolean

    NYHA class
    Beschrijving

    NYHA class

    Datatype

    integer

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

    LVEF

    Datatype

    float

    Maateenheden
    • %
    Alias
    UMLS CUI [1]
    C0428772
    %
    Left ventricular ejection fraction Not evaluated
    Beschrijving

    Left ventricular ejection fraction

    Datatype

    boolean

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

    Interventricular septal wall thickness

    Datatype

    float

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

    Interventricular septal wall thickness

    Datatype

    boolean

    Weight loss
    Beschrijving

    Weight loss

    Datatype

    integer

    Malabsorption
    Beschrijving

    Malabsorption

    Datatype

    integer

    GI bleeding
    Beschrijving

    GI Bleeding

    Datatype

    integer

    If other evidence of gastrointestinal involvement, please specify
    Beschrijving

    Other evidence of gastrointestinal involvement

    Datatype

    text

    Neurological exam
    Beschrijving

    Neurological exam

    Datatype

    text

    If abnormal: Specify abnormality
    Beschrijving

    Neurological exam

    Datatype

    text

    PNP severity
    Beschrijving

    PNP severity

    Datatype

    integer

    Orthostatic hypotension
    Beschrijving

    Orthostatic hypotension

    Datatype

    integer

    Intractable diarrhoea
    Beschrijving

    Intractable diarrhoea

    Datatype

    integer

    Inflexible pulse rate
    Beschrijving

    Inflexible pulse rate

    Datatype

    integer

    Clinical evidence for involvement of other sites
    Beschrijving

    Other sites

    Datatype

    text

    PRE-HSCT TREATMENT
    Beschrijving

    PRE-HSCT TREATMENT

    WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?
    Beschrijving

    WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?

    Datatype

    integer

    Chemotherapy Modality
    Beschrijving

    Chemotherapy

    Datatype

    boolean

    Modality, if Chemotherapy
    Beschrijving

    Chemotherapy

    Datatype

    text

    If Other, please specify
    Beschrijving

    Modality

    Datatype

    text

    HSCT
    Beschrijving

    HSCT

    DATE OF HSCT
    Beschrijving

    DATE OF HSCT

    Datatype

    date

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

    HSCT TYPE

    Datatype

    boolean

    Autologous: Date of 1st collection or pheresis
    Beschrijving

    Autologous: Date of 1st collection or pheresis

    Datatype

    date

    STATUS OF DISEASE AT COLLECTION (AUTOGRAFTS ONLY)
    Beschrijving

    STATUS OF DISEASE AT COLLECTION (AUTOGRAFTS ONLY)

    Haematological status
    Beschrijving

    Haematological status

    Datatype

    text

    Organ status
    Beschrijving

    Organ status

    Datatype

    integer

    STATUS OF DISEASE AT START OF CONDITIONING FOR BMT
    Beschrijving

    STATUS OF DISEASE AT START OF CONDITIONING FOR BMT

    Haematological status
    Beschrijving

    Haematological status

    Datatype

    integer

    Organ status
    Beschrijving

    Organ status

    Datatype

    integer

    Hb (g/dl) CLINICAL AND LABORATORY DATA
    Beschrijving

    HbLab

    Datatype

    float

    Hb (g/dl) CLINICAL AND LABORATORY DATA
    Beschrijving

    Hb (g/dL)

    Datatype

    integer

    CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum creatinine

    Datatype

    float

    CLINICAL AND LABORATORY DATA Serum creatinine
    Beschrijving

    Serum creatinine

    Datatype

    text

    CLINICAL AND LABORATORY DATA Serum creatinine
    Beschrijving

    Serum creatinine

    Datatype

    integer

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

    Creatinine clearance (mL/min)

    Datatype

    float

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

    Creatinine clearance (mL/min)

    Datatype

    integer

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

    Total urinary protein excretion (mg/24 h)

    Datatype

    float

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

    Total urinary protein excretion (mg/24 h)

    Datatype

    integer

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

    Total urinary albumin excretion (mg/24 h)

    Datatype

    float

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

    Total urinary albumin excretion (mg/24 h)

    Datatype

    integer

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

    Serum calcium (mmol/L)

    Datatype

    float

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

    Serum calcium (mmol/L)

    Datatype

    integer

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

    Serum albumin (g/L)

    Datatype

    float

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

    Serum albumin (g/L)

    Datatype

    integer

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

    Serum alkaline phosphatase (IU/L)

    Datatype

    float

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

    Serum alkaline phosphatase (IU/L)

    Datatype

    integer

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    integer

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    float

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    integer

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

    Serum NT-pro-BNP (ng/L)

    Datatype

    float

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

    Serum NT-pro-BNP (ng/L)

    Datatype

    integer

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

    Serum c-Troponin T (μg/L)

    Datatype

    float

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

    Serum c-Troponin T (μg/L)

    Datatype

    integer

    BM aspirate: % plasmacytosis
    Beschrijving

    BM aspirate

    Datatype

    float

    BM aspirate % plasmacytosis
    Beschrijving

    BM aspirate

    Datatype

    integer

    BM trephine % plasmacytosis
    Beschrijving

    BM trephine

    Datatype

    float

    BM trephine: % plasmacytosis
    Beschrijving

    BM trephine

    Datatype

    integer

    Monoclonal Ig in serum
    Beschrijving

    Monoclonal Ig in serum

    Datatype

    float

    Maateenheden
    • g/L
    g/L
    Immunofixation of serum
    Beschrijving

    Immunofixation of serum

    Datatype

    integer

    Free light chains in serum Kappa light chains
    Beschrijving

    Kappa light chains

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Kappa light chains Not evaluated
    Beschrijving

    Kappa light chains

    Datatype

    boolean

    Lambda light chains
    Beschrijving

    Lambda light chains

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Lambda light chains Not evaluated
    Beschrijving

    Lambda light chains

    Datatype

    boolean

    Immunofixation of urine
    Beschrijving

    Immunofixation of urine

    Datatype

    integer

    Monoclonal light chains in urine
    Beschrijving

    Monoclonal light chains in urine

    Datatype

    float

    Maateenheden
    • g/24h
    g/24h
    Serum Beta2 microglobulin
    Beschrijving

    Serum Beta2 microglobulin

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Soft Tissues
    Beschrijving

    Soft Tissues

    Datatype

    text

    Gastrointestinal Tract
    Beschrijving

    Gastrointestinal Tract

    Datatype

    integer

    Heart
    Beschrijving

    Heart

    Datatype

    integer

    Liver
    Beschrijving

    Liver

    Datatype

    integer

    Kidney
    Beschrijving

    Kidney

    Datatype

    integer

    Peripheral nerves
    Beschrijving

    Peripheral nerves

    Datatype

    integer

    Autonomic nerves
    Beschrijving

    Autonomic nerves

    Datatype

    integer

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

    Liver span in ultrasound or CT scan

    Datatype

    float

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

    Liver span in ultrasound or CT scan

    Datatype

    boolean

    NYHA class
    Beschrijving

    NYHA class

    Datatype

    integer

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

    LVEF

    Datatype

    float

    Maateenheden
    • %
    Alias
    UMLS CUI [1]
    C0428772
    %
    Left ventricular ejection fraction Not evaluated
    Beschrijving

    Left ventricular ejection fraction

    Datatype

    boolean

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

    Interventricular septal wall thickness

    Datatype

    float

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

    Interventricular septal wall thickness

    Datatype

    boolean

    Weight loss
    Beschrijving

    Weight loss

    Datatype

    integer

    Malabsorption
    Beschrijving

    Malabsorption

    Datatype

    integer

    GI bleeding
    Beschrijving

    GI Bleeding

    Datatype

    integer

    If other evidence of gastrointestinal involvement, please specify
    Beschrijving

    Other evidence of gastrointestinal involvement

    Datatype

    text

    Neurological exam
    Beschrijving

    Neurological exam

    Datatype

    text

    If abnormal: Specify abnormality
    Beschrijving

    Neurological exam

    Datatype

    text

    PNP severity
    Beschrijving

    PNP severity

    Datatype

    integer

    Orthostatic hypotension
    Beschrijving

    Orthostatic hypotension

    Datatype

    integer

    Intractable diarrhoea
    Beschrijving

    Intractable diarrhoea

    Datatype

    integer

    Inflexible pulse rate
    Beschrijving

    Inflexible pulse rate

    Datatype

    integer

    Clinical evidence for involvement of other sites
    Beschrijving

    Other sites

    Datatype

    text

    STATUS OF DISEASE AT 100 DAYS AFTER HSCT
    Beschrijving

    STATUS OF DISEASE AT 100 DAYS AFTER HSCT

    BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS
    Beschrijving

    BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS

    Datatype

    text

    DATE RESPONSE ACHIEVED OR ASSESSED
    Beschrijving

    DATE RESPONSE ACHIEVED OR ASSESSED

    Datatype

    date

    Hb (g/dl) CLINICAL AND LABORATORY DATA
    Beschrijving

    Hb (g/dL)

    Datatype

    integer

    CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum creatinine

    Datatype

    float

    CLINICAL AND LABORATORY DATA Serum creatinine
    Beschrijving

    Serum creatinine

    Datatype

    text

    CLINICAL AND LABORATORY DATA Serum creatinine
    Beschrijving

    Serum creatinine

    Datatype

    integer

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

    Creatinine clearance (mL/min)

    Datatype

    float

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

    Creatinine clearance (mL/min)

    Datatype

    integer

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

    Total urinary protein excretion (mg/24 h)

    Datatype

    float

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

    Total urinary protein excretion (mg/24 h)

    Datatype

    integer

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

    Total urinary albumin excretion (mg/24 h)

    Datatype

    float

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

    Total urinary albumin excretion (mg/24 h)

    Datatype

    integer

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

    Serum calcium (mmol/L)

    Datatype

    float

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

    Serum calcium (mmol/L)

    Datatype

    integer

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

    Serum albumin (g/L)

    Datatype

    float

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

    Serum albumin (g/L)

    Datatype

    integer

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

    Serum alkaline phosphatase (IU/L)

    Datatype

    float

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

    Serum alkaline phosphatase (IU/L)

    Datatype

    integer

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    integer

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    float

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    integer

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

    Serum NT-pro-BNP (ng/L)

    Datatype

    float

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

    Serum NT-pro-BNP (ng/L)

    Datatype

    integer

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

    Serum c-Troponin T (μg/L)

    Datatype

    float

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

    Serum c-Troponin T (μg/L)

    Datatype

    integer

    BM aspirate: % plasmacytosis
    Beschrijving

    BM aspirate

    Datatype

    float

    BM aspirate % plasmacytosis
    Beschrijving

    BM aspirate

    Datatype

    integer

    BM trephine % plasmacytosis
    Beschrijving

    BM trephine

    Datatype

    float

    BM trephine: % plasmacytosis
    Beschrijving

    BM trephine

    Datatype

    integer

    Monoclonal Ig in serum
    Beschrijving

    Monoclonal Ig in serum

    Datatype

    float

    Maateenheden
    • g/L
    g/L
    Immunofixation of serum
    Beschrijving

    Immunofixation of serum

    Datatype

    integer

    Free light chains in serum Kappa light chains
    Beschrijving

    Kappa light chains

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Kappa light chains Not evaluated
    Beschrijving

    Kappa light chains

    Datatype

    boolean

    Lambda light chains
    Beschrijving

    Lambda light chains

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Lambda light chains Not evaluated
    Beschrijving

    Lambda light chains

    Datatype

    boolean

    Immunofixation of urine
    Beschrijving

    Immunofixation of urine

    Datatype

    integer

    Monoclonal light chains in urine
    Beschrijving

    Monoclonal light chains in urine

    Datatype

    float

    Maateenheden
    • g/24h
    g/24h
    Serum Beta2 microglobulin
    Beschrijving

    Serum Beta2 microglobulin

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    ORGAN-SPECIFIC RESPONSES AT 100 DAYS AFTER HSCT
    Beschrijving

    ORGAN-SPECIFIC RESPONSES AT 100 DAYS AFTER HSCT

    Kidney
    Beschrijving

    Renal response

    Datatype

    integer

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

    Liver span in ultrasound or CT scan

    Datatype

    float

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

    Liver span in ultrasound or CT scan

    Datatype

    boolean

    Hepatic response
    Beschrijving

    Hepatic response

    Datatype

    integer

    Heart NYHA class
    Beschrijving

    NYHA class

    Datatype

    integer

    Left ventricular ejection fraction
    Beschrijving

    Left ventricular ejection fraction

    Datatype

    float

    Maateenheden
    • %
    %
    Left ventricular ejection fraction
    Beschrijving

    Left ventricular ejection fraction

    Datatype

    integer

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

    Interventricular septal wall thickness

    Datatype

    float

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

    Interventricular septal wall thickness

    Datatype

    integer

    Cardiac response
    Beschrijving

    Cardiac response

    Datatype

    text

    Weight loss
    Beschrijving

    Weight loss

    Datatype

    integer

    Malabsorption
    Beschrijving

    Malabsorption

    Datatype

    integer

    GI bleeding
    Beschrijving

    GI Bleeding

    Datatype

    integer

    GI response
    Beschrijving

    GI response

    Datatype

    integer

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

    Neurological exam

    Datatype

    integer

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

    PNP severity

    Datatype

    integer

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

    PN response

    Datatype

    integer

    AN response Autonomic neuropathy
    Beschrijving

    AN response

    Datatype

    integer

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

    Clinical evidence for involvement of new sites

    Datatype

    text

    KARNOFSKY
    Beschrijving

    KARNOFSKY

    Datatype

    text

    FORMS TO BE FILLED IN
    Beschrijving

    FORMS TO BE FILLED IN

    Type of Transplant
    Beschrijving

    Type of Transplant

    Datatype

    text

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

    FOLLOW UP AL AMYLOIDOSIS

    Unique Identification Code (UIC) (if known)
    Beschrijving

    Unique Identification Code (UIC)

    Datatype

    text

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

    Hospital Unique Patient Number

    Datatype

    text

    Alias
    UMLS CUI [1]
    C2348585
    Initials
    Beschrijving

    Initialen

    Datatype

    text

    Alias
    UMLS CUI [1]
    C2986440
    Date of birth
    Beschrijving

    Date of birth

    Datatype

    date

    Alias
    UMLS CUI [1]
    C0421451
    Date of HSCT
    Beschrijving

    Date of HSCT

    Datatype

    date

    Alias
    UMLS CUI [1]
    C2584899
    PATIENT LAST SEEN
    Beschrijving

    PATIENT LAST SEEN

    Date of Last Contact or Death
    Beschrijving

    Date last contact

    Datatype

    date

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

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

    Datatype

    integer

    GRAFT VERSUS HOST DISEASE (GvHD) SINCE LAST REPORT
    Beschrijving

    GRAFT VERSUS HOST DISEASE (GvHD) SINCE LAST REPORT

    Maximum Grade of Acute GVHD
    Beschrijving

    AcuteGraftVersusHostDiseaseMaximumOverallGrade

    Datatype

    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
    Beschrijving

    Maximum grade

    Datatype

    integer

    Reason if present
    Beschrijving

    Maximum grade

    Datatype

    text

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

    Date onset of this episode

    Datatype

    date

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

    Date onset of this episode

    Datatype

    boolean

    Stage skin
    Beschrijving

    aGvHD Stage Skin

    Datatype

    integer

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

    aGvHD Stage liver

    Datatype

    integer

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

    aGvHD stage gut

    Datatype

    integer

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

    aGvHD Resolution

    Datatype

    integer

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

    aGvHD Date of resolution

    Datatype

    date

    Maateenheden
    • 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
    Beschrijving

    Chronic Graft versus Host Disease

    Datatype

    text

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

    Presence of cGVHD

    Datatype

    integer

    Date of onset
    Beschrijving

    cGvHD Date of onset

    Datatype

    date

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

    cGvHD grade

    Datatype

    integer

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

    Organs affected

    Datatype

    integer

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

    Date of Resolution

    Datatype

    date

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

    OTHER COMPLICATIONS SINCE LAST REPORT

    Infection related complications
    Beschrijving

    Infection related complications

    Datatype

    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
    Beschrijving

    Bacteraemia / fungemia / viremia / parasites

    Datatype

    text

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

    Bacteraemia / fungemia / viremia / parasites

    Datatype

    text

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

    Septic shock

    Datatype

    text

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

    Septic shock

    Datatype

    text

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

    ARDS

    Datatype

    text

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

    ARDS

    Datatype

    text

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

    Multiorgan failure due to infection

    Datatype

    text

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

    Multiorgan failure due to infection

    Datatype

    text

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

    Pneumonia

    Datatype

    text

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

    Pneumonia

    Datatype

    text

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

    Hepatitis

    Datatype

    text

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

    Hepatitis

    Datatype

    text

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

    CNS infection

    Datatype

    text

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

    CNS infection

    Datatype

    text

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

    Gut infection

    Datatype

    text

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

    Gut infection

    Datatype

    text

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

    Skin infection

    Datatype

    text

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

    Skin infection

    Datatype

    text

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

    Cystitis

    Datatype

    text

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

    Cystitis

    Datatype

    text

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

    Retinitis

    Datatype

    text

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

    Retinitis

    Datatype

    text

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

    Other

    Datatype

    text

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

    Other

    Datatype

    text

    Non infection related complications
    Beschrijving

    Non infection related complications

    Datatype

    boolean

    Alias
    UMLS CUI [1]
    C0009566
    CTC grade Cardiovascular
    Beschrijving

    CTC grade Cardiovascular

    Datatype

    integer

    Date Cardiovascular
    Beschrijving

    Date Cardiovascular

    Datatype

    date

    Comments
    Beschrijving

    Cardiovascular

    Datatype

    text

    CTC grade Dermatologic
    Beschrijving

    CTC grade Dermatologic

    Datatype

    integer

    Date Dermatologic
    Beschrijving

    Date Dermatologic

    Datatype

    date

    Comments
    Beschrijving

    Dermatologic

    Datatype

    text

    CTC grade Gastrointestinal
    Beschrijving

    CTC grade Gastrointestinal

    Datatype

    integer

    Date Gastrointestinal
    Beschrijving

    Date Gastrointestinal

    Datatype

    date

    Comments
    Beschrijving

    Gastrointestinal

    Datatype

    text

    CTC grade Haemorrhage
    Beschrijving

    CTC grade Haemorrhage

    Datatype

    integer

    Date Haemorrhage
    Beschrijving

    Date Haemorrhage

    Datatype

    date

    Haemorrhage Comments
    Beschrijving

    Haemorrhage Comments

    Datatype

    text

    CTC grade Hepatic
    Beschrijving

    CTC grade Hepatic

    Datatype

    integer

    Date Hepatic
    Beschrijving

    Date Hepatic

    Datatype

    date

    Comments
    Beschrijving

    Hepatic Comments

    Datatype

    text

    CTC grade Neurologic
    Beschrijving

    CTC grade Neurologic

    Datatype

    integer

    Date Neurologic
    Beschrijving

    Date Neurologic

    Datatype

    date

    Neurologic Comments
    Beschrijving

    Neurologic Comments

    Datatype

    text

    CTC grade Pulmonary
    Beschrijving

    CTC grade Pulmonary

    Datatype

    integer

    Pulmonary Date
    Beschrijving

    Pulmonary Date

    Datatype

    date

    Pulmonary Comments
    Beschrijving

    Pulmonary Comments

    Datatype

    text

    CTC grade Renal
    Beschrijving

    CTC grade Renal

    Datatype

    integer

    Renal Date
    Beschrijving

    Renal Date

    Datatype

    date

    Renal Comments
    Beschrijving

    Renal Comments

    Datatype

    text

    Other CTC grade
    Beschrijving

    Other CTC grade

    Datatype

    integer

    Date of other Typte
    Beschrijving

    Date of other Typte

    Datatype

    date

    Comments of Other type
    Beschrijving

    Comments of Other type

    Datatype

    text

    Graft loss
    Beschrijving

    Graft loss

    Datatype

    text

    Alias
    UMLS CUI [1]
    C0877042
    Overall chimaerism
    Beschrijving

    Overall chimaerism

    Datatype

    integer

    GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM
    Beschrijving

    GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM

    Date of Test
    Beschrijving

    Date of Test

    Datatype

    date

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

    Identification

    Datatype

    text

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

    Number in the infusion order

    Datatype

    text

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

    Number in the infusion order

    Datatype

    integer

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

    Bone marrow

    Datatype

    float

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

    PB mononuclear cells (PBMC)

    Datatype

    float

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

    T-Cells

    Datatype

    float

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

    B-Cells

    Datatype

    float

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

    Red blood cells

    Datatype

    float

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

    Monocytes

    Datatype

    float

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

    PMNs (neutrophils)

    Datatype

    float

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

    Lymphocytes, NOS

    Datatype

    float

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

    Myeloid cells, NOS

    Datatype

    float

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

    Other

    Datatype

    float

    Maateenheden
    • %
    %
    Test used:
    Beschrijving

    Laboratory tests

    Datatype

    text

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

    SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED

    Datatype

    integer

    Date of diagnosis
    Beschrijving

    Diagnose-Datum

    Datatype

    date

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

    Diagnosis

    Datatype

    integer

    If other diagnosis, please specify
    Beschrijving

    Diagnosis

    Datatype

    text

    ADDITIONAL THERAPIES SINCE LAST FOLLOW UP
    Beschrijving

    ADDITIONAL THERAPIES SINCE LAST FOLLOW UP

    Treatment given since last report
    Beschrijving

    Additional treatment

    Datatype

    text

    Alias
    UMLS CUI [1]
    C1706712
    Date started
    Beschrijving

    Datestarted

    Datatype

    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.
    Beschrijving

    ADDITIONAL TREATMENT

    Datatype

    integer

    Disease status before this cellular therapy
    Beschrijving

    Disease status before this cellular therapy

    Datatype

    integer

    If yes: Type of cells
    Beschrijving

    Type of cells

    Datatype

    integer

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

    Nucleated cells

    Datatype

    text

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

    Nucleated cells

    Datatype

    text

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

    CD 34+

    Datatype

    text

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

    CD 34+

    Datatype

    text

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

    CD 3+

    Datatype

    text

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

    CD 3+

    Datatype

    float

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

    All cells

    Datatype

    float

    Maateenheden
    • x10^6/kg
    Alias
    UMLS CUI [1]
    C0007584
    x10^6/kg
    All cells
    Beschrijving

    All cells

    Datatype

    text

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

    Chronological number

    Datatype

    float

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

    Indication

    Datatype

    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)
    Beschrijving

    Infusion count

    Datatype

    float

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

    AcuteGraftVersusHostDiseaseMaximumOverallGrade

    Datatype

    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)
    Beschrijving

    Disease treatment

    Datatype

    integer

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

    FIRST EVIDENCE OF DISEASE WORSENING SINCE LAST HSCT

    EVIDENCE OF DISEASE ACTIVITY
    Beschrijving

    EVIDENCE OF DISEASE ACTIVITY

    Datatype

    text

    If yes, date first noted
    Beschrijving

    EVIDENCE OF DISEASE ACTIVITY

    Datatype

    date

    LAST DISEASE AND PATIENT STATUS
    Beschrijving

    LAST DISEASE AND PATIENT STATUS

    HAEMATOLOGICAL DISEASE STATUS
    Beschrijving

    HAEMATOLOGICAL DISEASE STATUS

    Datatype

    integer

    Organ Response
    Beschrijving

    ORGAN RESPONSE

    Datatype

    integer

    Hb (g/dl) CLINICAL AND LABORATORY DATA
    Beschrijving

    Hb (g/dL)

    Datatype

    integer

    CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum creatinine

    Datatype

    float

    CLINICAL AND LABORATORY DATA Serum creatinine
    Beschrijving

    Serum creatinine

    Datatype

    text

    CLINICAL AND LABORATORY DATA Serum creatinine
    Beschrijving

    Serum creatinine

    Datatype

    integer

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

    Creatinine clearance (mL/min)

    Datatype

    float

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

    Creatinine clearance (mL/min)

    Datatype

    integer

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

    Total urinary protein excretion (mg/24 h)

    Datatype

    float

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

    Total urinary protein excretion (mg/24 h)

    Datatype

    integer

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

    Total urinary albumin excretion (mg/24 h)

    Datatype

    float

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

    Total urinary albumin excretion (mg/24 h)

    Datatype

    integer

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

    Serum calcium (mmol/L)

    Datatype

    float

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

    Serum calcium (mmol/L)

    Datatype

    integer

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

    Serum albumin (g/L)

    Datatype

    float

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

    Serum albumin (g/L)

    Datatype

    integer

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

    Serum alkaline phosphatase (IU/L)

    Datatype

    float

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

    Serum alkaline phosphatase (IU/L)

    Datatype

    integer

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    integer

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    float

    Serum bilirubin CLINICAL AND LABORATORY DATA
    Beschrijving

    Serum bilirubin

    Datatype

    integer

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

    Serum NT-pro-BNP (ng/L)

    Datatype

    float

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

    Serum NT-pro-BNP (ng/L)

    Datatype

    integer

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

    Serum c-Troponin T (μg/L)

    Datatype

    float

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

    Serum c-Troponin T (μg/L)

    Datatype

    integer

    BM aspirate: % plasmacytosis
    Beschrijving

    BM aspirate

    Datatype

    float

    BM aspirate % plasmacytosis
    Beschrijving

    BM aspirate

    Datatype

    integer

    BM trephine % plasmacytosis
    Beschrijving

    BM trephine

    Datatype

    float

    BM trephine: % plasmacytosis
    Beschrijving

    BM trephine

    Datatype

    integer

    Monoclonal Ig in serum
    Beschrijving

    Monoclonal Ig in serum

    Datatype

    float

    Maateenheden
    • g/L
    g/L
    Immunofixation of serum
    Beschrijving

    Immunofixation of serum

    Datatype

    integer

    Free light chains in serum Kappa light chains
    Beschrijving

    Kappa light chains

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Kappa light chains Not evaluated
    Beschrijving

    Kappa light chains

    Datatype

    boolean

    Lambda light chains
    Beschrijving

    Lambda light chains

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Lambda light chains Not evaluated
    Beschrijving

    Lambda light chains

    Datatype

    boolean

    Immunofixation of urine
    Beschrijving

    Immunofixation of urine

    Datatype

    integer

    Monoclonal light chains in urine
    Beschrijving

    Monoclonal light chains in urine

    Datatype

    float

    Maateenheden
    • g/24h
    g/24h
    Serum Beta2 microglobulin
    Beschrijving

    Serum Beta2 microglobulin

    Datatype

    float

    Maateenheden
    • mg/L
    mg/L
    Renal response ORGAN-SPECIFIC RESPONSES AT THIS FOLLOW UP
    Beschrijving

    Renal response

    Datatype

    integer

    Liver (cm craniocaudal diameter)
    Beschrijving

    Liver span in ultrasound or CT scan

    Datatype

    float

    Liver (cm craniocaudal diameter)
    Beschrijving

    Liver span in ultrasound or CT scan

    Datatype

    integer

    Hepatic response
    Beschrijving

    Hepatic response

    Datatype

    text

    NYHA class
    Beschrijving

    NYHA class

    Datatype

    integer

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

    LVEF

    Datatype

    float

    Maateenheden
    • %
    Alias
    UMLS CUI [1]
    C0428772
    %
    Left Ventricular Ejection Fraction
    Beschrijving

    LVEF

    Datatype

    integer

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

    Interventricular septal wall thickness

    Datatype

    float

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

    Interventricular septal wall thickness

    Datatype

    integer

    Cardiac response
    Beschrijving

    Cardiac response

    Datatype

    integer

    Weight loss
    Beschrijving

    Weight loss

    Datatype

    integer

    Malabsorption
    Beschrijving

    Malabsorption

    Datatype

    integer

    GI bleeding
    Beschrijving

    GI bleeding

    Datatype

    integer

    GI response
    Beschrijving

    GI response

    Datatype

    integer

    Neurological exam
    Beschrijving

    Neurological exam

    Datatype

    integer

    PNP severity
    Beschrijving

    PNP severity

    Datatype

    integer

    PN response
    Beschrijving

    PN response

    Datatype

    integer

    AN response
    Beschrijving

    AN response

    Datatype

    integer

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

    Evidence of new organ involvement

    Datatype

    text

    Has patient or partner become pregnant after this HSCT?
    Beschrijving

    Has patient or partner become pregnant after this HSCT?

    Datatype

    integer

    Survival Status
    Beschrijving

    Survival Status

    Datatype

    integer

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

    Type of score used

    Datatype

    integer

    Score
    Beschrijving

    Performance score

    Datatype

    integer

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

    CAUSE OF DEATH

    Datatype

    integer

    cGvHD
    Beschrijving

    cGvHD cause

    Datatype

    integer

    Interstitial pneumonitis Cause
    Beschrijving

    Interstitial pneumonitis

    Datatype

    integer

    Pulmonary toxicity Cause
    Beschrijving

    Pulmonary toxicity

    Datatype

    integer

    Infection
    Beschrijving

    Infection

    Datatype

    integer

    Infection:
    Beschrijving

    Infection

    Datatype

    integer

    Rejection / poor graft function
    Beschrijving

    Rejection / poor graft function

    Datatype

    integer

    Veno-Occlusive disease (VOD)
    Beschrijving

    Veno-Occlusive disease (VOD)

    Datatype

    integer

    Haemorrhage
    Beschrijving

    Haemorrhage

    Datatype

    integer

    Cardiac toxicity
    Beschrijving

    Cardiac toxicity

    Datatype

    integer

    Central nervous system toxicity
    Beschrijving

    Central nervous system toxicity

    Datatype

    integer

    Gastro intestinal toxicity
    Beschrijving

    Gastro intestinal toxicity

    Datatype

    integer

    Skin toxicity
    Beschrijving

    Skin toxicity

    Datatype

    integer

    Renal failure
    Beschrijving

    Renal failure

    Datatype

    integer

    Multiple organ failure
    Beschrijving

    Multiple organ failure

    Datatype

    integer

    If other HSCT related cause, please specify
    Beschrijving

    Other

    Datatype

    text

    ADDITIONAL NOTES IF APPLICABLE
    Beschrijving

    ADDITIONAL NOTES IF APPLICABLE

    Comments
    Beschrijving

    Comments

    Datatype

    text

    IDENTIFICATION & SIGNATURE
    Beschrijving

    IDENTIFICATION & SIGNATURE

    Datatype

    text

    Similar models

    18pp EBMT Amyloidosis

    1. StudyEvent: ODM
      1. 18pp EBMT Amyloidosis
    Name
    Type
    Description | Question | Decode (Coded Value)
    Datatype
    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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