ID

15818

Beschrijving

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

Trefwoorden

Versies (1)
  1. 14-06-16 14-06-16 -
Geüploaded op

14 juni 2016

DOI

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Licentie

Creative Commons BY-NC 3.0
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EBMT Multiple Myeloma GENERAL INFORMATION

Engels

EBMT Multiple Myeloma GENERAL INFORMATION

1 Formulieren  
GENERAL INFORMATION, Team
Beschrijving

GENERAL INFORMATION, Team

EBMT Centre Identification Code (CIC)
Beschrijving

EBMT Centre Identification Code (CIC)

Datatype

integer

Alias
UMLS CUI [1,1]
C2348585
UMLS CUI [1,2]
C3826859
Name of the hospital
Beschrijving

Hospital

Datatype

text

Alias
UMLS CUI [1]
C0019994
Unit
Beschrijving

Unit

Datatype

text

Alias
UMLS CUI [1]
C0019988
Name of contact person
Beschrijving

Contact person

Datatype

text

Alias
UMLS CUI [1]
C0337611
Telephone number of contact person
Beschrijving

Telephone

Datatype

text

Alias
UMLS CUI [1]
C1515258
Fax #
Beschrijving

Fax #

Datatype

integer

Alias
UMLS CUI [1]
C1549619
E-mail
Beschrijving

Email

Datatype

integer

Alias
UMLS CUI [1]
C0013849
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]
C2348560
PATIENT
Beschrijving

PATIENT

Unique Identification Code (UIC)
Beschrijving

To be entered only if patient previously reported

Datatype

integer

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

Hospital Unique Patient Number or Code

Datatype

integer

Alias
UMLS CUI [1]
C1827636
Initials
Beschrijving

First name(s) - surname(s) (Registration will not be accepted if this item is left blank)

Datatype

text

Alias
UMLS CUI [1]
C2986440
Date of Birth
Beschrijving

Patient Birth Date

Datatype

date

Alias
UMLS CUI [1]
C0421451
Sex:
Beschrijving

PatientGender

Datatype

integer

Alias
UMLS CUI [1]
C0079399
ABO Group
Beschrijving

ABO Group

Datatype

integer

Alias
UMLS CUI [1]
C0000778
Rh factor
Beschrijving

Rh factor

Datatype

integer

Alias
UMLS CUI [1]
C0035403
DISEASE
Beschrijving

DISEASE

Date of Diagnosis
Beschrijving

Date of Diagnosis

Datatype

date

Alias
UMLS CUI [1]
C2316983
Primary Disease Diagnosis
Beschrijving

Check the disease for which this transplant was performed

Datatype

integer

Alias
UMLS CUI [1]
C0277554
Non infection related complications
Beschrijving

Non infection related complications

Datatype

boolean

Alias
UMLS CUI [1]
C0009566
PLASMA CELL DISORDERS (INCLUDING MULTIPLE MYELOMA)
Beschrijving

PLASMA CELL DISORDERS (INCLUDING MULTIPLE MYELOMA)

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

Submitted Previously

Datatype

integer

Alias
UMLS CUI [1]
C2348568
SUBCLASSIFICATION
Beschrijving

Select one

Datatype

integer

Alias
UMLS CUI [1]
C0008902
Heavy chain and light chain
Beschrijving

(check light and heavy chain types)

Datatype

text

Alias
UMLS CUI [1]
C0018852
UMLS CUI [2]
C0238239
Light chain only
Beschrijving

(check light chain type only)

Datatype

integer

Alias
UMLS CUI [1]
C2347305
STAGE AT DIAGNOSIS
Beschrijving

SALMON AND DURIE

Datatype

integer

Alias
UMLS CUI [1]
C0278722
STAGE AT DIAGNOSIS: ISS Stage
Beschrijving

STAGE AT DIAGNOSIS: ISS Stage

Datatype

integer

Alias
UMLS CUI [1]
C2346508
Chromosome analysis
Beschrijving

CYTOGENETICS AND MOLECULAR DATA

Datatype

integer

Alias
UMLS CUI [1]
C0200867
Number of metaphases with anomalies:
Beschrijving

Number of abnormal metaphases

Datatype

float

Alias
UMLS CUI [1,1]
C1621812
Number of metaphases examined
Beschrijving

Number of examined metaphases

Datatype

float

Alias
UMLS CUI [1,1]
C1621812
UMLS CUI [1,2]
C0260877
IF ABNORMAL, INDICATE ABNORMALITIES FOUND
Beschrijving

IF ABNORMAL, INDICATE ABNORMALITIES FOUND

Datatype

integer

Alias
UMLS CUI [1]
C1704257
IF ABNORMAL, INDICATE ABNORMALITIES FOUND
Beschrijving

Other or associated abnormalities

Datatype

text

Molecular analysis
Beschrijving

Molecular analysis

Datatype

integer

Alias
UMLS CUI [1]
C1513380
CLINICAL AND LABORATORY DATA
Beschrijving

CLINICAL AND LABORATORY DATA

Datatype

integer

Alias
UMLS CUI [1]
C1516606
UMLS CUI [2]
C1254595
Lytic lesions
Beschrijving

INVOLVEMENT AT DIAGNOSIS Bone structure

Datatype

integer

Alias
UMLS CUI [1]
C0221204
Extramedullary involvement
Beschrijving

Extramedullary involvement

Datatype

integer

Alias
UMLS CUI [1]
C4055047
if yes, please specify location
Beschrijving

Extramedullary involvement

Datatype

integer

Alias
UMLS CUI [1,1]
C4055047
UMLS CUI [1,2]
C1515974
PRE-HSCT TREATMENT
Beschrijving

PRE-HSCT TREATMENT

Was the patient treated before the HSCT procedure?
Beschrijving

Previous treatment

Datatype

text

Alias
UMLS CUI [1]
C0087111
Sequential number of this treatment
Beschrijving

counted from diagnosis, or last HSCT if applicable

Datatype

integer

Alias
UMLS CUI [1]
C1115395
Modality Chemo/Drugs
Beschrijving

Modality Chemo/Drugs

Datatype

boolean

Alias
UMLS CUI [1]
C0695347
Modality Chemo/Drugs regimen
Beschrijving

Modality Chemo/Drugs regimen

Datatype

integer

Alias
UMLS CUI [1]
C0392920
UMLS CUI [2]
C0013227
Modality Radiotherapy
Beschrijving

Modality Radiotherapy

Datatype

boolean

Alias
UMLS CUI [1]
C1522449
Response
Beschrijving

Response see manual for full definition of each response

Datatype

integer

Alias
UMLS CUI [1]
C1704632
HSCT
Beschrijving

HSCT

Date of HSCT
Beschrijving

Date of HSCT

Datatype

date

Alias
UMLS CUI [1]
C2584899
HSCT Type
Beschrijving

HSCT Type

Datatype

text

Alias
UMLS CUI [1]
C0472699
Autologous Date of 1st collection or pheresis
Beschrijving

Autologous Date of 1st collection or pheresis

Datatype

date

Alias
UMLS CUI [1]
C4065498
STATUS OF DISEASE AT COLLECTION
Beschrijving

STATUS OF DISEASE AT COLLECTION

STATUS OF DISEASE AT COLLECTION
Beschrijving

SEE MANUAL FOR FULL DEFINITION OF EACH DISEASE STATUS

Datatype

integer

Alias
UMLS CUI [1]
C3899365
If sCR or CR: NUMBER OF THIS COMPLETE REMISSION
Beschrijving

STATUS OF DISEASE AT COLLECTION

Datatype

integer

Alias
UMLS CUI [1]
C4050416
If VGPR or PR: NUMBER OF THIS PARTIAL REMISSION
Beschrijving

STATUS OF DISEASE AT COLLECTION

Datatype

integer

Alias
UMLS CUI [1]
C2349122
UMLS CUI [2]
C1562651
NUMBER OF THIS RELAPSE
Beschrijving

STATUS OF DISEASE AT COLLECTION

Datatype

integer

Alias
UMLS CUI [1,1]
C0035020
UMLS CUI [1,2]
C0449788
Plateau
Beschrijving

(COMPLETE ONLY IF STATUS IS STABLE DIEASE OR PR) (not applicable for non secretory myelona) PLATEAU

Datatype

integer

Alias
UMLS CUI [1]
C2964353
CLINICAL AND LABORATORY DATA
Beschrijving

CLINICAL AND LABORATORY DATA

Datatype

integer

Alias
UMLS CUI [1]
C1516606
UMLS CUI [2]
C1254595
Lytic lesions
Beschrijving

Bone structure

Datatype

integer

ADDITIONAL TREATMENT POST-HSCT
Beschrijving

ADDITIONAL TREATMENT POST-HSCT

Additional Disease Treatment
Beschrijving

Additional Disease Treatment

Datatype

integer

Alias
UMLS CUI [1]
C1706712
ADDITIONAL DISEASE TREATMENT, specify:
Beschrijving

If Yes

Datatype

integer

Alias
UMLS CUI [1,1]
C1706712
UMLS CUI [1,2]
C1521902
Chemo/drug/agent
Beschrijving

(including MoAB, etc.)

Datatype

integer

Alias
UMLS CUI [1]
C0392920
Chemo/drug/agent, if other, please specify
Beschrijving

if other, please specify

Datatype

integer

Alias
UMLS CUI [1]
C0392920
Radiotherapy
Beschrijving

Radiotherapy

Datatype

integer

Alias
UMLS CUI [1]
C1522449
If additional treatment: Other treatment
Beschrijving

Other Treatment

Datatype

text

Alias
UMLS CUI [1]
C1706712
STATUS OF DISEASE AT 100 DAYS AFTER HSCT
Beschrijving

STATUS OF DISEASE AT 100 DAYS AFTER HSCT

BEST RESPONSE TO HSCT AT 100 DAYS
Beschrijving

(see manual for full definition of each response)

Datatype

integer

Alias
UMLS CUI [1]
C2986560
If sCR or CR: NUMBER OF THIS COMPLETE REMISSION
Beschrijving

If sCR or CR: NUMBER OF THIS COMPLETE REMISSION

Datatype

integer

Alias
UMLS CUI [1]
C4050416
UMLS CUI [2]
C0677874
If VGPR or PR: NUMBER OF THIS PARTIAL REMISSION
Beschrijving

BEST RESPONSE TO HSCT AT 100 DAYS

Datatype

integer

If complete response: date of CR
Beschrijving

CR Date

Datatype

date

Maateenheden
  • yyyy/mm/dd
Alias
UMLS CUI [1,1]
C0677874
UMLS CUI [1,2]
C0011008
yyyy/mm/dd
Otherwise: date of evaluation
Beschrijving

Otherwise

Datatype

date

Alias
UMLS CUI [1]
C1708335
Plateau
Beschrijving

(COMPLETE ONLY IF STATUS IS STABLE DISEASE OR PR) (not applicable for non secretory myelona)

Datatype

integer

Alias
UMLS CUI [1]
C2964353
FORMS TO BE FILLED IN
Beschrijving

FORMS TO BE FILLED IN

Alias
UMLS CUI-1
C2985594
Type of Transplant
Beschrijving

Type of Transplant

Datatype

text

Alias
UMLS CUI [1,1]
C0559189
UMLS CUI [1,2]
C0040739
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Similar models

EBMT Multiple Myeloma GENERAL INFORMATION

1 Formulieren
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)
integer
C2348585 (UMLS CUI [1,1])
C3826859 (UMLS CUI [1,2])
Hospital
Item
Name of the hospital
text
C0019994 (UMLS CUI [1])
Unit
Item
Unit
text
C0019988 (UMLS CUI [1])
Contact person
Item
Name of contact person
text
C0337611 (UMLS CUI [1])
Telephone
Item
Telephone number of contact person
text
C1515258 (UMLS CUI [1])
Fax #
Item
Fax #
integer
C1549619 (UMLS CUI [1])
Email
Item
E-mail
integer
C0013849 (UMLS CUI [1])
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])
Patient in Trial
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
C2348560 (UMLS CUI [1])
Item Group
PATIENT
Unique Identification Code (UIC)
Item
Unique Identification Code (UIC)
integer
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number or Code
Item
Hospital Unique Patient Number or Code
integer
C1827636 (UMLS CUI [1])
Initials
Item
Initials
text
C2986440 (UMLS CUI [1])
Patient Birth Date
Item
Date of Birth
date
C0421451 (UMLS CUI [1])
Item
Sex:
integer
C0079399 (UMLS CUI [1])
PatientGender
Code List
Sex:
CL Item
Male (Male)
CL Item
Female (Female)
ABO Group
Item
ABO Group
integer
C0000778 (UMLS CUI [1])
Item
Rh factor
integer
C0035403 (UMLS CUI [1])
Rh factor
Code List
Rh factor
CL Item
Absent  (Absent )
C2699077 (UMLS CUI-1)
CL Item
Present (Present)
C2699078 (UMLS CUI-1)
CL Item
Not evaluated (Not evaluated)
C3846720 (UMLS CUI-1)
Item Group
DISEASE
Date of Diagnosis
Item
Date of Diagnosis
date
C2316983 (UMLS CUI [1])
Item
Primary Disease Diagnosis
integer
C0277554 (UMLS CUI [1])
Primary Disease Diagnosis
Code List
Primary Disease Diagnosis
CL Item
Acute Leukaemia (Acute Leukaemia)
C0085669 (UMLS CUI-1)
CL Item
Acute Myelogenous Leukaemia (AML) (Acute Myelogenous Leukaemia (AML))
C0023467 (UMLS CUI-1)
CL Item
Acute Lymphoblastic Leukaemia (ALL) (Acute Lymphoblastic Leukaemia (ALL))
C0023449 (UMLS CUI-1)
CL Item
Secondary Acute Leukaemia (do not use if transformed from MDS/MPN) (Secondary Acute Leukaemia (do not use if transformed from MDS/MPN))
C0856053 (UMLS CUI-1)
CL Item
Chronic Leukaemia (Chronic Leukaemia)
C0856053 (UMLS CUI-1)
CL Item
Chronic Myeloid Leukaemia (CML) (Chronic Myeloid Leukaemia (CML))
C0023473 (UMLS CUI-1)
CL Item
Chronic Lymphocytic Leukaemia (Chronic Lymphocytic Leukaemia)
C0023434 (UMLS CUI-1)
CL Item
Lymphoma (Lymphoma)
C0024299 (UMLS CUI-1)
CL Item
Non Hodgkin (Non Hodgkin)
C0024305 (UMLS CUI-1)
CL Item
Myeloma/ Plasma cell disorder (Myeloma/ Plasma cell disorder)
C0026764 (UMLS CUI-1)
CL Item
Solid Tumour (Solid Tumour)
C0006826 (UMLS CUI-1)
CL Item
Myelodysplastic syndromes (Myelodysplastic syndromes)
C0280450 (UMLS CUI-1)
CL Item
MDS (MDS)
C3463824 (UMLS CUI-1)
CL Item
MD/ MPN (MD/ MPN)
C1292778 (UMLS CUI-1)
CL Item
Myeloproliferative neoplasm (Myeloproliferative neoplasm)
C1333046 (UMLS CUI-1)
CL Item
Bone marrow failure including Aplastic anaemia (Bone marrow failure including Aplastic anaemia)
C0002874 (UMLS CUI-1)
CL Item
Inherited disorders (Inherited disorders)
C0019247 (UMLS CUI-1)
CL Item
Primary immune deficiencies (Primary immune deficiencies)
C0398686 (UMLS CUI-1)
CL Item
Metabolic disorders (Metabolic disorders)
C0025517 (UMLS CUI-1)
CL Item
Histiocytic disorders (Histiocytic disorders)
C0398597 (UMLS CUI-1)
CL Item
Autoimmune disease (Autoimmune disease)
C0004364 (UMLS CUI-1)
CL Item
Juvenile Idiopathic Arthritis (Juvenile Idiopathic Arthritis)
C1444841 (UMLS CUI-1)
CL Item
Multiple Sclerosis (Multiple Sclerosis)
C0026769 (UMLS CUI-1)
CL Item
Systemic Lupus (Systemic Lupus)
C0024141 (UMLS CUI-1)
CL Item
Systemic Sclerosis (Systemic Sclerosis)
C0036421 (UMLS CUI-1)
CL Item
Haemoglobinopathy (Haemoglobinopathiy)
C0019045 (UMLS CUI-1)
CL Item
Other diagnosis (Other diagnosis)
C0205394 (UMLS CUI-1)
CL Item
Hodgkin´s Disease (Hodgkin´s Disease)
C0019829 (UMLS CUI-1)
Non infection related complications
Item
Non infection related complications
boolean
C0009566 (UMLS CUI [1])
Item Group
PLASMA CELL DISORDERS (INCLUDING MULTIPLE MYELOMA)
Item
Has the information requested in this section been submitted with a previous HSCT registration for this patient?
integer
C2348568 (UMLS CUI [1])
SubmittedPreviously
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 2, Pre HSCT Treatment (1)
CL Item
No: proceed with this section (2)
Item
SUBCLASSIFICATION
integer
C0008902 (UMLS CUI [1])
SUBCLASSIFICATION
Code List
SUBCLASSIFICATION
CL Item
Multiple myeloma (1)
C0026764 (UMLS CUI-1)
CL Item
Plasma Cell Leukaemia (2)
C0023484 (UMLS CUI-1)
CL Item
Solitary plasmacytoma of bone (3)
C0272256 (UMLS CUI-1)
CL Item
POEMS (4)
C0085404 (UMLS CUI-1)
CL Item
Monoclonal light and heavy chain deposition disease (LCDD/HCDD) (5)
C1333947 (UMLS CUI-1)
CL Item
Other (6)
C0205394 (UMLS CUI-1)
Item
Heavy chain and light chain
text
C0018852 (UMLS CUI [1])
C0238239 (UMLS CUI [2])
Multiple myeloma
Code List
Heavy chain and light chain
CL Item
IgG (IgG)
C0202087 (UMLS CUI-1)
CL Item
IgA (IgA)
C0202083 (UMLS CUI-1)
CL Item
IgD (IgD)
C0577612 (UMLS CUI-1)
CL Item
IgE (IgE)
C0020846 (UMLS CUI-1)
CL Item
IgM (IgM)
C0202084 (UMLS CUI-1)
CL Item
Kappa (Kappa)
C0439099 (UMLS CUI-1)
CL Item
Lambda (Lambda)
C0021037 (UMLS CUI-1)
Item
Light chain only
integer
C2347305 (UMLS CUI [1])
Multiple myeloma
Code List
Light chain only
CL Item
Kappa (1)
C0439099 (UMLS CUI-1)
CL Item
Lambda (2)
C0021037 (UMLS CUI-1)
Item
STAGE AT DIAGNOSIS
integer
C0278722 (UMLS CUI [1])
SALMON AND DURIE
Code List
STAGE AT DIAGNOSIS
CL Item
I (I)
CL Item
II (II)
CL Item
III (III)
Item
STAGE AT DIAGNOSIS: ISS Stage
integer
C2346508 (UMLS CUI [1])
ISS Stage
Code List
STAGE AT DIAGNOSIS: ISS Stage
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
Item
Chromosome analysis
integer
C0200867 (UMLS CUI [1])
CYTOGENETICS AND MOLECULAR DATA
Code List
Chromosome analysis
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not done or failed (3)
CL Item
Unknown (4)
Number of abnormal metaphases
Item
Number of metaphases with anomalies:
float
C1621812 (UMLS CUI [1,1])
Number of examined metaphases
Item
Number of metaphases examined
float
C1621812 (UMLS CUI [1,1])
C0260877 (UMLS CUI [1,2])
Item
IF ABNORMAL, INDICATE ABNORMALITIES FOUND
integer
C1704257 (UMLS CUI [1])
Del 13q14
Code List
IF ABNORMAL, INDICATE ABNORMALITIES FOUND
CL Item
Del 13q14 (1)
C1515582 (UMLS CUI-1)
CL Item
t(11;14) (2)
C1515703 (UMLS CUI-1)
CL Item
abn 17q (3)
CL Item
17p del (4)
C1517965 (UMLS CUI-1)
CL Item
t(4:14) (5)
C2986942 (UMLS CUI-1)
CL Item
t(14:16) (6)
C2986943 (UMLS CUI-1)
CL Item
1q amplification (7)
C1327882 (UMLS CUI-1)
CL Item
c-myc (8)
C0079068 (UMLS CUI-1)
CL Item
Other, specify (9)
C1299220 (UMLS CUI-1)
Other or associated abnormalities
Item
IF ABNORMAL, INDICATE ABNORMALITIES FOUND
text
Item
Molecular analysis
integer
C1513380 (UMLS CUI [1])
Molecular analysis
Code List
Molecular analysis
CL Item
Done but failed (1)
C1513380 (UMLS CUI-1)
C0231175 (UMLS CUI-2)
CL Item
Done, successful (2)
C1513380 (UMLS CUI-1)
C3258067 (UMLS CUI-2)
CL Item
Not evaluated (3)
C1513380 (UMLS CUI-1)
C0220825 (UMLS CUI-2)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
Item
CLINICAL AND LABORATORY DATA
integer
C1516606 (UMLS CUI [1])
C1254595 (UMLS CUI [2])
CLINICAL AND LABORATORY DATA
Code List
CLINICAL AND LABORATORY DATA
CL Item
Hb (g/dl)  (1)
C0019046 (UMLS CUI-1)
CL Item
Serum creatinine (ymol/L) (2)
C0600061 (UMLS CUI-1)
CL Item
Serum calcium (mmol/L) (3)
C0036785 (UMLS CUI-1)
CL Item
Serum albumin (g/L) (4)
C0036773 (UMLS CUI-1)
CL Item
BM aspirate: % plasmacytosis (5)
C0857285 (UMLS CUI-1)
CL Item
BM trephine: % plasmacytosis (6)
C0398526 (UMLS CUI-1)
CL Item
Monoclonal Ig in serum (g/L) (7)
C0202081 (UMLS CUI-1)
CL Item
Monoclonal Ig in urine (g/24 h) (8)
C1532873 (UMLS CUI-1)
CL Item
Serum beta-2 microglobulin (mg/L) (9)
C0005149 (UMLS CUI-1)
Item
Lytic lesions
integer
C0221204 (UMLS CUI [1])
Lytic lesions
Code List
Lytic lesions
CL Item
Normal (1)
C0205307 (UMLS CUI-1)
CL Item
Minor (2)
C0205165 (UMLS CUI-1)
CL Item
Major (3)
C0205164 (UMLS CUI-1)
CL Item
Not evaluated (4)
C3846720 (UMLS CUI-1)
Item
Extramedullary involvement
integer
C4055047 (UMLS CUI [1])
Extramedullary involvement
Code List
Extramedullary involvement
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Extramedullary involvement
Item
if yes, please specify location
integer
C4055047 (UMLS CUI [1,1])
C1515974 (UMLS CUI [1,2])
Item Group
PRE-HSCT TREATMENT
Item
Was the patient treated before the HSCT procedure?
text
C0087111 (UMLS CUI [1])
Previous treatment
Code List
Was the patient treated before the HSCT procedure?
CL Item
No (proceed to `Date of HSCT`) (No (proceed to `Date of HSCT`))
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Sequential number of this treatment
Item
Sequential number of this treatment
integer
C1115395 (UMLS CUI [1])
Modality Chemo/Drugs
Item
Modality Chemo/Drugs
boolean
C0695347 (UMLS CUI [1])
Modality Chemo/Drugs regimen
Item
Modality Chemo/Drugs regimen
integer
C0392920 (UMLS CUI [1])
C0013227 (UMLS CUI [2])
Modality Radiotherapy
Item
Modality Radiotherapy
boolean
C1522449 (UMLS CUI [1])
Item
Response
integer
C1704632 (UMLS CUI [1])
Response
Code List
Response
CL Item
sCR (0)
CL Item
CR (1)
C0677874 (UMLS CUI-1)
CL Item
vgPR (2)
C4053871 (UMLS CUI-1)
CL Item
PR (3)
C1521726 (UMLS CUI-1)
CL Item
Stable disease (5)
C0677946 (UMLS CUI-1)
CL Item
Progression (6)
C0242656 (UMLS CUI-1)
CL Item
Not evaluated (7)
C3846720 (UMLS CUI-1)
CL Item
Unknown (8)
C0439673 (UMLS CUI-1)
Item Group
HSCT
Date of HSCT
Item
Date of HSCT
date
C2584899 (UMLS CUI [1])
Item
HSCT Type
text
C0472699 (UMLS CUI [1])
HSCT Type
Code List
HSCT Type
CL Item
Allogenic (Allogenic)
C1515895 (UMLS CUI-1)
CL Item
Autologous (Autologuos)
C0439859 (UMLS CUI-1)
Autologous Date of 1st collection or pheresis
Item
Autologous Date of 1st collection or pheresis
date
C4065498 (UMLS CUI [1])
Item Group
STATUS OF DISEASE AT COLLECTION
Item
STATUS OF DISEASE AT COLLECTION
integer
C3899365 (UMLS CUI [1])
STATUS OF DISEASE AT COLLECTION
Code List
STATUS OF DISEASE AT COLLECTION
CL Item
Stringent complete remission (sCR) (1)
C4050416 (UMLS CUI-1)
CL Item
Complete remission (CR) (2)
C0677874 (UMLS CUI-1)
CL Item
Very good PR (VGPR) (3)
C4053871 (UMLS CUI-1)
CL Item
PR (4)
C1521726 (UMLS CUI-1)
CL Item
Relapse from CR (5)
C0035020 (UMLS CUI-1)
CL Item
Stable disease (no change, includes old MR) (6)
C0677946 (UMLS CUI-1)
CL Item
Progression (7)
C0242656 (UMLS CUI-1)
CL Item
Unknown (8)
C0439673 (UMLS CUI-1)
Item
If sCR or CR: NUMBER OF THIS COMPLETE REMISSION
integer
C4050416 (UMLS CUI [1])
STATUS OF DISEASE AT COLLECTION
Code List
If sCR or CR: NUMBER OF THIS COMPLETE REMISSION
CL Item
1st  (1st )
CL Item
2nd (2nd)
CL Item
3rd or higher (3rd or higher)
Item
If VGPR or PR: NUMBER OF THIS PARTIAL REMISSION
integer
C2349122 (UMLS CUI [1])
C1562651 (UMLS CUI [2])
STATUS OF DISEASE AT COLLECTION
Code List
If VGPR or PR: NUMBER OF THIS PARTIAL REMISSION
CL Item
1st  (1st )
CL Item
2nd (2nd)
CL Item
3rd or higher (3rd or higher)
Item
NUMBER OF THIS RELAPSE
integer
C0035020 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
STATUS OF DISEASE AT COLLECTION
Code List
NUMBER OF THIS RELAPSE
CL Item
1st  (1st )
CL Item
2nd (2nd)
CL Item
3rd or higher (3rd or higher)
Item
Plateau
integer
C2964353 (UMLS CUI [1])
Plateau
Code List
Plateau
CL Item
no (1)
CL Item
yes (2)
CL Item
unknown (3)
Item
CLINICAL AND LABORATORY DATA
integer
C1516606 (UMLS CUI [1])
C1254595 (UMLS CUI [2])
CLINICAL AND LABORATORY DATA
Code List
CLINICAL AND LABORATORY DATA
CL Item
Hb (1)
C0518015 (UMLS CUI-1)
CL Item
Serum creatinine (2)
C0201976 (UMLS CUI-1)
CL Item
Serum calcium (3)
C0728876 (UMLS CUI-1)
CL Item
Serum albumin (4)
C0036773 (UMLS CUI-1)
CL Item
bone marrow aspirate (5)
C0857285 (UMLS CUI-1)
CL Item
bone marrow trephine (6)
C0005954 (UMLS CUI-1)
CL Item
Monoclonal Ig in serum (7)
C1532873 (UMLS CUI-1)
C3516447 (UMLS CUI-2)
CL Item
Immunofixation of serum (8)
C1271678 (UMLS CUI-1)
CL Item
Monoclonal Ig in urine (9)
C1532873 (UMLS CUI-1)
C0042014 (UMLS CUI-2)
CL Item
Immunofixation of urine (10)
C1271641 (UMLS CUI-1)
CL Item
Serum beta-2 microglobulin (11)
C0005149 (UMLS CUI-1)
Item
Lytic lesions
integer
Bone structure
Code List
Lytic lesions
CL Item
Normal (1)
CL Item
Minor (2)
CL Item
Major (3)
CL Item
Not evaluated (4)
Item Group
ADDITIONAL TREATMENT POST-HSCT
Item
Additional Disease Treatment
integer
C1706712 (UMLS CUI [1])
ADDITIONAL DISEASE TREATMENT
Code List
Additional Disease Treatment
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Item
ADDITIONAL DISEASE TREATMENT, specify:
integer
C1706712 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
ADDITIONAL DISEASE TREATMENT
Code List
ADDITIONAL DISEASE TREATMENT, specify:
CL Item
Planned (planned before HSCT took place) (1)
CL Item
Not planned (for relapse/progression or persistent disease), Date started (2)
Item
Chemo/drug/agent
integer
C0392920 (UMLS CUI [1])
Chemo/drug/agent
Code List
Chemo/drug/agent
CL Item
Thalidomide (Thalidomide)
C0039736 (UMLS CUI-1)
CL Item
Other (Other)
C0205394 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
Chemo/drug/agent, if other, please specify
Item
Chemo/drug/agent, if other, please specify
integer
C0392920 (UMLS CUI [1])
Item
Radiotherapy
integer
C1522449 (UMLS CUI [1])
Radiotherapy
Code List
Radiotherapy
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
If additional treatment: Other treatment
text
C1706712 (UMLS CUI [1])
Other Treatment
Code List
If additional treatment: Other treatment
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Item Group
STATUS OF DISEASE AT 100 DAYS AFTER HSCT
Item
BEST RESPONSE TO HSCT AT 100 DAYS
integer
C2986560 (UMLS CUI [1])
BEST RESPONSE TO HSCT AT 100 DAYS
Code List
BEST RESPONSE TO HSCT AT 100 DAYS
CL Item
Stringent complete remission (sCR) (1)
C4050416 (UMLS CUI-1)
CL Item
Complete remission (CR) (2)
C0677874 (UMLS CUI-1)
CL Item
Very good PR (VGPR) (3)
C4053871 (UMLS CUI-1)
CL Item
PR (4)
C1521726 (UMLS CUI-1)
CL Item
Stable disease (no change, includes old MR) (5)
C0677946 (UMLS CUI-1)
CL Item
Progression (6)
C0242656 (UMLS CUI-1)
CL Item
Unknown (7)
C0439673 (UMLS CUI-1)
Item
If sCR or CR: NUMBER OF THIS COMPLETE REMISSION
integer
C4050416 (UMLS CUI [1])
C0677874 (UMLS CUI [2])
STATUS OF DISEASE AT COLLECTION
Code List
If sCR or CR: NUMBER OF THIS COMPLETE REMISSION
CL Item
1st  (1st )
CL Item
2nd (2nd)
CL Item
3rd or higher (3rd or higher)
Item
If VGPR or PR: NUMBER OF THIS PARTIAL REMISSION
integer
STATUS OF DISEASE AT COLLECTION
Code List
If VGPR or PR: NUMBER OF THIS PARTIAL REMISSION
CL Item
1st  (1st )
CL Item
2nd (2nd)
CL Item
3rd or higher (3rd or higher)
CR Date
Item
If complete response: date of CR
date
C0677874 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Otherwise
Item
Otherwise: date of evaluation
date
C1708335 (UMLS CUI [1])
Item
Plateau
integer
C2964353 (UMLS CUI [1])
Plateau
Code List
Plateau
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item Group
FORMS TO BE FILLED IN
C2985594 (UMLS CUI-1)
Item
Type of Transplant
text
C0559189 (UMLS CUI [1,1])
C0040739 (UMLS CUI [1,2])
Type of Transplant
Code List
Type of Transplant
CL Item
AUTOgraft (proceed to Autograft form) (AUTOgraft (proceed to Autograft form))
C0040736 (UMLS CUI-1)
CL Item
ALLOgraft or Syngeneic graft (proceed to Allograft form) (ALLOgraft or Syngeneic graft (proceed to Allograft form))
C0040739 (UMLS CUI-1)
CL Item
Other (contact the EBMT Central Registry for instructions) (Other (contact the EBMT Central Registry for instructions))
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