ID
17562
Description
ODM form derived from 100days past HSCT EBMT. please refer to: http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx HLA typing results of patient and donor should be attached and sent: - to your NATIONAL REGISTRY if - you normally report to your National Registry and - you are based in the Netherlands, Switzerland, Turkey or the UK - to the EBMT REGISTRY OFFICE in London for any other centre Contact: Shelley Hewerdine EBMT Registry Office 4th Floor, Tabard House Guy's Hospital Great Maze Pond London SE1 9RT United Kingdom Phone: 00 44-207-188-8409 Fax: 00 44-207-188-8411 Email: shelley.hewerdine@ebmt.org
Link
Keywords
Versions (4)
- 8/9/16 8/9/16 -
- 9/23/16 9/23/16 -
- 9/24/16 9/24/16 -
- 9/20/21 9/20/21 -
Uploaded on
September 23, 2016
DOI
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License
Creative Commons BY-NC 3.0
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100 days past HSCT EBMT
100 days past HSCT EBMT
- StudyEvent: ODM
Description
PATIENT DATA
Description
Date of this report
Data type
date
Alias
- UMLS CUI [1]
- C1302584
Description
Patient following national / international study / trial
Data type
integer
Alias
- UMLS CUI [1]
- C1997894
Description
Name of study / trial
Data type
integer
Alias
- UMLS CUI [1]
- C0008976
Description
Hospital Unique Patient Number
Data type
integer
Alias
- UMLS CUI [1]
- C2348585
Description
Initials
Data type
integer
Alias
- UMLS CUI [1]
- C2986440
Description
Date of Birth
Data type
date
Alias
- UMLS CUI [1]
- C0421451
Description
Sex
Data type
text
Alias
- UMLS CUI [1]
- C0079399
Description
DISEASE
Description
HSCT
Description
Performance score
Data type
integer
Alias
- UMLS CUI [1]
- C1518965
Description
Score
Data type
text
Alias
- UMLS CUI [1]
- C1518965
Description
Type of HSCT
Data type
integer
Alias
- UMLS CUI [1]
- C0472699
Description
Patient CMV status
Data type
integer
Alias
- UMLS CUI [1]
- C0582172
Description
Multiple donors
Data type
boolean
Alias
- UMLS CUI [1]
- C0013018
Description
if yes, Number (including multiple CB units or different stem cell products from same donor)
Data type
integer
Alias
- UMLS CUI [1]
- C0013018
Description
STEM CELLS (autograft or allograft)
Description
(check all that apply)
Data type
integer
Alias
- UMLS CUI [1]
- C0018956
Description
Source of Stem Cells
Data type
integer
Alias
- UMLS CUI [1]
- C0018956
Description
Donor ID
Data type
text
Alias
- UMLS CUI [1]
- C1718162
Description
if autograft, go to Graft manipulation below
Data type
integer
Alias
- UMLS CUI [1]
- C1718162
Description
HLA match type
Data type
integer
Alias
- UMLS CUI [1]
- C0242318
Description
Degree of mismatch
Data type
integer
Alias
- UMLS CUI [1]
- C1881865
Description
donor registry
Data type
integer
Alias
- UMLS CUI [1]
- C0034975
Description
BMDW/WMDA code
Data type
integer
Alias
- UMLS CUI [1]
- C2987198
Description
Number of mismatches A
Data type
integer
Alias
- UMLS CUI [1,1]
- C1881865
- UMLS CUI [1,2]
- C0449788
Description
Number of mismatches B
Data type
integer
Alias
- UMLS CUI [1,1]
- C1881865
- UMLS CUI [1,2]
- C0449788
Description
Number of mismatches C
Data type
integer
Alias
- UMLS CUI [1,1]
- C1881865
- UMLS CUI [1,2]
- C0449788
Description
Number of mismatches DRB1
Data type
integer
Alias
- UMLS CUI [1,1]
- C1881865
- UMLS CUI [1,2]
- C0449788
Description
Number of mismatches DQB1
Data type
integer
Alias
- UMLS CUI [1,1]
- C1881865
- UMLS CUI [1,2]
- C0449788
Description
Number of mismatches DPB1
Data type
integer
Alias
- UMLS CUI [1,1]
- C1881865
- UMLS CUI [1,2]
- C0449788
Description
Donor Sex
Data type
integer
Alias
- UMLS CUI [1]
- C0079399
Description
Donor age
Data type
integer
Alias
- UMLS CUI [1,1]
- C0013018
- UMLS CUI [1,2]
- C0421451
Description
Graft manipulation ex-vivo (including T-cell depletion) other than for RBC removal or volume reduction
Data type
boolean
Alias
- UMLS CUI [1]
- C0677960
Description
HSCT
Description
Chronological number of HSCT
Data type
integer
Alias
- UMLS CUI [1,1]
- C1318453
- UMLS CUI [1,2]
- C0449788
Description
If >1, date of last HSCT before this one
Data type
date
Alias
- UMLS CUI [1,1]
- C0018956
- UMLS CUI [1,2]
- C0029216
- UMLS CUI [1,3]
- C2745955
- UMLS CUI [1,4]
- C0011008
Description
HSCT part of a planned multiple graft protocol?
Data type
boolean
Description
Preparative (conditioning) regimen given?
Data type
boolean
Alias
- UMLS CUI [1]
- C1882454
Description
Was this intended to be myeloablative?
Data type
boolean
Alias
- UMLS CUI [1]
- C1831742
Description
Reason HSCT
Data type
integer
Alias
- UMLS CUI [1]
- C0392360
Description
Ara-C
Data type
float
Measurement units
- mg
Alias
- UMLS CUI [1]
- C0733521
Description
Ara-C (cytarabine)
Data type
integer
Alias
- UMLS CUI [1,1]
- C0733521
- UMLS CUI [1,2]
- C1321095
Description
ALS
Data type
float
Alias
- UMLS CUI [1]
- C0002736
Description
AST: Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C1321095
- UMLS CUI [1,2]
- C0004002
Description
Animal origin
Data type
integer
Alias
- UMLS CUI [1]
- C3494749
Description
Bleomycin
Data type
float
Alias
- UMLS CUI [1]
- C0005740
Description
Unit of doseing
Data type
integer
Alias
- UMLS CUI [1]
- C1321095
Description
Busulfan
Data type
float
Alias
- UMLS CUI [1]
- C0006463
Description
Busulfan Unit of dosing:
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0006463
Description
Busulfan
Data type
integer
Description
BCNU
Data type
float
Alias
- UMLS CUI [1]
- C0007257
Description
BCNU Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0007257
Description
Bexar (radiolabelled MoAB)
Data type
float
Alias
- UMLS CUI [1]
- C3831356
Description
Bexar Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C3831356
Description
CCNU
Data type
float
Alias
- UMLS CUI [1]
- C0687700
Description
CCNU Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0687700
Description
Campath
Data type
float
Alias
- UMLS CUI [1]
- C0939276
Description
Campath Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0939276
Description
Carboplatin
Data type
float
Alias
- UMLS CUI [1]
- C0079083
Description
Carboplatin Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0079083
Description
Cisplatin
Data type
float
Alias
- UMLS CUI [1]
- C0008838
Description
Cisplatin Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0008838
Description
Corticosteroids
Data type
float
Alias
- UMLS CUI [1]
- C0001617
Description
Corticosteroids Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0001617
Description
Cyclophosphamide
Data type
float
Alias
- UMLS CUI [1]
- C0010583
Description
Cyclophosphamide Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0010583
Description
Daunorubicin
Data type
float
Alias
- UMLS CUI [1]
- C0011015
Description
Unit of dosing Daunorubicin
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0011015
Description
Doxorubicin
Data type
float
Alias
- UMLS CUI [1]
- C0013089
Description
Doxorubicin Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0013089
Description
Etoposide
Data type
float
Alias
- UMLS CUI [1]
- C0015133
Description
Etoposide Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0015133
Description
Fludarabine
Data type
float
Alias
- UMLS CUI [1]
- C0059985
Description
Fludarabine Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0059985
Description
Gemtuzumab
Data type
float
Alias
- UMLS CUI [1]
- C0872968
Description
Gemtuzumab Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0872968
Description
Idarubicin
Data type
float
Alias
- UMLS CUI [1]
- C0020789
Description
Idarubicin Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0020789
Description
Ifosfamide
Data type
float
Alias
- UMLS CUI [1]
- C0020823
Description
Ifosfamide Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0020823
Description
Imatinib mesylate
Data type
float
Alias
- UMLS CUI [1]
- C0939537
Description
Imatinib mesylate Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0939537
Description
Melphalan
Data type
float
Alias
- UMLS CUI [1]
- C0025241
Description
Melphalan Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0025241
Description
Mitoxantrone
Data type
float
Alias
- UMLS CUI [1]
- C0026259
Description
Mitoxantrone Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0026259
Description
Paclitaxel
Data type
float
Alias
- UMLS CUI [1]
- C0144576
Description
Paclitaxel Unit of dosing
Data type
integer
Alias
- UMLS CUI [1]
- C0869039
Description
Rituximab
Data type
float
Alias
- UMLS CUI [1]
- C0393022
Description
Rituximab Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0393022
Description
Teniposide
Data type
float
Alias
- UMLS CUI [1]
- C0039512
Description
Teniposide Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0039512
Description
Thiotepa
Data type
float
Alias
- UMLS CUI [1]
- C0039871
Description
Thiotepa Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0039871
Description
Zevalin
Data type
float
Alias
- UMLS CUI [1]
- C0919274
Description
Zevalin Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0919274
Description
other radiolabelled MoAB
Data type
float
Alias
- UMLS CUI [1,1]
- C0003250
- UMLS CUI [1,2]
- C0454110
Description
other radiolabelled MoAB Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0003250
- UMLS CUI [1,3]
- C0454110
Description
Other radiolabelled MoAB: if other, please specify
Data type
integer
Alias
- UMLS CUI [1,1]
- C0205394
- UMLS CUI [1,2]
- C0003250
- UMLS CUI [1,3]
- C0454110
Description
Other MoAB
Data type
float
Alias
- UMLS CUI [1]
- C0003250
Description
MoAB Unit of dosing
Data type
integer
Alias
- UMLS CUI [1,1]
- C0869039
- UMLS CUI [1,2]
- C0003250
Description
Total body irradiation
Data type
boolean
Alias
- UMLS CUI [1]
- C0043162
Description
Total Body Irradiation: if yes, please specify value
Data type
integer
Alias
- UMLS CUI [1,1]
- C4035158
- UMLS CUI [1,2]
- C0043162
Description
TLI, TNI, TAI
Data type
boolean
Alias
- UMLS CUI [1]
- C4035158
- UMLS CUI [2]
- C0043162
Description
AFTER HSCT
Description
GvHD prophylaxis
Data type
boolean
Alias
- UMLS CUI [1]
- C0278845
Description
GvHD prophylaxis or preventive treatment: if yes, please specify
Data type
integer
Alias
- UMLS CUI [1,1]
- C0278845
- UMLS CUI [1,2]
- C4035158
Description
GvHD prophylaxis or preventive treatment: if other, please specify
Data type
integer
Alias
- UMLS CUI [1,1]
- C4035158
- UMLS CUI [1,2]
- C4035158
Description
GvHD prophylaxis or preventive treatment: if Other monoclonal antibody, please specify
Data type
integer
Alias
- UMLS CUI [1,1]
- C4035158
- UMLS CUI [1,2]
- C4035158
- UMLS CUI [1,3]
- C0003250
Description
Absolute neutrophil count
Data type
integer
Alias
- UMLS CUI [1]
- C0948762
Description
Date of last assessment
Data type
date
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C1516048
Description
Date of ANC recovery
Data type
date
Alias
- UMLS CUI [1,1]
- C0948762
- UMLS CUI [1,2]
- C2004454
- UMLS CUI [1,3]
- C0011008
Description
Date of last assessment
Data type
date
Alias
- UMLS CUI [1,1]
- C0011008
- UMLS CUI [1,2]
- C1516048
Description
Maximum grade
Data type
integer
Alias
- UMLS CUI [1,1]
- C0856825
- UMLS CUI [1,2]
- C0441800
Description
ADDITIONAL TREATMENT INCLUDING CELL THERAPY
Description
Cell infusion
Data type
boolean
Alias
- UMLS CUI [1]
- C2145394
Description
(can be the same as HSCT date)
Data type
date
Alias
- UMLS CUI [1,1]
- C0574032
- UMLS CUI [1,2]
- C0011008
Description
Type of cell(s): (check all that apply)
Data type
integer
Description
Type of cell(s): (check all that apply)
Data type
text
Description
Chronological no. of CI for this patient
Data type
text
Description
Indication
Data type
text
Alias
- UMLS CUI [1,1]
- C3146298
- UMLS CUI [1,2]
- C0302189
Description
Indication:
Data type
text
Description
Infusion count
Data type
float
Alias
- UMLS CUI [1,1]
- C0574032
- UMLS CUI [1,2]
- C0750480
Description
Disease treatment
Data type
integer
Alias
- UMLS CUI [1]
- C0087111
Description
DISEASE STATUS
Similar models
100 days past HSCT EBMT
- StudyEvent: ODM
C0600091 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
C0029216 (UMLS CUI [1,2])
C2745955 (UMLS CUI [1,3])
C0011008 (UMLS CUI [1,4])
C1321095 (UMLS CUI [1,2])
C0004002 (UMLS CUI [1,2])
C0006463 (UMLS CUI [1,2])
C0007257 (UMLS CUI [1,2])
C3831356 (UMLS CUI [1,2])
C0687700 (UMLS CUI [1,2])
C0939276 (UMLS CUI [1,2])
C0079083 (UMLS CUI [1,2])
C0008838 (UMLS CUI [1,2])
C0001617 (UMLS CUI [1,2])
C0010583 (UMLS CUI [1,2])
C0011015 (UMLS CUI [1,2])
C0013089 (UMLS CUI [1,2])
C0015133 (UMLS CUI [1,2])
C0059985 (UMLS CUI [1,2])
C0872968 (UMLS CUI [1,2])
C0020789 (UMLS CUI [1,2])
C0020823 (UMLS CUI [1,2])
C0939537 (UMLS CUI [1,2])
C0025241 (UMLS CUI [1,2])
C0026259 (UMLS CUI [1,2])
C0393022 (UMLS CUI [1,2])
C0039512 (UMLS CUI [1,2])
C0039871 (UMLS CUI [1,2])
C0919274 (UMLS CUI [1,2])
C0454110 (UMLS CUI [1,2])
C0003250 (UMLS CUI [1,2])
C0454110 (UMLS CUI [1,3])
C0003250 (UMLS CUI [1,2])
C0454110 (UMLS CUI [1,3])
C0003250 (UMLS CUI [1,2])
C0043162 (UMLS CUI [1,2])
C0043162 (UMLS CUI [2])
C4035158 (UMLS CUI [1,2])
C4035158 (UMLS CUI [1,2])
C4035158 (UMLS CUI [1,2])
C0003250 (UMLS CUI [1,3])
C1516048 (UMLS CUI [1,2])
C2004454 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
C1516048 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0302189 (UMLS CUI [1,2])
C0750480 (UMLS CUI [1,2])