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])
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
Not evaluated (3)
Name of study / trial
Item
Name of study / trial
text
C0008976 (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])
Date of last HSCT for this patient
Item
Date of last HSCT for this patient
date
C0472699 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
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
C0677874 (UMLS CUI [1])
Code List
Complete haematological remission obtained after the HSCT in the absence of additional disease treatment
CL Item
Previously reported (1)
C0205309 (UMLS CUI-1)
CL Item
Yes, date (2)
C1705108 (UMLS CUI-1)
CL Item
No (3)
C1298908 (UMLS CUI-1)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
Item
Acute Graft versus Host Disease (aGvHD) - Grade
integer
C0856825 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
Code List
Acute Graft versus Host Disease (aGvHD) - Grade
CL Item
grade 0 (Absent) (1)
CL Item
Not evaluated (6)
Item
ACUTE GRAFT VERSUS HOST DISEASE (AGVHD)
integer
C0441799 (UMLS CUI [1])
Code List
ACUTE GRAFT VERSUS HOST DISEASE (AGVHD)
CL Item
New onset (New onset)
C0746890 (UMLS CUI-1)
CL Item
Recurrent (Recurrent)
C2945760 (UMLS CUI-1)
CL Item
Persistent (Persistent)
C0205322 (UMLS CUI-1)
Item
aGvHD Reason
integer
C0856825 (UMLS CUI [1,1])
M (UMLS CUI [1,2])
CL Item
Tapering (1)
C0441640 (UMLS CUI-1)
CL Item
DLI (2)
C1512034 (UMLS CUI-1)
CL Item
Unexplained (3)
C0439673 (UMLS CUI-1)
Date onset of this episode
Item
Date onset of this episode (if new or recurrent)
date
C0574845 (UMLS CUI [1])
Item
aGvHD Stage liver
integer
C1610054 (UMLS CUI [1])
Code List
aGvHD Stage liver
Item
aGvHD Stage skin
integer
C1610605 (UMLS CUI [1])
Code List
aGvHD Stage skin
CL Item
Not evaluated (6)
aGvHD Resolution
Item
aGvHD Resolution
boolean
C0856825 (UMLS CUI [1,1])
C1514893 (UMLS CUI [1,2])
aGvHD Date of resolution
Item
aGvHD Date of resolution
date
C0856825 (UMLS CUI [1,1])
C1514893 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item
Chronic Graft versus Host Disease (cGvHD)
integer
C0867389 (UMLS CUI [1])
Code List
Chronic Graft versus Host Disease (cGvHD)
CL Item
Present continuously since last reported episode (Present continuously since last reported episode)
CL Item
Resolved (Resolved)
Item
Chronic Graft versus Host Disease (cGvHD)
integer
Code List
Chronic Graft versus Host Disease (cGvHD)
CL Item
First episode (1)
Date of onset
Item
Date of onset
date
C0574845 (UMLS CUI [1])
Item
If present continously since last report, specify cGvHD gade:
text
C0867389 (UMLS CUI [1,1])
C0441799 (UMLS CUI [1,2])
Code List
If present continously since last report, specify cGvHD gade:
CL Item
Limited (Limited)
C0439801 (UMLS CUI-1)
CL Item
Extensive (Extensive)
C0205231 (UMLS CUI-1)
Item
cGvHD Organs affected
integer
C0867389 (UMLS CUI [1,1])
C2095124 (UMLS CUI [1,2])
Code List
cGvHD Organs affected
CL Item
Skin (1)
C1123023 (UMLS CUI-1)
CL Item
Gut (2)
C0021853 (UMLS CUI-1)
CL Item
Liver (3)
C0023884 (UMLS CUI-1)
CL Item
Mouth (4)
C0230028 (UMLS CUI-1)
CL Item
Eyes (5)
C0015392 (UMLS CUI-1)
CL Item
Lung (6)
C0024109 (UMLS CUI-1)
CL Item
Other, specify (7)
C1299220 (UMLS CUI-1)
CL Item
Unknown (8)
C0439673 (UMLS CUI-1)
Date of Resolution
Item
If resolved, specify the date of resolution:
date
C1514893 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Infection related complications
Item
Infection related complications
boolean
C0009450 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])
Item
Bacteremia / fungemia / viremia / parasites
integer
C0004610 (UMLS CUI [1])
C0085082 (UMLS CUI [2])
C0042749 (UMLS CUI [3])
C0030498 (UMLS CUI [4])
Code List
Bacteremia / fungemia / viremia / parasites
Item
Septic shock
integer
C0036983 (UMLS CUI [1])
Item
integer
C0035222 (UMLS CUI [1])
Item
Multiorgan failure due to infection
integer
C0026766 (UMLS CUI [1])
Code List
Multiorgan failure due to infection
CL Item
Pathogen (1)
C0450254 (UMLS CUI-1)
CL Item
Date (2)
C0011008 (UMLS CUI-1)
Item
Pneumonia
integer
C0032285 (UMLS CUI [1])
CL Item
Pathogen (1)
C0450254 (UMLS CUI-1)
CL Item
Date (2)
C0011008 (UMLS CUI-1)
Item
Hepatitis
integer
C0019158 (UMLS CUI [1])
CL Item
Pathogen (1)
C0450254 (UMLS CUI-1)
CL Item
Date (2)
C0011008 (UMLS CUI-1)
Item
CNS infection
integer
C0007684 (UMLS CUI [1])
CL Item
Pathogen (1)
C0450254 (UMLS CUI-1)
CL Item
Date (2)
C0011008 (UMLS CUI-1)
Item
Gut infection
integer
C0178238 (UMLS CUI [1])
CL Item
Pathogen (1)
C0450254 (UMLS CUI-1)
CL Item
Date (2)
C0011008 (UMLS CUI-1)
Item
Skin infection
integer
C0037278 (UMLS CUI [1])
CL Item
Pathogen (1)
C0450254 (UMLS CUI-1)
CL Item
Date (2)
C0011008 (UMLS CUI-1)
Item
Cystitis
integer
C0010692 (UMLS CUI [1])
CL Item
Pathogen (1)
C0450254 (UMLS CUI-1)
CL Item
Date (2)
C0011008 (UMLS CUI-1)
Item
Retinitis
integer
C0035333 (UMLS CUI [1])
CL Item
Pathogen (1)
C0450254 (UMLS CUI-1)
CL Item
Date (2)
C0011008 (UMLS CUI-1)
CL Item
Unknown (3)
C0439673 (UMLS CUI-1)
Item
Other
integer
C0205394 (UMLS CUI [1])
CL Item
Pathogen (1)
C0450254 (UMLS CUI-1)
CL Item
Date (2)
C0011008 (UMLS CUI-1)
Non infection related complications
Item
Non infection related complications
boolean
C0009566 (UMLS CUI [1])
Item
Idiopathic pneumonia syndrome
integer
C1504431 (UMLS CUI [1])
Code List
Idiopathic pneumonia syndrome
CL Item
Unknown (Unknown)
Item
VOD
text
C0948441 (UMLS CUI [1])
CL Item
Unknown (Unknown)
Item
Cataract
integer
C0086543 (UMLS CUI [1])
CL Item
Unknown (Unknown)
Item
Haemorrhagic cystitis, non infectious
integer
C0085692 (UMLS CUI [1])
Code List
Haemorrhagic cystitis, non infectious
CL Item
Unknown (Unknown)
Item
ARDS, non infectious
integer
C0035222 (UMLS CUI [1])
Code List
ARDS, non infectious
CL Item
Unknown (Unknown)
Item
Multiorgan failure, non infectious
integer
Code List
Multiorgan failure, non infectious
Item
HSCT-associated microangiopathy
integer
C0155765 (UMLS CUI [1])
Code List
HSCT-associated microangiopathy
CL Item
Unknown (Unknown)
Item
Renal failure requiring dialysis
integer
C0035078 (UMLS CUI [1])
Code List
Renal failure requiring dialysis
CL Item
Unknown (Unknown)
Item
Haemolytic anaemia due to blood group
integer
C0002878 (UMLS CUI [1])
Code List
Haemolytic anaemia due to blood group
CL Item
Unknown (Unknown)
Item
Aseptic bone necrosis
integer
C0158452 (UMLS CUI [1])
Code List
Aseptic bone necrosis
CL Item
Unknown (Unknown)
Other INFECTION RELATED COMPLICATIONS
Item
Other INFECTION RELATED COMPLICATIONS if other, please specify
integer
C3714514 (UMLS CUI [1])
Item
Graft loss
integer
C0877042 (UMLS CUI [1])
CL Item
Not evaluated (3)
Item
Overall Chimerism
integer
C0333678 (UMLS CUI [1])
Code List
Overall Chimerism
CL Item
Full (donor > 95%) (1)
C0333678 (UMLS CUI-1)
CL Item
Mixed (partial) (2)
C3160715 (UMLS CUI-1)
CL Item
Autologuos reconstitution (recipient > 95%) (3)
C0301944 (UMLS CUI-1)
CL Item
Aplasia (4)
C0243065 (UMLS CUI-1)
CL Item
Not evaluated (5)
C3846720 (UMLS CUI-1)
Identification
Item
Identification of donor or Cord Blood Unit given by the centre
text
C1718162 (UMLS CUI [1])
Date of Test
Item
Date of Test
date
C0024671 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
Number in the infusion order (if applicable)
integer
C2348184 (UMLS CUI [1])
Code List
Number in the infusion order (if applicable)
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 (Indicate the date(s) and results of all tests done for all donors. Split the results by donor and by the cell type on which the test was performed if applicable. Copy this table as many times as necessary.)
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
text
Item
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
integer
Code List
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
CL Item
Previously reported (Previously reported)
CL Item
No at date of this follow-up (No at date of this follow-up)
Date of diagnosis
Item
If yes, specify date of diagnosis
date
C2316983 (UMLS CUI [1])
Item
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
text
Code List
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
CL Item
Lymphoproliferative disorder (Lymphoproliferative disorder)
Diagnosis
Item
if other, please specify
text
Item
ADDITIONAL Therapy SINCE LAST FOLLOW UP
text
C1706712 (UMLS CUI [1])
Code List
ADDITIONAL Therapy SINCE LAST FOLLOW UP
CL Item
Yes, date started (Yes, date started)
CL Item
Unknown (Unknown)
Date started
Item
Date ADDITIONAL THERAPIES SINCE LAST FOLLOW UP started
date
C1706712 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Item
If yes: Cellular therapy
integer
C0302189 (UMLS CUI [1])
Code List
If yes: Cellular therapy
CL Item
Yes (Mark disease status before this cellular therapy) (2)
Item
if yes, Disease status before this cellular therapy
integer
C0018759 (UMLS CUI [1])
Code List
if yes, Disease status before this cellular therapy
CL Item
CR (CR)
C0677874 (UMLS CUI-1)
CL Item
Not in CR (Not in CR)
C0677874 (UMLS CUI-1)
CL Item
Not evaluated (Not evaluated)
C3846720 (UMLS CUI-1)
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)
C1512034 (UMLS CUI-1)
CL Item
Mesenchymal cells (2)
C1257975 (UMLS CUI-1)
CL Item
Other (3)
C0205394 (UMLS CUI-1)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
Item
Number of cells infused by type
integer
Code List
Number of cells infused by type
CL Item
Number of Nucleated cells infused (DLI only) (1)
C1180059 (UMLS CUI-1)
CL Item
CD 34+ (cells/kg*) (DLI only) (2)
C1955216 (UMLS CUI-1)
CL Item
CD 3+ (cells/kg*) (DLI only) (3)
C0483189 (UMLS CUI-1)
Item
Total number of cells infused (non DLI only)
integer
C0007584 (UMLS CUI [1])
Code List
Total number of cells infused (non DLI only)
CL Item
Not evaluated (2)
Chronological number
Item
Chronological number of this cell therapy for this patient
float
C2348184 (UMLS CUI [1])
Item
Indication (check all that apply)
integer
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)
Number of Infusions
Item
Number of Infusions (within 10 weeks) (count only infusions that are part of same regimen and given for the same indication)
float
C2348184 (UMLS CUI [1,1])
C1289919 (UMLS CUI [1,2])
Item
Acute Graft versus Host Disease
integer
C0856825 (UMLS CUI [1])
Code List
Acute Graft versus Host Disease
CL Item
grade 0 (absent) (grade 0 (absent))
CL Item
grade 1 (grade 1)
CL Item
grade 2 (grade 2)
CL Item
grade 3 (grade 3)
CL Item
grade 4 (grade 4)
CL Item
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
Yes: Planned (planned before HSCT took place) (2)
CL Item
Yes: Not planned (for relapse/progression or persistent disease) (3)
Item
Relapse or Progression
integer
C0277556 (UMLS CUI [1])
C0242656 (UMLS CUI [2])
Code List
Relapse or Progression
CL Item
Previously reported (Previously reported)
C0205309 (UMLS CUI-1)
CL Item
No (No)
C1298908 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
CL Item
Continous progression since transplant (Continous progression since transplant)
C0242656 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
If yes, date diagnosed
Item
If yes, date diagnosed RELAPSE OR PROGRESSION
date
C0035020 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
Item
last disease status
integer
C0421168 (UMLS CUI [1])
Code List
last disease status
CL Item
Complete Remission (Complete Remission)
C0677874 (UMLS CUI-1)
CL Item
Stable disease (Stable disease)
C0677946 (UMLS CUI-1)
CL Item
Relapse (Relapse)
C0277556 (UMLS CUI-1)
CL Item
Treatment failure/ progression (Treatment failure/ progression)
C0242656 (UMLS CUI-1)
Item
Has patient or partner become pregnant after this HSCT?
integer
C0032961 (UMLS CUI [1])
Code List
Has patient or partner become pregnant after this HSCT?
CL Item
Unknown (Unknown)
Item
Survival Status
integer
C1148433 (UMLS CUI [1])
Code List
Survival Status
Item
If alive: Type of score used:
integer
C1518965 (UMLS CUI [1])
Code List
If alive: Type of score used:
CL Item
Karnofsky (Karnofsky)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
Item
Performance score
integer
C1518965 (UMLS CUI [1])
Code List
Performance 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)
Item
CAUSE OF DEATH
integer
C0007465 (UMLS CUI [1])
CL Item
Relapse or progression (Relapse or progression)
C0277556 (UMLS CUI-1)
C0242656 (UMLS CUI-2)
CL Item
Secondary malignancy (Secondary malignancy)
C3266877 (UMLS CUI-1)
CL Item
HSCT related cause (HSCT related cause)
C0472699 (UMLS CUI-1)
C0007465 (UMLS CUI-2)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
CL Item
Other (Other)
C0205394 (UMLS CUI-1)
Item
HSCT related cause of death
integer
C0007465 (UMLS CUI [1,1])
C0472699 (UMLS CUI [1,2])
Code List
HSCT related cause of death
CL Item
GvHD (1)
C0018133 (UMLS CUI-1)
CL Item
Interstitial pneumonitis (2)
C0206061 (UMLS CUI-1)
CL Item
Pulmonary toxicity (3)
C0919924 (UMLS CUI-1)
CL Item
Infection bacterial (4)
C0004623 (UMLS CUI-1)
CL Item
Infection viral (5)
C0042769 (UMLS CUI-1)
CL Item
Infection fungal (6)
C0026946 (UMLS CUI-1)
CL Item
Infection parasitic (7)
C0030498 (UMLS CUI-1)
CL Item
Infection unknown (8)
C0009450 (UMLS CUI-1)
CL Item
Rejection / poor graft function (9)
C1268811 (UMLS CUI-1)
CL Item
Veno-occlusive disease (VOD) (10)
C0948441 (UMLS CUI-1)
CL Item
Haemorrhage (11)
C0019080 (UMLS CUI-1)
CL Item
Cardiac toxicity (12)
C0876994 (UMLS CUI-1)
CL Item
Central nervous system toxicity (13)
C3160947 (UMLS CUI-1)
CL Item
Gastro intestinal toxicity (14)
C0007465 (UMLS CUI-1)
C1142499 (UMLS CUI-2)
CL Item
Skin toxicity (15)
C1167791 (UMLS CUI-1)
CL Item
Renal failure (16)
C1533077 (UMLS CUI-1)
CL Item
Multiple organ failure (17)
C0026766 (UMLS CUI-1)
CL Item
Other (18)
C0205394 (UMLS CUI-1)
Comments
Item
Comments
integer
C0947611 (UMLS CUI [1])
IDENTIFICATION & SIGNATURE
Item
IDENTIFICATION & SIGNATURE
integer
C0205396 (UMLS CUI [1,1])
C1519316 (UMLS CUI [1,2])