EBMT Multiple Myeloma General Information

Item

Patient following national / international study / trial

integer

C1997894 (UMLS CUI [1])

Primary Disease Diagnosis

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])

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])

PersonBirthDate

Item

Date of Birth

date

C0011008 (UMLS CUI [1,1])
C0027361 (UMLS CUI [1,2])
C0005615 (UMLS CUI [1,3])

Sex

Item

Sex

integer

Sex

Code List

Sex

CL Item

Male (1)

CL Item

Female (2)

ABO Group

Item

ABO Group

text

Rh factor

Item

Rh factor

text

Rh factor

Code List

Rh factor

CL Item

Absent (Absent)

CL Item

Present (Present)

CL Item

Not evaluated (Not evaluated)

Date of Diagnosis

Item

Date of Diagnosis

date

C2316983 (UMLS CUI [1])

Item

Check the disease for which this transplant was performed

text

C0277554 (UMLS CUI [1])

Primary Disease Diagnosis

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)

Primary Disease Diagnosis

Item

If other diagnosis, specify:

text

C0277554 (UMLS CUI [1,1])
C2348235 (UMLS CUI [1,2])

SubmittedPreviously

Item

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

integer

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)

SUBCLASSIFICATION

Item

text

SUBCLASSIFICATION

Code List

SUBCLASSIFICATION

CL Item

Multiple myeloma (Multiple myeloma)

CL Item

Plasma Cell Leukaemia (Plasma Cell Leukaemia)

CL Item

Solitary plasmacytoma of bone (Solitary plasmacytoma of bone)

CL Item

POEMS (POEMS)

CL Item

Monoclonal light and heavy chain deposition disease (LCDD/HCDD) (Monoclonal light and heavy chain deposition disease (LCDD/HCDD))

CL Item

Other (Other)

Multiple myeloma

Item

if Multiple myeloma

integer

Multiple myeloma

Code List

if Multiple myeloma

CL Item

Heavy chain and light chain (check light and heavy chain types) (1)

CL Item

Light chain only (check light chain type only) (2)

CL Item

Non secretory (3)

Item

Heavy chain and light chain

integer

Code List

Heavy chain and light chain

CL Item

IgG (1)

CL Item

IgA (2)

CL Item

IgD (3)

CL Item

IgE (4)

CL Item

IgM (5)

Item

Heavy chain and light chain

integer

SALMON AND DURIE Stage at diagnosis

Code List

Heavy chain and light chain

CL Item

Kappa (1)

CL Item

Lambda (2)

Light chain only

Item

Light chain only

integer

Light chain only

Code List

Light chain only

CL Item

Kappa (1)

CL Item

Lambda (2)

Item

SALMON AND DURIE Stage at diagnosis

integer

C3846373 (UMLS CUI [1])

SALMON AND DURIE Stage at diagnosis

Code List

SALMON AND DURIE Stage at diagnosis

CL Item

A I (1)

CL Item

A II (2)

CL Item

A III (3)

CL Item

B I (4)

CL Item

B II (5)

CL Item

B III (6)

ISS (Multiple Myeloma Prognosis Score)

Item

ISS (Multiple Myeloma Prognosis) (Stage 1-3)

integer

C2346508 (UMLS CUI [1])

ISS

Code List

ISS (Multiple Myeloma Prognosis) (Stage 1-3)

Item

Chromosome analysis

text

C0200867 (UMLS CUI [1])

Code List

Chromosome analysis

CL Item

Not Done or failed (Not Done or failed)

CL Item

Done: normal (Done: normal)

CL Item

Done: abnormal (Done: abnormal)

CL Item

Unknown (Unknown)

Number of abnormal metaphases

Item

Number of metaphases with anomalies:

float

C1621812 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])

Number of examined metaphases

Item

Number of metaphases examined

float

C1621812 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
C0260877 (UMLS CUI [1,3])

Item

IF ABNORMAL, INDICATE ABNORMALITIES FOUND Del 13q14

text

Code List

IF ABNORMAL, INDICATE ABNORMALITIES FOUND Del 13q14

CL Item

Absent (Absent)

CL Item

Present (Present)

CL Item

Not evaluated (Not evaluated)

Item

IF ABNORMAL, INDICATE ABNORMALITIES FOUND t(11;14)

integer

Code List

IF ABNORMAL, INDICATE ABNORMALITIES FOUND t(11;14)

CL Item

Absent (Absent)

CL Item

Present (Present)

CL Item

Not evaluated (Not evaluated)

Item

IF ABNORMAL, INDICATE ABNORMALITIES FOUND abn 17q

integer

Code List

IF ABNORMAL, INDICATE ABNORMALITIES FOUND abn 17q

CL Item

Absent (Absent)

CL Item

Present (Present)

CL Item

Not evaluated (Not evaluated)

Item

IF ABNORMAL, INDICATE ABNORMALITIES FOUND 17p del

integer

Code List

IF ABNORMAL, INDICATE ABNORMALITIES FOUND 17p del

CL Item

Absent (Absent)

CL Item

Present (Present)

CL Item

Not evaluated (Not evaluated)

Item

IF ABNORMAL, INDICATE ABNORMALITIES FOUND t(4:14)

integer

Code List

IF ABNORMAL, INDICATE ABNORMALITIES FOUND t(4:14)

CL Item

Absent (Absent)

CL Item

Present (Present)

CL Item

Not evaluated (Not evaluated)

Item

IF ABNORMAL, INDICATE ABNORMALITIES FOUND (14:16)

integer

Code List

IF ABNORMAL, INDICATE ABNORMALITIES FOUND (14:16)

CL Item

Absent (Absent)

CL Item

Present (Present)

CL Item

Not evaluated (Not evaluated)

Item

IF ABNORMAL, INDICATE ABNORMALITIES FOUND 1q amplification

integer

Code List

IF ABNORMAL, INDICATE ABNORMALITIES FOUND 1q amplification

CL Item

Absent (Absent)

CL Item

Present (Present)

CL Item

Not evaluated (Not evaluated)

Item

IF ABNORMAL, INDICATE ABNORMALITIES FOUND c-myc

integer

Code List

IF ABNORMAL, INDICATE ABNORMALITIES FOUND c-myc

CL Item

Absent (Absent)

CL Item

Present (Present)

CL Item

Not evaluated (Not evaluated)

Item

IF Other ABNORMAL, INDICATE ABNORMALITIES FOUND, please specify

integer

Code List

IF Other ABNORMAL, INDICATE ABNORMALITIES FOUND, please specify

CL Item

Absent (Absent)

CL Item

Present (Present)

CL Item

Not evaluated (Not evaluated)

Chromosome analysis

Item

Other or associated abnormalities (specify) please specify

text

Molecular Analysis

Item

Molecular Analysis

integer

C1513380 (UMLS CUI [1])

Molecular Analysis

Code List

Molecular Analysis

CL Item

Done but failed (1)

CL Item

Done, successful (2)

CL Item

Not evaluated (3)

CL Item

Unknown (4)

CLINICAL AND LABORATORY DATA

Item

Hb (g/dL)

float

Item

Hb (g/dL)

integer

Code List

Hb (g/dL)

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

Serum creatinine (mol/L)

float

Item

Serum creatinine (mol/L)

text

Code List

Serum creatinine (mol/L)

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

Serum calcium (mmol/L)

float

Item

Serum calcium (mmol/L)

integer

Code List

Serum calcium (mmol/L)

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

Serum albumin (g/L)

float

Item

Serum albumin (g/L)

integer

Code List

Serum albumin (g/L)

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

BM aspirate: % plasmacytosis

float

Item

BM aspirate: % plasmacytosis

integer

Code List

BM aspirate: % plasmacytosis

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

BM trephine: % plasmacytosis

float

Item

BM trephine: % plasmacytosis

integer

Code List

BM trephine: % plasmacytosis

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

Monoclonal Ig in serum (g/L)

float

Item

Monoclonal Ig in serum (g/L)

integer

Code List

Monoclonal Ig in serum (g/L)

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

Monoclonal Ig in urine (g/24 h)

float

Item

Monoclonal Ig in urine (g/24 h)

integer

Code List

Monoclonal Ig in urine (g/24 h)

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

Serum ß2 microglobulin (mg/L)

float

Item

Serum ß2 microglobulin (mg/L)

integer

Extramedullary involvement

Code List

Serum ß2 microglobulin (mg/L)

CL Item

Not evaluated (1)

Lytic lesions

Item

INVOLVEMENT AT DIAGNOSIS, Bone structure

integer

Lytic lesions

Code List

INVOLVEMENT AT DIAGNOSIS, Bone structure

CL Item

Normal (1)

CL Item

Minor (2)

CL Item

Major (3)

CL Item

Not evaluated (4)

Item

INVOLVEMENT AT DIAGNOSIS, Bone structure

integer

Extramedullary involvement

Code List

INVOLVEMENT AT DIAGNOSIS, Bone structure

CL Item

No (1)

CL Item

Yes (2)

CL Item

Unknown (3)

Extramedullary involvement

Item

if yes, specify location

text

Previous 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

(counted from diagnosis, or last HSCT if applicable)

text

Item

Chemo/Drugs

text

C0695347 (UMLS CUI [1])

Code List

Chemo/Drugs

CL Item

No (No)

CL Item

Yes, Chemo/Drug regimen (Yes, Chemo/Drug regimen)

Extramedullary involvement

Item

Radiotherapy

integer

C0695347 (UMLS CUI [1])

Code List

Radiotherapy

CL Item

No (1)

CL Item

Yes (2)

CL Item

Unknown (3)

Item

see manual for full definition of each response

integer

Additional Pre-HSCT treatment

Code List

see manual for full definition of each response

CL Item

sCR (1)

CL Item

CR (2)

CL Item

VGPR (3)

CL Item

PR (4)

CL Item

Stable disease (5)

CL Item

Progression (6)

CL Item

Not evaluated (7)

CL Item

Unknown (8)

Item

Additional Pre-HSCT treatment

text

C1706712 (UMLS CUI [1,1])
C2709094 (UMLS CUI [1,2])

Additional Pre-HSCT treatment

Code List

Additional Pre-HSCT treatment

CL Item

No (No)

CL Item

Yes (Yes)

CL Item

Unknown (Unknown)

Sequential number of this treatment

Item

(counted from diagnosis, or last HSCT if applicable)

text

Item

Chemo/Drugs

integer

Code List

Chemo/Drugs

CL Item

No (1)

CL Item

Yes, Chemo/Drug regimen (2)

Item

Radiotherapy

integer

Code List

Radiotherapy

CL Item

No (1)

CL Item

Yes (2)

Item

(see manual for full definition of each response)

integer

ADDITIONAL PRE-HSCT TREATMENT?

Code List

(see manual for full definition of each response)

CL Item

sCR (1)

CL Item

CR (2)

CL Item

VGPR (3)

CL Item

PR (4)

CL Item

Stable disease (5)

CL Item

Progression (6)

CL Item

Not evaluated (7)

CL Item

Unknown (8)

Item

ADDITIONAL PRE-HSCT TREATMENT?

integer

ADDITIONAL PRE-HSCT TREATMENT?

Code List

ADDITIONAL PRE-HSCT TREATMENT?

CL Item

No (1)

CL Item

Yes, Date started (2)

Sequential number of this treatment

Item

Sequential number of this treatment

text

Item

Chemo/Drugs

text

Code List

Chemo/Drugs

CL Item

No (No)

CL Item

Yes: Chemo/Drug regimen (Yes: Chemo/Drug regimen)

Item

Radiotherapy

integer

Code List

Radiotherapy

CL Item

No (1)

CL Item

Yes (2)

Item

Response

integer

Code List

Response

CL Item

sCR (1)

CL Item

CR (2)

CL Item

VGPR (3)

CL Item

PR (4)

CL Item

Stable disease (5)

CL Item

Progression (6)

CL Item

Not evaluated (7)

CL Item

Unknown (8)

Date of HSCT

Item

Date of HSCT

date

C2584899 (UMLS CUI [1])

HSCT type

Item

HSCT type

integer

C0472699 (UMLS CUI [1])

HSCT type

Code List

HSCT type

CL Item

Autologous (1)

CL Item

Allogeneic (2)

Date of 1st collection or pheresis

Item

Autologous

date

Item

STATUS OF DISEASE AT COLLECTION

integer

Code List

STATUS OF DISEASE AT COLLECTION

CL Item

At diagnosis (untreated) (1)

CL Item

Stringent complete remission (sCR) (2)

CL Item

Complete remission (CR) (3)

CL Item

Very good PR (VGPR) (4)

CL Item

PR (5)

CL Item

Relapse from CR (6)

CL Item

Stable disease (7)

CL Item

Progression (8)

CL Item

Unknown (9)

Item

If sCR or CR: NUMBER OF THIS COMPLETE REMISSION

integer

Code List

If sCR or CR: NUMBER OF THIS COMPLETE REMISSION

CL Item

1st (1)

CL Item

2nd (2)

CL Item

3rd or higher (3)

Item

If VGPR or PR: NUMBER OF THIS PARTIAL REMISSION

integer

Code List

If VGPR or PR: NUMBER OF THIS PARTIAL REMISSION

CL Item

1st (1)

CL Item

2nd (2)

CL Item

3rd or higher (3)

Item

Relapse from CR, NUMBER OF THIS RELAPSE

integer

Code List

Relapse from CR, NUMBER OF THIS RELAPSE

CL Item

1st (1)

CL Item

2nd (2)

CL Item

3rd or higher (3)

Item

Relapse from CR, NUMBER OF THIS RELAPSE

integer

Code List

Relapse from CR, NUMBER OF THIS RELAPSE

CL Item

1st (1)

CL Item

2nd (2)

CL Item

3rd or higher (3)

Item

Plateau

integer

Code List

Plateau

CL Item

No (1)

CL Item

Yes (2)

CL Item

Unknown (3)

CLINICAL AND LABORATORY DATA

Item

Hb (g/dL)

float

Item

Hb (g/dL)

integer

Code List

Hb (g/dL)

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

Serum creatinine (mol/L)

float

Item

Serum creatinine (mol/L)

integer

Code List

Serum creatinine (mol/L)

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

Serum calcium (mmol/L)

float

Item

Serum calcium (mmol/L)

integer

Code List

Serum calcium (mmol/L)

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

Serum albumin (g/L)

float

albumin

Item

Serum albumin (g/L)

integer

C0201838 (UMLS CUI [1])

Code List

Serum albumin (g/L)

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

BM aspirate: % plasmacytosis

float

Item

BM aspirate: % plasmacytosis

integer

Code List

BM aspirate: % plasmacytosis

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

BM trephine: % plasmacytosis

float

Item

BM trephine: % plasmacytosis

integer

Code List

BM trephine: % plasmacytosis

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

Monoclonal Ig in serum (g/L)

float

Item

Monoclonal Ig in serum (g/L)

integer

Code List

Monoclonal Ig in serum (g/L)

CL Item

Not evaluated (1)

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)

CLINICAL AND LABORATORY DATA

Item

Monoclonal Ig in urine (g/24 h)

float

Item

Monoclonal Ig in urine (g/24 h)

integer

Code List

Monoclonal Ig in urine (g/24 h)

CL Item

Not evaluated (1)

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)

CLINICAL AND LABORATORY DATA

Item

Serum 2 microglobulin (mg/L)

float

Item

Serum 2 microglobulin (mg/L)

integer

Code List

Serum 2 microglobulin (mg/L)

CL Item

Not evaluated (1)

Item

Bone structure, Lytic lesions

text

Code List

Bone structure, Lytic lesions

CL Item

Normal (Normal)

CL Item

Minor (Minor)

CL Item

Major (Major)

CL Item

Not evaluated (Not evaluated)

DISEASE STATUS AT HSCT

Item

DISEASE STATUS AT HSCT

integer

DISEASE STATUS AT HSCT

Code List

DISEASE STATUS AT HSCT

CL Item

At diagnosis (1)

CL Item

Stringent complete remission (sCR) (2)

CL Item

Complete remission (CR) (3)

CL Item

Very good PR (VGPR) (4)

CL Item

PR (5)

CL Item

Relapse from CR (6)

CL Item

Stable disease (no change, includes old MR) (7)

CL Item

Progression (8)

CL Item

Unknown (9)

If sCR or CR

Item

NUMBER OF THIS COMPLETE REMISSION

integer

If sCR or CR

Code List

NUMBER OF THIS COMPLETE REMISSION

CL Item

1st (1)

CL Item

2nd (2)

CL Item

3rd or higher (3)

If VGPR or PR

Item

NUMBER OF THIS PARTIAL REMISSION

integer

If VGPR or PR

Code List

NUMBER OF THIS PARTIAL REMISSION

CL Item

1st (1)

CL Item

2nd (2)

CL Item

3rd or higher (3)

Relapse from CR

Item

NUMBER OF THIS RELAPSE

integer

Relapse from CR

Code List

NUMBER OF THIS RELAPSE

CL Item

1st (1)

CL Item

2nd (2)

CL Item

3rd or higher (3)

Item

(not applicable for non secretory myelona)

integer

Code List

(not applicable for non secretory myelona)

CL Item

No (1)

CL Item

Yes (2)

CL Item

Unknown (3)

CLINICAL AND LABORATORY DATA

Item

Hb (g/dL)

float

Item

Hb (g/dL)

text

Code List

Hb (g/dL)

CL Item

Not evaluated (Not evaluated)

CLINICAL AND LABORATORY DATA

Item

Serum creatinine (mol/L)

float

Item

Serum creatinine (mol/L)

integer

Code List

Serum creatinine (mol/L)

CL Item

Not evaluated (Not evaluated)

CLINICAL AND LABORATORY DATA

Item

Serum calcium (mmol/L)

float

Item

Serum calcium (mmol/L)

integer

Code List

Serum calcium (mmol/L)

CL Item

Not evaluated (Not evaluated)

CLINICAL AND LABORATORY DATA

Item

Serum albumin (g/L)

float

Item

Serum albumin (g/L)

integer

Code List

Serum albumin (g/L)

CL Item

Not evaluated (Not evaluated)

CLINICAL AND LABORATORY DATA

Item

BM aspirate: % plasmacytosis

float

Item

BM aspirate: % plasmacytosis

integer

Code List

BM aspirate: % plasmacytosis

CL Item

Not evaluated (Not evaluated)

CLINICAL AND LABORATORY DATA

Item

Monoclonal Ig in serum (g/L)

float

Item

Monoclonal Ig in serum (g/L)

integer

Code List

Monoclonal Ig in serum (g/L)

CL Item

Not evaluated (Not evaluated)

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)

CLINICAL AND LABORATORY DATA

Item

Monoclonal Ig in urine (g/24 h)

float

Item

Monoclonal Ig in urine (g/24 h)

integer

Code List

Monoclonal Ig in urine (g/24 h)

CL Item

Negative (1)

CL Item

Positive (2)

CL Item

Not evaluated (3)

CL Item

Unknown (4)

Item

Immunofixation of urine

text

Code List

Immunofixation of urine

CL Item

Negative (Negative)

CL Item

Positive (Positive)

CL Item

Not evaluated (Not evaluated)

CL Item

Unknown (Unknown)

CLINICAL AND LABORATORY DATA

Item

Serum 2 microglobulin (mg/L)

float

Item

Serum 2 microglobulin (mg/L)

integer

Code List

Serum 2 microglobulin (mg/L)

CL Item

Not evaluated (1)

Item

Lytic lesions

integer

Additional Disease Treatment

Code List

Lytic lesions

CL Item

Normal (1)

CL Item

Minor (2)

CL Item

Major (3)

CL Item

Not evaluated (4)

Item

Additional Disease Treatment

text

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

if yes

text

Code List

if yes

CL Item

Planned (planned before HSCT took place) (Planned (planned before HSCT took place))

CL Item

Not planned (for relapse/progression or persistent disease) (Not planned (for relapse/progression or persistent disease))

ADDITIONAL DISEASE TREATMENT

Item

Date started

date

Item

Chemo/drug/agen

text

C1706712 (UMLS CUI [1])

Code List

Chemo/drug/agen

CL Item

Thalidomide (Thalidomide)

CL Item

Other (Other)

CL Item

Unknown (Unknown)

ADDITIONAL DISEASE TREATMENT

Item

if other

text

Item

Radiotherapy

text

Code List

Radiotherapy

CL Item

No (No)

CL Item

Yes (Yes)

CL Item

Unknown (Unknown)

Item

Other treatment

integer

C1706712 (UMLS CUI [1])

Code List

Other treatment

CL Item

No (1)

CL Item

Yes (2)

CL Item

Unknown (3)

ADDITIONAL DISEASE TREATMENT

Item

if other treatment please specify

text

Item

text

Code List

BEST RESPONSE TO HSCT AT 100 DAYS

CL Item

Stringent complete remission (sCR) (Stringent complete remission (sCR))

CL Item

Complete remission (CR) (Complete remission (CR))

CL Item

Very good PR (VGPR) (Very good PR (VGPR))

CL Item

PR (PR)

CL Item

Stable disease (no change, includes old MR) (Stable disease (no change, includes old MR))

CL Item

Progression (Progression)

CL Item

Unknown (Unknown)

Item

If sCR or CR: NUMBER OF THIS COMPLETE REMISSION

integer

Code List

If sCR or CR: NUMBER OF THIS COMPLETE REMISSION

CL Item

1st (1)

CL Item

2nd (2)

CL Item

3rd or higher (3)

Item

If VGPR or PR: NUMBER OF THIS PARTIAL REMISSION

integer

Code List

If VGPR or PR: NUMBER OF THIS PARTIAL REMISSION

CL Item

1st (1)

CL Item

2nd (2)

CL Item

3rd or higher (3)

BEST RESPONSE TO HSCT AT 100 DAYS

Item

If complete response: Date of CR

date

BEST RESPONSE TO HSCT AT 100 DAYS

Item

Otherwise: date of evaluation

date

Item

(COMPLETE ONLY IF STATUS IS STABLE DISEASE OR PR)

text

Code List

(COMPLETE ONLY IF STATUS IS STABLE DISEASE OR PR)

CL Item

No (No)

CL Item

Yes (Yes)

CL Item

Unknown (Unknown)

CLINICAL AND LABORATORY DATA

Item

BM aspirate: % plasmacytosis

float

Item

BM aspirate: % plasmacytosis

integer

Code List

BM aspirate: % plasmacytosis

CL Item

Not evaluated (1)

CLINICAL AND LABORATORY DATA

Item

BM trephine: % plasmacytosis

float

CLINICAL AND LABORATORY DATA

Item

Monoclonal Ig in serum (g/L)

float

Item

Monoclonal Ig in serum (g/L)

integer

Code List

Monoclonal Ig in serum (g/L)

CL Item

Not evaluated (1)

Item

Immunofixation of serum

text

Code List

Immunofixation of serum

CL Item

Negative (Negative)

CL Item

Positive (Positive)

CL Item

Not evaluated (Not evaluated)

CL Item

Unknown (Unknown)

CLINICAL AND LABORATORY DATA

Item

Monoclonal Ig in urine (g/24 h)

float

Item

Monoclonal Ig in urine (g/24 h)

integer

Code List

Monoclonal Ig in urine (g/24 h)

CL Item

Not evaluated (1)

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)

CLINICAL AND LABORATORY DATA

Item

Serum 2 microglobulin (mg/L)

float

Item

Serum 2 microglobulin (mg/L)

integer

Code List

Serum 2 microglobulin (mg/L)

CL Item

Not evaluated (1)

Item

Lytic lesions

integer

Code List

Lytic lesions

CL Item

Normal (1)

CL Item

Minor (2)

CL Item

Major (3)

CL Item

Not evaluated (4)

Type of Transplant

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))

CL Item

ALLOgraft or Syngeneic graft (proceed to Allograft form) (ALLOgraft or Syngeneic graft (proceed to Allograft form))

CL Item

Other (contact the EBMT Central Registry for instructions) (Other (contact the EBMT Central Registry for instructions))

TYPE OF TRANSPLANT

Item

If Other contact the EBMT Central Registry Office for instructions

text

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])

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

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])

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

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

Code List

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

CL Item

Previously reported (1)

CL Item

Yes (2)

CL Item

No (3)

CL Item

Unknown (4)

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

Item

if yes, date

date

aGvHD Grade

Item

Acute Graft versus Host Disease (aGvHD) - Grade

integer

C0856825 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])

aGvHD Grade

Code List

Acute Graft versus Host Disease (aGvHD) - Grade

CL Item

grade 0 (Absent) (1)

CL Item

grade I (2)

CL Item

grade II (3)

CL Item

grade III (4)

CL Item

grade IV (5)

CL Item

Not evaluated (6)

Item

if present

integer

C0856825 (UMLS CUI [1,1])
C0806909 (UMLS CUI [1,2])
C0441800 (UMLS CUI [1,3])
C1561607 (UMLS CUI [1,4])

Code List

if present

CL Item

New onset (1)

CL Item

Recurrent (2)

CL Item

Persistent (3)

Item

Reason

integer

Date onset of this episode

Code List

Reason

CL Item

Tapering (1)

CL Item

DLI (2)

CL Item

Unexplained (3)

Date onset of this episode

Item

Date onset of this episode (if new or recurrent)

date

C0574845 (UMLS CUI [1])

Item

Date onset of this episode

integer

Date onset of this episode

Code List

Date onset of this episode

CL Item

Not applicable (1)

aGvHD Stage Skin

Item

Stage skin

integer

C0856825 (UMLS CUI [1,1])
C1306673 (UMLS CUI [1,2])
C1306673 (UMLS CUI [1,3])

aGvHD Stage Skin

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)

aGvHD Stage liver

Item

Stage liver

integer

C0856825 (UMLS CUI [1,1])
C1306673 (UMLS CUI [1,2])
C0023884 (UMLS CUI [1,3])

aGvHD Stage liver

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)

aGvHD stage gut

Item

Stage gut

integer

C0856825 (UMLS CUI [1,1])
C1306673 (UMLS CUI [1,2])
C0021853 (UMLS CUI [1,3])

aGvHD stage gut

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)

Resolution

Item

aGvHD Resolution

boolean

C0856825 (UMLS CUI [1,1])
C1514893 (UMLS CUI [1,2])

aGvHD Date of resolution

Item

Date of resolution

date

C0856825 (UMLS CUI [1,1])
C1514893 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])

Chronic Graft versus Host Disease (cGvHD)

Item

Presence of cGvHD

text

C0867389 (UMLS CUI [1])

Chronic Graft versus Host Disease (cGvHD)

Code List

Presence of cGvHD

CL Item

No (No)

CL Item

Yes (Yes)

CL Item

Present continuously since last reported episode (Present continuously since last reported episode)

CL Item

Resolved (Resolved)

CHRONIC GRAFT VERSUS HOST DISEASE (CGVHD)

Item

Presence of cGVHD, if yes

integer

CHRONIC GRAFT VERSUS HOST DISEASE (CGVHD)

Code List

Presence of cGVHD, if yes

CL Item

First episode (1)

CL Item

Recurrence (2)

Date of onset

Item

Date of onset

date

C0574845 (UMLS CUI [1])

cGvHD grade

Item

If present continously since last report, specify cGvHD gade:

text

C0867389 (UMLS CUI [1,1])
C0441799 (UMLS CUI [1,2])

cGvHD grade

Code List

If present continously since last report, specify cGvHD gade:

CL Item

Limited (Limited)

CL Item

Extensive (Extensive)

Organs affected

Item

Organs affected

integer

C0449642 (UMLS CUI [1])

Organs affected

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)

Organs affected

Item

if Other please specify

text

Presence of cGVHD

Item

If Resolved: Date of resolution

date

Infection related complications

Item

Infection related complications

boolean

C0009450 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])

Bacteremia / fungemia / viremia / parasites

Item

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

text

Septic shock

Item

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

text

ARDS

Item

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

text

Multiorgan failure due to infection

Item

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

text

Pneumonia

Item

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

text

Hepatitis

Item

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

text

CNS infection

Item

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

text

Gut infection

Item

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

text

Skin infection

Item

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

text

Cystitis

Item

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

text

Retinitis

Item

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

text

Other

Item

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

text

Bacteremia / fungemia / viremia / parasites

Item

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

date

Septic shock

Item

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

date

Multiorgan failure due to infection

Item

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

date

Pneumonia

Item

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

date

Hepatitis

Item

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

date

CNS infection

Item

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

date

Gut infection

Item

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

date

Skin infection

Item

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

date

Cystitis

Item

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

date

Retinitis

Item

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

date

Other

Item

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

date

Non infection related complications

Item

Non infection related complications

boolean

C0009566 (UMLS CUI [1])

Idiopathic pneumonia syndrome

Item

(Check all that are applicable for this period)

integer

Idiopathic pneumonia syndrome

Code List

(Check all that are applicable for this period)

CL Item

Yes (Yes)

CL Item

No (No )

CL Item

Unknown (Unknown)

Idiopathic pneumonia syndrome

Item

Idiopathic pneumonia syndrome

date

VOD

Item

(Check all that are applicable for this period)

integer

C0948441 (UMLS CUI [1])

Idiopathic pneumonia syndrome

Code List

(Check all that are applicable for this period)

CL Item

Yes (Yes)

CL Item

No (No )

CL Item

Unknown (Unknown)

VOD

Item

VOD

date

Cataract

Item

(Check all that are applicable for this period)

integer

C0086543 (UMLS CUI [1])

Cataract

Code List

(Check all that are applicable for this period)

CL Item

Yes (Yes)

CL Item

No (No)

CL Item

Unknown (Unknown)

Cataract

Item

Cataract

date

Haemorrhagic cystitis, non infectious

Item

Check all that are applicable for this period Haemorrhagic cystitis, non infectious

text

C0085692 (UMLS CUI [1])

Haemorrhagic cystitis, non infectious

Code List

Check all that are applicable for this period Haemorrhagic cystitis, non infectious

CL Item

Yes (Yes )

CL Item

No (No )

CL Item

Unknown (Unknown)

Haemorrhagic cystitis, non infectious

Item

Haemorrhagic cystitis, non infectious

date

ARDS, non infectious

Item

ARDS, non infectious ARDS, non infectious

integer

C0035222 (UMLS CUI [1])

ARDS, non infectious

Code List

ARDS, non infectious ARDS, non infectious

CL Item

Yes (Yes)

CL Item

No (No)

CL Item

Unknown (Unknown)

ARDS, non infectious

Item

ARDS, non infectious

date

Multiorgan failure, non infectious

Item

Check all that are applicable for this period)

integer

Multiorgan failure, non infectious

Code List

Check all that are applicable for this period)

CL Item

Yes (1)

CL Item

No (2)

CL Item

Unknown (3)

Multiorgan failure, non infectious

Item

Multiorgan failure, non infectious

date

HSCT-associated microangiopathy

Item

(Check all that are applicable for this period HSCT-associated microangiopathy

text

C0155765 (UMLS CUI [1])

HSCT-associated microangiopathy

Code List

(Check all that are applicable for this period HSCT-associated microangiopathy

CL Item

Yes (Yes)

CL Item

No (No)

CL Item

Unknown (Unknown)

HSCT-associated microangiopathy

Item

HSCT-associated microangiopathy

date

Renal failure requiring dialysis

Item

(Check all that are applicable for this period) Renal failure requiring dialysis

text

C0035078 (UMLS CUI [1])

Renal failure requiring dialysis

Code List

(Check all that are applicable for this period) Renal failure requiring dialysis

CL Item

Yes (Yes)

CL Item

No (No)

CL Item

Unknown (Unknown)

Renal failure requiring dialysis

Item

Renal failure requiring dialysis

date

Haemolytic anaemia due to blood group

Item

(Check all that are applicable for this period) Haemolytic anaemia due to blood group

integer

C0002878 (UMLS CUI [1])

Haemolytic anaemia due to blood group

Code List

(Check all that are applicable for this period) Haemolytic anaemia due to blood group

CL Item

Yes (Yes)

CL Item

No (No)

CL Item

Unknown (Unknown)

Haemolytic anaemia due to blood group

Item

Haemolytic anaemia due to blood group

date

Aseptic bone necrosis

Item

Check all that are applicable for this period) Aseptic bone necrosis

text

C0158452 (UMLS CUI [1])

Aseptic bone necrosis

Code List

Check all that are applicable for this period) Aseptic bone necrosis

CL Item

Yes (Yes)

CL Item

No (No)

CL Item

Unknown (Unknown)

Aseptic bone necrosis

Item

Aseptic bone necrosis

date

Other type of complication

Item

Other type of complication > CTCAE grade 2

boolean

GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM

Item

Graft loss

integer

GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM

Code List

Graft loss

CL Item

No (1)

CL Item

Yes (2)

CL Item

Not evaluated (3)

Overall chimaerism

Item

Overall chimaerism

text

C0333678 (UMLS CUI [1])

Overall chimaerism

Code List

Overall chimaerism

CL Item

95%) (Full (donor >)

CL Item

Mixed (partial) (Mixed (partial))

CL Item

95%) (Autologuos reconstitution (recipient >)

CL Item

Aplasia (Aplasia)

CL Item

Not evaluated (Not evaluated)

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])

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

Laboratory tests

Item

Test used:

text

C0022885 (UMLS CUI [1])

Laboratory tests

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)

SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED

Item

SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED

integer

SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED

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)

Date of Diagnosis

Item

Date of Diagnosis

date

C2316983 (UMLS CUI [1])

Diagnosis

Item

text

C0011900 (UMLS CUI [1])

Diagnosis

Code List

Diagnosis

CL Item

AML (AML)

CL Item

MDS (MDS)

CL Item

Lymphoproliferative disorder (Lymphoproliferative disorder)

CL Item

Other (Other)

diagnosis

Item

if other, please specify

text

Additional treatment

Item

Treatment given since last report

text

C1706712 (UMLS CUI [1])

Additional treatment

Code List

Treatment given since last report

CL Item

No (No)

CL Item

Yes (Yes)

CL Item

Unknown (Unknown)

ADDITIONAL TREATMENT

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

ADDITIONAL TREATMENT

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)

Disease status before this cellular therapy

Item

text

Disease status before this cellular therapy

Code List

Disease status before this cellular therapy

CL Item

CR (CR)

CL Item

Not in CR (Not in CR)

CL Item

Not evaluated (Not evaluated)

Type of cells

Item

If yes: Type of cells

integer

C0302189 (UMLS CUI [1])

Type of cells

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)

Nucleated cells

Item

Number of Nucleated cells infused (DLI only)

integer

C1180059 (UMLS CUI [1])

Nucleated cells

Code List

Number of Nucleated cells infused (DLI only)

CL Item

Number (1)

CL Item

Not evaluated (2)

CL Item

Unknown (3)

CD 34+

Item

If DLI, specify the number of cells infused by type: CD 34+

text

C3538723 (UMLS CUI [1])

CD 34+

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 3+

Item

If DLI, specify the number of cells infused by type: CD 3+

text

C3542405 (UMLS CUI [1])

CD 3+

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)

All cells

Item

Total number of cells infused (non DLI only)

integer

C0007584 (UMLS CUI [1])

All cells

Code List

Total number of cells infused (non DLI only)

CL Item

Number (1)

CL Item

Not evaluated (2)

CL Item

Unknown (3)

Chronological number

Item

Chronological number of this cell therapy for this patient

float

C2348184 (UMLS CUI [1])

Indication

Item

Indication (check all that apply)

text

C3146298 (UMLS CUI [1,1])
C0302189 (UMLS CUI [1,2])

Indication

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)

Indication

Item

If Other, please specify

text

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])

Acute Graft versus Host Disease

Item

Acute Graft versus Host Disease (after this infusion but before any further infusion/ transplant) Maximum grade:

text

C0856825 (UMLS CUI [1])

Acute Graft versus Host Disease

Code List

Acute Graft versus Host Disease (after this infusion but before any further infusion/ transplant) Maximum grade:

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)

Disease treatment

Item

Disease treatment (apart from donor cell infusion or other type of cell therapy)

integer

C0087111 (UMLS CUI [1])

Disease treatment

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)

Relapse or Progression

Item

Relapse or Progression

text

C0277556 (UMLS CUI [1,1])
C0242656 (UMLS CUI [1,2])

Relapse or Progression

Code List

Relapse or Progression

CL Item

Previously reported (Previously reported)

CL Item

No (No)

CL Item

Yes (Yes)

CL Item

Continous progression since transplant (Continous progression since transplant)

CL Item

Unknown (Unknown)

RELAPSE OR PROGRESSION

Item

if yes, date diagnosed

date

Disease response

Item

Last Disease Status

text

C1704632 (UMLS CUI [1])

Disease response

Code List

Last Disease Status

CL Item

Complete Remission (Complete Remission)

CL Item

Stable disease (Stable disease)

CL Item

Relapse (Relapse)

CL Item

Progression (Progression)

Conception

Item

Has patient or partner become pregnant after this HSCT?

text

C0032961 (UMLS CUI [1])

Conception

Code List

Has patient or partner become pregnant after this HSCT?

CL Item

No (No)

CL Item

Yes (Yes)

CL Item

Unknown (Unknown)

Survival Status

Item

Survival Status

integer

C1148433 (UMLS CUI [1])

Survival Status

Code List

Survival Status

CL Item

alive (0)

CL Item

dead (1)

Type of score used

Item

Type of score used

text

Type of score used

Code List

Type of score used

CL Item

Karnofsky (Karnofsky)

CL Item

Lansky (Lansky)

Performance score

Item

Score

integer

C1518965 (UMLS CUI [1])

Performance score

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)

Cause of Death

Item

If dead, specify cause of death:

text

C0007465 (UMLS CUI [1])

Cause of Death

Code List

If dead, specify cause of death:

CL Item

Relapse or progression (Relapse or progression)

CL Item

Secondary malignancy (including lymphoproliferative disease) (Secondary malignancy (including lymphoproliferative disease))

CL Item

HSCT related cause (HSCT related cause )

CL Item

Unknown (Unknown )

CL Item

Other (Other)

GvHD

Item

If dead and HSCT related cause of death, specify (check as many as apppropriate): GvHD

text

C0007465 (UMLS CUI [1,1])
C0018133 (UMLS CUI [1,2])

GvHD

Code List

If dead and HSCT related cause of death, specify (check as many as apppropriate): GvHD

CL Item

Yes (Yes)

CL Item

No (No )

CL Item

Unknown (Unknown)

Interstitial Pneumonitis

Item

If dead and HSCT related cause of death, specify (check as many as apppropriate): Interstitial Pneumonitis

text

C0007465 (UMLS CUI [1,1])
C0206061 (UMLS CUI [1,2])

Interstitial Pneumonitis

Code List

If dead and HSCT related cause of death, specify (check as many as apppropriate): Interstitial Pneumonitis

CL Item

Yes (Yes)

CL Item

No (No )

CL Item

Unknown (Unknown)

Pulmonary toxicity

Item

If dead and HSCT related cause of death, specify (check as many as apppropriate): Pulmonary toxicity

text

C0007465 (UMLS CUI [1,1])
C0919924 (UMLS CUI [1,2])

Pulmonary toxicity

Code List

If dead and HSCT related cause of death, specify (check as many as apppropriate): Pulmonary toxicity

CL Item

Yes (Yes)

CL Item

No (No )

CL Item

Unknown (Unknown)

Item

If dead and HSCT related cause of death, specify (check as many as apppropriate): Infection

text

C0007465 (UMLS CUI [1,1])
C0009450 (UMLS CUI [1,2])

Code List

If dead and HSCT related cause of death, specify (check as many as apppropriate): Infection

CL Item

Yes (Yes)

CL Item

No (No )

CL Item

Unknown (Unknown)

Item

check as many as appropriate

text