0 Ratings
ID

3419

Description

2455 Revision 1 - Selective Post-Transplant Essential Data Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=65E0AFD5-EC90-4729-E040-BB89AD431189

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=65E0AFD5-EC90-4729-E040-BB89AD431189

Keywords

Versions (1)
  1. 9/20/12 9/20/12 -
Uploaded on

September 20, 2012

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0 Legacy
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

  • Newest
  • Oldest
  • Popular
  • Newest
    • Newest
    • Oldest
    • Popular

    No comments

    In order to download data models you must be logged in. Please log in or register for free.

    Treatment - 2455 Revision 1 - Selective Post-Transplant Essential Data - 2855957v1.0

    English

    Note: "Greater than 100 Days Report" answer since last report

    1 forms  
    1. StudyEvent: 2455 Revision 1 - Selective Post-Transplant Essential Data
      1. Note: "Greater than 100 Days Report" answer since last report
    Registry Use Only
    Description

    Registry Use Only

    Sequence number:
    Description

    ClinicalDataFormSequenceNumber

    Data type

    double

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus Property
    C19464
    UMLS 2011AA Property
    C0376315
    NCI Thesaurus ObjectClass
    C15783
    UMLS 2011AA ObjectClass
    C1516606
    NCI Thesaurus ValueDomain
    C25673
    UMLS 2011AA ValueDomain
    C1519249
    Date received:
    Description

    ClinicalDataFormReceivedDate

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus Property
    C19464
    UMLS 2011AA Property
    C0376315
    NCI Thesaurus ValueDomain
    C25639
    UMLS 2011AA ValueDomain
    C1514756
    NCI Thesaurus ObjectClass
    C15783
    UMLS 2011AA ObjectClass
    C1516606
    Center Identification
    Description

    Center Identification

    CIBMTR Center Number:
    Description

    HematopoieticStemCellTransplantationRecipientInstitution::CenterforInternationalBloodandMarrowTransplantResearchFacilityNumber

    Data type

    double

    Alias
    NCI Thesaurus ObjectClass
    C12551
    UMLS 2011AA ObjectClass
    C0018956
    NCI Thesaurus ObjectClass
    C15342
    UMLS 2011AA ObjectClass
    C0029216
    NCI Thesaurus Property
    C53268
    UMLS 2011AA Property
    C1709854
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ValueDomain
    C41206
    UMLS 2011AA ValueDomain
    C1272753
    NCI Thesaurus ValueDomain
    C62574
    UMLS 2011AA ValueDomain
    C1547538
    EBMT Code (CIC) Number
    Description

    OrganizationalUnit::EBMT(CIC)CodeNumber

    Data type

    double

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus Property
    C25162
    UMLS 2011AA Property
    C0805701
    NCI Thesaurus ValueDomain
    C25162
    UMLS 2011AA ValueDomain
    C0805701
    NCI Thesaurus ObjectClass
    C41167
    UMLS 2011AA ObjectClass
    C0029246
    Date of this report:
    Description

    ClinicalDataFormTodayDate

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus Property
    C19464
    UMLS 2011AA Property
    C0376315
    NCI Thesaurus ObjectClass
    C15783
    UMLS 2011AA ObjectClass
    C1516606
    NCI Thesaurus ValueDomain
    C41134
    UMLS 2011AA ValueDomain
    C0750526
    Follow-Up:
    Description

    RecipientTransplantationFollow-upTimepointType

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C53268
    UMLS 2011AA ObjectClass
    C1709854
    NCI Thesaurus ObjectClass
    C15342
    UMLS 2011AA ObjectClass
    C0029216
    NCI Thesaurus Property
    C16033
    UMLS 2011AA Property
    C1522577
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ValueDomain
    C68568
    UMLS 2011AA ValueDomain
    C2348792
    annual, specify year:
    Description

    Follow-upReportPostTransplantationTimepointYearCount

    Data type

    double

    Alias
    NCI Thesaurus ObjectClass
    C16033
    UMLS 2011AA ObjectClass
    C1522577
    NCI Thesaurus ObjectClass
    C25375
    UMLS 2011AA ObjectClass
    C0684224
    NCI Thesaurus Property
    C38008
    UMLS 2011AA Property
    C0687676
    NCI Thesaurus Property
    C15342
    UMLS 2011AA Property
    C0029216
    NCI Thesaurus Property
    C68568
    UMLS 2011AA Property
    C2348792
    NCI Thesaurus ValueDomain
    C29848
    UMLS 2011AA ValueDomain
    C0439234
    NCI Thesaurus ValueDomain
    C25463
    UMLS 2011AA ValueDomain
    C0750480
    Recipient Identification
    Description

    Recipient Identification

    CIBMTR Recipient ID:
    Description

    HematopoieticStemCellTransplantationRecipientIdentificationNumber

    Data type

    double

    Alias
    NCI Thesaurus ObjectClass
    C12551
    UMLS 2011AA ObjectClass
    C0018956
    NCI Thesaurus ObjectClass
    C15342
    UMLS 2011AA ObjectClass
    C0029216
    NCI Thesaurus Property
    C53268
    UMLS 2011AA Property
    C1709854
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ValueDomain
    C25737
    UMLS 2011AA ValueDomain
    C0205396
    Chronological # of this: HSCT #:
    Description

    HematopoieticStemCellTransplantationOccurrenceTherapeuticProcedureNumber

    Data type

    double

    Alias
    NCI Thesaurus ObjectClass
    C12551
    UMLS 2011AA ObjectClass
    C0018956
    NCI Thesaurus ObjectClass
    C15342
    UMLS 2011AA ObjectClass
    C0029216
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ValueDomain
    C49236
    UMLS 2011AA ValueDomain
    C0087111
    Chronological # of this: DCI #:
    Description

    DonorCellularInfusionOccurrenceTherapeuticProcedureNumber

    Data type

    double

    Alias
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ValueDomain
    C49236
    UMLS 2011AA ValueDomain
    C0087111
    NCI Thesaurus ObjectClass
    C77273
    UMLS 2011AA ObjectClass
    C2699799
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    Date of HSCT for this follow - up:
    Description

    HematopoieticStemCellTransplantationOccurrenceDate

    Data type

    date

    Alias
    NCI Thesaurus ObjectClass
    C12551
    UMLS 2011AA ObjectClass
    C0018956
    NCI Thesaurus ObjectClass
    C15342
    UMLS 2011AA ObjectClass
    C0029216
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ValueDomain
    C15342
    UMLS 2011AA ValueDomain
    C0029216
    Did the recipient receive a subsequent HSCT since the date of contact from the last report?
    Description

    RecipientReceivedNextHematopoieticStemCellTransplantationSinceDateLastReportIndicator

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C53268
    UMLS 2011AA ObjectClass
    C1709854
    NCI Thesaurus ObjectClass
    C12551
    UMLS 2011AA ObjectClass
    C0018956
    NCI Thesaurus ObjectClass
    C15342
    UMLS 2011AA ObjectClass
    C0029216
    NCI Thesaurus ObjectClass
    C25639
    UMLS 2011AA ObjectClass
    C1514756
    NCI Thesaurus ObjectClass
    C53286
    UMLS 2011AA ObjectClass
    C0332282
    NCI Thesaurus Property
    C25164
    UMLS 2011AA Property
    C0011008
    NCI Thesaurus Property
    C25375
    UMLS 2011AA Property
    C0684224
    NCI Thesaurus Property
    C25551
    UMLS 2011AA Property
    C1517741
    NCI Thesaurus Property
    C45325
    UMLS 2011AA Property
    C1711239
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ValueDomain
    C49488
    UMLS 2011AA ValueDomain
    C1705108
    NCI Thesaurus ValueDomain
    C49487
    UMLS 2011AA ValueDomain
    C1298908
    NCI Thesaurus ValueDomain
    C48660
    UMLS 2011AA ValueDomain
    C1272460
    NCI Thesaurus ValueDomain
    C17998
    UMLS 2011AA ValueDomain
    C0439673
    NCI Thesaurus ValueDomain
    C49484
    UMLS 2011AA ValueDomain
    C1272696
    New Malignancy, Lymphoproliferative Or Myeloproliferative Disorder
    Description

    New Malignancy, Lymphoproliferative Or Myeloproliferative Disorder

    Did a new malignancy, lymphoproliferative or myeloproliferative disorder occur? (Different from the disease for which HSCT performed not recurrence or transformation.)
    Description

    NewMalignantNeoplasmLymphoproliferativeMyelodysplastic/MyeloproliferativeDiseasesandDisordersDiagnosisIND

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25586
    UMLS 2011AA ObjectClass
    C0205314
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus ObjectClass
    C9308
    UMLS 2011AA ObjectClass
    C0024314
    NCI Thesaurus ObjectClass
    C27262
    UMLS 2011AA ObjectClass
    C1301355
    NCI Thesaurus Property
    C15220
    UMLS 2011AA Property
    C0011900
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ValueDomain
    C49488
    UMLS 2011AA ValueDomain
    C1705108
    NCI Thesaurus ValueDomain
    C49487
    UMLS 2011AA ValueDomain
    C1298908
    NCI Thesaurus ValueDomain
    C48660
    UMLS 2011AA ValueDomain
    C1272460
    NCI Thesaurus ValueDomain
    C17998
    UMLS 2011AA ValueDomain
    C0439673
    NCI Thesaurus ValueDomain
    C49484
    UMLS 2011AA ValueDomain
    C1272696
    New Malignancy, Lymphoproliferative Or Myeloproliferative Disorder
    Description

    New Malignancy, Lymphoproliferative Or Myeloproliferative Disorder

    Date of diagnosis:
    Description

    NewMalignantNeoplasmLymphoproliferativeDisorderMyelodysplastic/MyeloproliferativeDiseaseDiseasesandDisordersDiagnosisDate

    Data type

    date

    Alias
    NCI Thesaurus ObjectClass
    C25586
    UMLS 2011AA ObjectClass
    C0205314
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus ObjectClass
    C9308
    UMLS 2011AA ObjectClass
    C0024314
    NCI Thesaurus ObjectClass
    C27262
    UMLS 2011AA ObjectClass
    C1301355
    NCI Thesaurus Property
    C15220
    UMLS 2011AA Property
    C0011900
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    Specify:
    Description

    NewMalignantNeoplasmLymphoproliferativeMyelodysplastic/MyeloproliferativeDiseasesandDisordersDiagnosisType

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25586
    UMLS 2011AA ObjectClass
    C0205314
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus ObjectClass
    C2991
    UMLS 2011AA ObjectClass
    C0012634
    NCI Thesaurus ObjectClass
    C9308
    UMLS 2011AA ObjectClass
    C0024314
    NCI Thesaurus ObjectClass
    C27262
    UMLS 2011AA ObjectClass
    C1301355
    NCI Thesaurus Property
    C15220
    UMLS 2011AA Property
    C0011900
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ValueDomain
    C9305
    UMLS 2011AA ValueDomain
    C0006826
    Please specify the new other leukemia disorder that occurred.
    Description

    NewOtherLeukemiaDiseaseDiagnosisSpecify

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C17649
    UMLS 2011AA ObjectClass
    C0205394
    NCI Thesaurus ObjectClass
    C25586
    UMLS 2011AA ObjectClass
    C0205314
    NCI Thesaurus ObjectClass
    C3161
    UMLS 2011AA ObjectClass
    C0023418
    NCI Thesaurus Property
    C15220
    UMLS 2011AA Property
    C0011900
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    NCI Thesaurus ValueDomain
    C17649
    UMLS 2011AA ValueDomain
    C0205394
    Is the tumor EBV positive?
    Description

    LymphomaOrLymphoproliferativeDisorderEpstein-BarrVirusPositiveFindingIndicator

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C14204
    UMLS 2011AA ObjectClass
    C0014644
    NCI Thesaurus ObjectClass
    C37998
    UMLS 2011AA ObjectClass
    C1518602
    NCI Thesaurus ObjectClass
    C9308
    UMLS 2011AA ObjectClass
    C0024314
    NCI Thesaurus ObjectClass
    C3208
    UMLS 2011AA ObjectClass
    C0024299
    NCI Thesaurus Property
    C38758
    UMLS 2011AA Property
    C1514241
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ValueDomain
    C49488
    UMLS 2011AA ValueDomain
    C1705108
    NCI Thesaurus ValueDomain
    C49487
    UMLS 2011AA ValueDomain
    C1298908
    NCI Thesaurus ValueDomain
    C48660
    UMLS 2011AA ValueDomain
    C1272460
    NCI Thesaurus ValueDomain
    C17998
    UMLS 2011AA ValueDomain
    C0439673
    NCI Thesaurus ValueDomain
    C49484
    UMLS 2011AA ValueDomain
    C1272696
    Specify the other new malignancy, lymphoproliferative or myeloproliferative disorder .
    Description

    OtherNewMalignantNeoplasmOccurrenceDiagnosisSpecify

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C17649
    UMLS 2011AA ObjectClass
    C0205394
    NCI Thesaurus ObjectClass
    C25586
    UMLS 2011AA ObjectClass
    C0205314
    NCI Thesaurus ObjectClass
    C9305
    UMLS 2011AA ObjectClass
    C0006826
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    Copy of pathology report / documentation attached?
    Description

    PathologyReportSubmissionYesNoCharacterIndicator

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus Property
    C25375
    UMLS 2011AA Property
    C0684224
    NCI Thesaurus ObjectClass
    C18189
    UMLS 2011AA ObjectClass
    C0030664
    NCI Thesaurus Property
    C25695
    UMLS 2011AA Property
    C1515023
    Survival
    Description

    Survival

    Survival status at latest follow-up:
    Description

    RecipientLastFollow-upTimepointStatus

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C53268
    UMLS 2011AA ObjectClass
    C1709854
    NCI Thesaurus Property
    C16033
    UMLS 2011AA Property
    C1522577
    NCI Thesaurus Property
    C68568
    UMLS 2011AA Property
    C2348792
    NCI Thesaurus Property
    C25551
    UMLS 2011AA Property
    C1517741
    NCI Thesaurus Property
    C25688
    UMLS 2011AA Property
    C0449438
    NCI Thesaurus ValueDomain
    C16033
    UMLS 2011AA ValueDomain
    C1522577
    NCI Thesaurus ValueDomain
    C25688
    UMLS 2011AA ValueDomain
    C0449438
    Latest follow-up:
    Description

    LastFollow-upOccurrenceDate

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C16033
    UMLS 2011AA ObjectClass
    C1522577
    NCI Thesaurus ObjectClass
    C25551
    UMLS 2011AA ObjectClass
    C1517741
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    Date of death:
    Description

    DeathOccurrenceDate

    Data type

    date

    Alias
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C28554
    UMLS 2011AA ObjectClass
    C0011065
    NCI Thesaurus Property
    C25275
    UMLS 2011AA Property
    C2745955
    Main cause of death: (check only one main cause)
    Description

    DeathMainReasonType

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C28554
    UMLS 2011AA ObjectClass
    C0011065
    NCI Thesaurus Property
    C25638
    UMLS 2011AA Property
    C0392360
    NCI Thesaurus Property
    C25562
    UMLS 2011AA Property
    C1542147
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ValueDomain
    C25638
    UMLS 2011AA ValueDomain
    C0392360
    NCI Thesaurus ValueDomain
    C28554
    UMLS 2011AA ValueDomain
    C0011065
    Main cause of death: Other,specify
    Description

    MainReasonDeathOtherTypeDiagnosisSpecify

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25638
    UMLS 2011AA ObjectClass
    C0392360
    NCI Thesaurus ObjectClass
    C28554
    UMLS 2011AA ObjectClass
    C0011065
    NCI Thesaurus ObjectClass
    C25562
    UMLS 2011AA ObjectClass
    C1542147
    NCI Thesaurus Property
    C25284
    UMLS 2011AA Property
    C0332307
    NCI Thesaurus Property
    C17649
    UMLS 2011AA Property
    C0205394
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    Last known date alive:
    Description

    LastKnownAliveDate

    Data type

    date

    Alias
    NCI Thesaurus Property
    C25164
    UMLS 2011AA Property
    C0011008
    NCI Thesaurus ValueDomain
    C25164
    UMLS 2011AA ValueDomain
    C0011008
    NCI Thesaurus ObjectClass
    C25551
    UMLS 2011AA ObjectClass
    C1517741
    NCI Thesaurus ObjectClass
    C17177
    UMLS 2011AA ObjectClass
    C0038952
    Day of the month is estimated
    Description

    Follow-upDayEstimateYesNoUnkNDNAIndicator

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C16033
    UMLS 2011AA ObjectClass
    C1522577
    NCI Thesaurus ObjectClass
    C25301
    UMLS 2011AA ObjectClass
    C0439228
    NCI Thesaurus Property
    C25498
    UMLS 2011AA Property
    C0750572
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ValueDomain
    C49488
    UMLS 2011AA ValueDomain
    C1705108
    NCI Thesaurus ValueDomain
    C49487
    UMLS 2011AA ValueDomain
    C1298908
    NCI Thesaurus ValueDomain
    C48660
    UMLS 2011AA ValueDomain
    C1272460
    NCI Thesaurus ValueDomain
    C17998
    UMLS 2011AA ValueDomain
    C0439673
    NCI Thesaurus ValueDomain
    C49484
    UMLS 2011AA ValueDomain
    C1272696
    Survival
    Description

    Survival

    HSCT related causes (Check as many as appropriate )
    Description

    HematopoieticStemCellTransplantationRelationshipDeathMainReasonType

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25648
    UMLS 2011AA ObjectClass
    C0439849
    NCI Thesaurus ObjectClass
    C28554
    UMLS 2011AA ObjectClass
    C0011065
    NCI Thesaurus ObjectClass
    C12551
    UMLS 2011AA ObjectClass
    C0018956
    NCI Thesaurus ObjectClass
    C15342
    UMLS 2011AA ObjectClass
    C0029216
    NCI Thesaurus Property
    C25638
    UMLS 2011AA Property
    C0392360
    NCI Thesaurus Property
    C25562
    UMLS 2011AA Property
    C1542147
    NCI Thesaurus ValueDomain
    C25284
    UMLS 2011AA ValueDomain
    C0332307
    NCI Thesaurus ValueDomain
    C25638
    UMLS 2011AA ValueDomain
    C0392360
    NCI Thesaurus ValueDomain
    C25648
    UMLS 2011AA ValueDomain
    C0439849
    NCI Thesaurus ValueDomain
    C28554
    UMLS 2011AA ValueDomain
    C0011065
    NCI Thesaurus ValueDomain
    C12551
    UMLS 2011AA ValueDomain
    C0018956
    NCI Thesaurus ValueDomain
    C15342
    UMLS 2011AA ValueDomain
    C0029216
    What is the main cause of HSCT related death?
    Description

    HematopoieticStemCellTransplantationRelationshipDeathMainReasonIndicator

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25648
    UMLS 2011AA ObjectClass
    C0439849
    NCI Thesaurus ObjectClass
    C28554
    UMLS 2011AA ObjectClass
    C0011065
    NCI Thesaurus ObjectClass
    C12551
    UMLS 2011AA ObjectClass
    C0018956
    NCI Thesaurus ObjectClass
    C15342
    UMLS 2011AA ObjectClass
    C0029216
    NCI Thesaurus Property
    C25638
    UMLS 2011AA Property
    C0392360
    NCI Thesaurus Property
    C25562
    UMLS 2011AA Property
    C1542147
    NCI Thesaurus ValueDomain
    C25180
    UMLS 2011AA ValueDomain
    C1522602
    NCI Thesaurus ValueDomain
    C49488
    UMLS 2011AA ValueDomain
    C1705108
    NCI Thesaurus ValueDomain
    C49487
    UMLS 2011AA ValueDomain
    C1298908
    NCI Thesaurus ValueDomain
    C48660
    UMLS 2011AA ValueDomain
    C1272460
    NCI Thesaurus ValueDomain
    C17998
    UMLS 2011AA ValueDomain
    C0439673
    NCI Thesaurus ValueDomain
    C49484
    UMLS 2011AA ValueDomain
    C1272696
    Specify: (Answer only if the response to CDE 2768637 is "Other".)
    Description

    HematopoieticStemCellTransplantationRelationshipDeathMainReasonDiagnosisSpecify

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25648
    UMLS 2011AA ObjectClass
    C0439849
    NCI Thesaurus ObjectClass
    C28554
    UMLS 2011AA ObjectClass
    C0011065
    NCI Thesaurus ObjectClass
    C12551
    UMLS 2011AA ObjectClass
    C0018956
    NCI Thesaurus ObjectClass
    C15342
    UMLS 2011AA ObjectClass
    C0029216
    NCI Thesaurus Property
    C25638
    UMLS 2011AA Property
    C0392360
    NCI Thesaurus Property
    C25562
    UMLS 2011AA Property
    C1542147
    NCI Thesaurus ValueDomain
    C25685
    UMLS 2011AA ValueDomain
    C1521902
    Author Information
    Description

    Author Information

    First Name
    Description

    PersonGiven/FirstName

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus Property
    C40974
    UMLS 2011AA Property
    C1443235
    Last Name
    Description

    PersonFamily/LastName

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25191
    UMLS 2011AA ValueDomain
    C1547383
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C25364
    UMLS 2011AA Property
    C0600091
    NCI Thesaurus Property
    C40975
    UMLS 2011AA Property
    C1301584
    Phone number:
    Description

    ContactPersonLocationTelephoneNumber

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus ObjectClass
    C25461
    UMLS 2011AA ObjectClass
    C0337611
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ValueDomain
    C25395
    UMLS 2011AA ValueDomain
    C0039457
    Fax number:
    Description

    ContactPersonLocationFaxNumber

    Data type

    text

    Alias
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus ObjectClass
    C25461
    UMLS 2011AA ObjectClass
    C0337611
    NCI Thesaurus Property
    C25341
    UMLS 2011AA Property
    C0450429
    NCI Thesaurus ValueDomain
    C25337
    UMLS 2011AA ValueDomain
    C0237753
    NCI Thesaurus ValueDomain
    C25210
    UMLS 2011AA ValueDomain
    C0085205
    E-mail address:
    Description

    PersonEmailAddressText

    Data type

    text

    Alias
    NCI Thesaurus ValueDomain
    C25704
    UMLS 2011AA ValueDomain
    C1527021
    NCI Thesaurus ObjectClass
    C25190
    UMLS 2011AA ObjectClass
    C0027361
    NCI Thesaurus Property
    C42775
    UMLS 2011AA Property
    C1705961
    Back to the top of the page

    Similar models

    Note: "Greater than 100 Days Report" answer since last report

    1 forms
    1. StudyEvent: 2455 Revision 1 - Selective Post-Transplant Essential Data
      1. Note: "Greater than 100 Days Report" answer since last report
    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Registry Use Only
    ClinicalDataFormSequenceNumber
    Item
    Sequence number:
    double
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C19464 (NCI Thesaurus Property)
    C0376315 (UMLS 2011AA Property)
    C15783 (NCI Thesaurus ObjectClass)
    C1516606 (UMLS 2011AA ObjectClass)
    C25673 (NCI Thesaurus ValueDomain)
    C1519249 (UMLS 2011AA ValueDomain)
    ClinicalDataFormReceivedDate
    Item
    Date received:
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C19464 (NCI Thesaurus Property)
    C0376315 (UMLS 2011AA Property)
    C25639 (NCI Thesaurus ValueDomain)
    C1514756 (UMLS 2011AA ValueDomain)
    C15783 (NCI Thesaurus ObjectClass)
    C1516606 (UMLS 2011AA ObjectClass)
    Item Group
    Center Identification
    HematopoieticStemCellTransplantationRecipientInstitution::CenterforInternationalBloodandMarrowTransplantResearchFacilityNumber
    Item
    CIBMTR Center Number:
    double
    C12551 (NCI Thesaurus ObjectClass)
    C0018956 (UMLS 2011AA ObjectClass)
    C15342 (NCI Thesaurus ObjectClass)
    C0029216 (UMLS 2011AA ObjectClass)
    C53268 (NCI Thesaurus Property)
    C1709854 (UMLS 2011AA Property)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C41206 (NCI Thesaurus ValueDomain)
    C1272753 (UMLS 2011AA ValueDomain)
    C62574 (NCI Thesaurus ValueDomain)
    C1547538 (UMLS 2011AA ValueDomain)
    OrganizationalUnit::EBMT(CIC)CodeNumber
    Item
    EBMT Code (CIC) Number
    double
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25162 (NCI Thesaurus Property)
    C0805701 (UMLS 2011AA Property)
    C25162 (NCI Thesaurus ValueDomain)
    C0805701 (UMLS 2011AA ValueDomain)
    C41167 (NCI Thesaurus ObjectClass)
    C0029246 (UMLS 2011AA ObjectClass)
    ClinicalDataFormTodayDate
    Item
    Date of this report:
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C19464 (NCI Thesaurus Property)
    C0376315 (UMLS 2011AA Property)
    C15783 (NCI Thesaurus ObjectClass)
    C1516606 (UMLS 2011AA ObjectClass)
    C41134 (NCI Thesaurus ValueDomain)
    C0750526 (UMLS 2011AA ValueDomain)
    Item
    Follow-Up:
    text
    C53268 (NCI Thesaurus ObjectClass)
    C1709854 (UMLS 2011AA ObjectClass)
    C15342 (NCI Thesaurus ObjectClass)
    C0029216 (UMLS 2011AA ObjectClass)
    C16033 (NCI Thesaurus Property)
    C1522577 (UMLS 2011AA Property)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C68568 (NCI Thesaurus ValueDomain)
    C2348792 (UMLS 2011AA ValueDomain)
    CL.1
    Code List
    Follow-Up:
    CL Item
    Integer::100 Day (Day 100)
    C25301 (NCI Thesaurus)
    C0439228 (UMLS 2011AA)
    C45255 (NCI Thesaurus)
    C1708523 (UMLS 2011AA)
    CL Item
    Integer::6 Month (6 Months)
    C45255 (NCI Thesaurus)
    C1708523 (UMLS 2011AA)
    C29846 (NCI Thesaurus)
    C0439231 (UMLS 2011AA)
    CL Item
    Annual (Annual)
    C54647 (NCI Thesaurus)
    C0332181 (UMLS 2011AA)
    Follow-upReportPostTransplantationTimepointYearCount
    Item
    annual, specify year:
    double
    C16033 (NCI Thesaurus ObjectClass)
    C1522577 (UMLS 2011AA ObjectClass)
    C25375 (NCI Thesaurus ObjectClass)
    C0684224 (UMLS 2011AA ObjectClass)
    C38008 (NCI Thesaurus Property)
    C0687676 (UMLS 2011AA Property)
    C15342 (NCI Thesaurus Property)
    C0029216 (UMLS 2011AA Property)
    C68568 (NCI Thesaurus Property)
    C2348792 (UMLS 2011AA Property)
    C29848 (NCI Thesaurus ValueDomain)
    C0439234 (UMLS 2011AA ValueDomain)
    C25463 (NCI Thesaurus ValueDomain)
    C0750480 (UMLS 2011AA ValueDomain)
    Item Group
    Recipient Identification
    HematopoieticStemCellTransplantationRecipientIdentificationNumber
    Item
    CIBMTR Recipient ID:
    double
    C12551 (NCI Thesaurus ObjectClass)
    C0018956 (UMLS 2011AA ObjectClass)
    C15342 (NCI Thesaurus ObjectClass)
    C0029216 (UMLS 2011AA ObjectClass)
    C53268 (NCI Thesaurus Property)
    C1709854 (UMLS 2011AA Property)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25737 (NCI Thesaurus ValueDomain)
    C0205396 (UMLS 2011AA ValueDomain)
    HematopoieticStemCellTransplantationOccurrenceTherapeuticProcedureNumber
    Item
    Chronological # of this: HSCT #:
    double
    C12551 (NCI Thesaurus ObjectClass)
    C0018956 (UMLS 2011AA ObjectClass)
    C15342 (NCI Thesaurus ObjectClass)
    C0029216 (UMLS 2011AA ObjectClass)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C49236 (NCI Thesaurus ValueDomain)
    C0087111 (UMLS 2011AA ValueDomain)
    DonorCellularInfusionOccurrenceTherapeuticProcedureNumber
    Item
    Chronological # of this: DCI #:
    double
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C49236 (NCI Thesaurus ValueDomain)
    C0087111 (UMLS 2011AA ValueDomain)
    C77273 (NCI Thesaurus ObjectClass)
    C2699799 (UMLS 2011AA ObjectClass)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    HematopoieticStemCellTransplantationOccurrenceDate
    Item
    Date of HSCT for this follow - up:
    date
    C12551 (NCI Thesaurus ObjectClass)
    C0018956 (UMLS 2011AA ObjectClass)
    C15342 (NCI Thesaurus ObjectClass)
    C0029216 (UMLS 2011AA ObjectClass)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C15342 (NCI Thesaurus ValueDomain)
    C0029216 (UMLS 2011AA ValueDomain)
    Item
    Did the recipient receive a subsequent HSCT since the date of contact from the last report?
    text
    C53268 (NCI Thesaurus ObjectClass)
    C1709854 (UMLS 2011AA ObjectClass)
    C12551 (NCI Thesaurus ObjectClass)
    C0018956 (UMLS 2011AA ObjectClass)
    C15342 (NCI Thesaurus ObjectClass)
    C0029216 (UMLS 2011AA ObjectClass)
    C25639 (NCI Thesaurus ObjectClass)
    C1514756 (UMLS 2011AA ObjectClass)
    C53286 (NCI Thesaurus ObjectClass)
    C0332282 (UMLS 2011AA ObjectClass)
    C25164 (NCI Thesaurus Property)
    C0011008 (UMLS 2011AA Property)
    C25375 (NCI Thesaurus Property)
    C0684224 (UMLS 2011AA Property)
    C25551 (NCI Thesaurus Property)
    C1517741 (UMLS 2011AA Property)
    C45325 (NCI Thesaurus Property)
    C1711239 (UMLS 2011AA Property)
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C49488 (NCI Thesaurus ValueDomain)
    C1705108 (UMLS 2011AA ValueDomain)
    C49487 (NCI Thesaurus ValueDomain)
    C1298908 (UMLS 2011AA ValueDomain)
    C48660 (NCI Thesaurus ValueDomain)
    C1272460 (UMLS 2011AA ValueDomain)
    C17998 (NCI Thesaurus ValueDomain)
    C0439673 (UMLS 2011AA ValueDomain)
    C49484 (NCI Thesaurus ValueDomain)
    C1272696 (UMLS 2011AA ValueDomain)
    CL.2
    Code List
    Did the recipient receive a subsequent HSCT since the date of contact from the last report?
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item Group
    New Malignancy, Lymphoproliferative Or Myeloproliferative Disorder
    Item
    Did a new malignancy, lymphoproliferative or myeloproliferative disorder occur? (Different from the disease for which HSCT performed not recurrence or transformation.)
    text
    C25586 (NCI Thesaurus ObjectClass)
    C0205314 (UMLS 2011AA ObjectClass)
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C9308 (NCI Thesaurus ObjectClass)
    C0024314 (UMLS 2011AA ObjectClass)
    C27262 (NCI Thesaurus ObjectClass)
    C1301355 (UMLS 2011AA ObjectClass)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C49488 (NCI Thesaurus ValueDomain)
    C1705108 (UMLS 2011AA ValueDomain)
    C49487 (NCI Thesaurus ValueDomain)
    C1298908 (UMLS 2011AA ValueDomain)
    C48660 (NCI Thesaurus ValueDomain)
    C1272460 (UMLS 2011AA ValueDomain)
    C17998 (NCI Thesaurus ValueDomain)
    C0439673 (UMLS 2011AA ValueDomain)
    C49484 (NCI Thesaurus ValueDomain)
    C1272696 (UMLS 2011AA ValueDomain)
    CL.3
    Code List
    Did a new malignancy, lymphoproliferative or myeloproliferative disorder occur? (Different from the disease for which HSCT performed not recurrence or transformation.)
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    Item Group
    New Malignancy, Lymphoproliferative Or Myeloproliferative Disorder
    NewMalignantNeoplasmLymphoproliferativeDisorderMyelodysplastic/MyeloproliferativeDiseaseDiseasesandDisordersDiagnosisDate
    Item
    Date of diagnosis:
    date
    C25586 (NCI Thesaurus ObjectClass)
    C0205314 (UMLS 2011AA ObjectClass)
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C9308 (NCI Thesaurus ObjectClass)
    C0024314 (UMLS 2011AA ObjectClass)
    C27262 (NCI Thesaurus ObjectClass)
    C1301355 (UMLS 2011AA ObjectClass)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    Item
    Specify:
    text
    C25586 (NCI Thesaurus ObjectClass)
    C0205314 (UMLS 2011AA ObjectClass)
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C2991 (NCI Thesaurus ObjectClass)
    C0012634 (UMLS 2011AA ObjectClass)
    C9308 (NCI Thesaurus ObjectClass)
    C0024314 (UMLS 2011AA ObjectClass)
    C27262 (NCI Thesaurus ObjectClass)
    C1301355 (UMLS 2011AA ObjectClass)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C9305 (NCI Thesaurus ValueDomain)
    C0006826 (UMLS 2011AA ValueDomain)
    CL.4
    Code List
    Specify:
    CL Item
    Acute Myeloid Leukemia (Acute myeloid leukemia (AML / ANLL))
    C3171 (NCI Thesaurus)
    C0023467 (UMLS 2011AA)
    CL Item
    Other Leukemia (Other leukemia including ALL)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    C3161 (NCI Thesaurus)
    C0023418 (UMLS 2011AA)
    CL Item
    Breast Carcinoma (Breast cancer)
    C4872 (NCI Thesaurus)
    C0678222 (UMLS 2011AA)
    CL Item
    Central Nervous System Neoplasm (Central nervous system (CNS) malignancy (glioblastoma, astrocytoma))
    C9293 (NCI Thesaurus)
    C0085136 (UMLS 2011AA)
    CL Item
    Clonality Cytogenetic Abnormality (Related by descent from clonal cytogenetic abnormality without leukemia or MDS)
    C2950 (NCI Thesaurus)
    C0008625 (UMLS 2011AA)
    C18304 (NCI Thesaurus)
    C1704387 (UMLS 2011AA)
    CL Item
    Malignant Gastrointestinal Neoplasm (Gastrointestinal malignancy (colon, rectum, stomach, pancreas, intestine))
    C4890 (NCI Thesaurus)
    C0685938 (UMLS 2011AA)
    CL Item
    Genitourinary System Malignant Neoplasm (Genitourinary malignancy (kidney, bladder, ovary, testicle, genitalia, uterus, cervix))
    C9305 (NCI Thesaurus)
    C0006826 (UMLS 2011AA)
    C12810 (NCI Thesaurus)
    C0042066 (UMLS 2011AA)
    CL Item
    Hodgkin's Lymphoma (Hodgkin disease)
    C9357 (NCI Thesaurus)
    C0019829 (UMLS 2011AA)
    CL Item
    Lung Carcinoma (Lung cancer)
    C4878 (NCI Thesaurus)
    C0684249 (UMLS 2011AA)
    CL Item
    Lymphoma Or Lymphoproliferative Disorder (Lymphoma or lymphoproliferative disease)
    C37998 (NCI Thesaurus)
    C1518602 (UMLS 2011AA)
    C9308 (NCI Thesaurus)
    C0024314 (UMLS 2011AA)
    C3208 (NCI Thesaurus)
    C0024299 (UMLS 2011AA)
    CL Item
    Melanoma (Melanoma)
    C3224 (NCI Thesaurus)
    C0025202 (UMLS 2011AA)
    CL Item
    Other Malignant Skin Neoplasm (Other skin malignancy (basal cell, squamous))
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    C2920 (NCI Thesaurus)
    C0007114 (UMLS 2011AA)
    CL Item
    Myelodysplastic/myeloproliferative Disease (Myelodysplasia (MDS), myeloproliferative (MPS) disorder)
    C27262 (NCI Thesaurus)
    C1301355 (UMLS 2011AA)
    CL Item
    Oropharyngeal Carcinoma (Oropharyngeal cancer (tongue, buccal mucosa))
    C9105 (NCI Thesaurus)
    C2349952 (UMLS 2011AA)
    CL Item
    Sarcoma (Sarcoma)
    C9118 (NCI Thesaurus)
    C1261473 (UMLS 2011AA)
    CL Item
    Thyroid Gland Carcinoma (Thyroid cancer)
    C4815 (NCI Thesaurus)
    C0549473 (UMLS 2011AA)
    CL Item
    Other Malignant Neoplasm (Other malignancy)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    C9305 (NCI Thesaurus)
    C0006826 (UMLS 2011AA)
    NewOtherLeukemiaDiseaseDiagnosisSpecify
    Item
    Please specify the new other leukemia disorder that occurred.
    text
    C17649 (NCI Thesaurus ObjectClass)
    C0205394 (UMLS 2011AA ObjectClass)
    C25586 (NCI Thesaurus ObjectClass)
    C0205314 (UMLS 2011AA ObjectClass)
    C3161 (NCI Thesaurus ObjectClass)
    C0023418 (UMLS 2011AA ObjectClass)
    C15220 (NCI Thesaurus Property)
    C0011900 (UMLS 2011AA Property)
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    C17649 (NCI Thesaurus ValueDomain)
    C0205394 (UMLS 2011AA ValueDomain)
    Item
    Is the tumor EBV positive?
    text
    C14204 (NCI Thesaurus ObjectClass)
    C0014644 (UMLS 2011AA ObjectClass)
    C37998 (NCI Thesaurus ObjectClass)
    C1518602 (UMLS 2011AA ObjectClass)
    C9308 (NCI Thesaurus ObjectClass)
    C0024314 (UMLS 2011AA ObjectClass)
    C3208 (NCI Thesaurus ObjectClass)
    C0024299 (UMLS 2011AA ObjectClass)
    C38758 (NCI Thesaurus Property)
    C1514241 (UMLS 2011AA Property)
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C49488 (NCI Thesaurus ValueDomain)
    C1705108 (UMLS 2011AA ValueDomain)
    C49487 (NCI Thesaurus ValueDomain)
    C1298908 (UMLS 2011AA ValueDomain)
    C48660 (NCI Thesaurus ValueDomain)
    C1272460 (UMLS 2011AA ValueDomain)
    C17998 (NCI Thesaurus ValueDomain)
    C0439673 (UMLS 2011AA ValueDomain)
    C49484 (NCI Thesaurus ValueDomain)
    C1272696 (UMLS 2011AA ValueDomain)
    CL.5
    Code List
    Is the tumor EBV positive?
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    OtherNewMalignantNeoplasmOccurrenceDiagnosisSpecify
    Item
    Specify the other new malignancy, lymphoproliferative or myeloproliferative disorder .
    text
    C17649 (NCI Thesaurus ObjectClass)
    C0205394 (UMLS 2011AA ObjectClass)
    C25586 (NCI Thesaurus ObjectClass)
    C0205314 (UMLS 2011AA ObjectClass)
    C9305 (NCI Thesaurus ObjectClass)
    C0006826 (UMLS 2011AA ObjectClass)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    Item
    Copy of pathology report / documentation attached?
    text
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C25375 (NCI Thesaurus Property)
    C0684224 (UMLS 2011AA Property)
    C18189 (NCI Thesaurus ObjectClass)
    C0030664 (UMLS 2011AA ObjectClass)
    C25695 (NCI Thesaurus Property)
    C1515023 (UMLS 2011AA Property)
    CL.6
    Code List
    Copy of pathology report / documentation attached?
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    Item Group
    Survival
    Item
    Survival status at latest follow-up:
    text
    C53268 (NCI Thesaurus ObjectClass)
    C1709854 (UMLS 2011AA ObjectClass)
    C16033 (NCI Thesaurus Property)
    C1522577 (UMLS 2011AA Property)
    C68568 (NCI Thesaurus Property)
    C2348792 (UMLS 2011AA Property)
    C25551 (NCI Thesaurus Property)
    C1517741 (UMLS 2011AA Property)
    C25688 (NCI Thesaurus Property)
    C0449438 (UMLS 2011AA Property)
    C16033 (NCI Thesaurus ValueDomain)
    C1522577 (UMLS 2011AA ValueDomain)
    C25688 (NCI Thesaurus ValueDomain)
    C0449438 (UMLS 2011AA ValueDomain)
    CL.7
    Code List
    Survival status at latest follow-up:
    CL Item
    Life (Alive)
    C37987 (NCI Thesaurus)
    C0376558 (UMLS 2011AA)
    CL Item
    Death (Dead)
    C28554 (NCI Thesaurus)
    C0011065 (UMLS 2011AA)
    CL Item
    Negation Follow-up (Lost to Follow-up(LTF))
    C25594 (NCI Thesaurus)
    C1518422 (UMLS 2011AA)
    C16033 (NCI Thesaurus)
    C1522577 (UMLS 2011AA)
    LastFollow-upOccurrenceDate
    Item
    Latest follow-up:
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C16033 (NCI Thesaurus ObjectClass)
    C1522577 (UMLS 2011AA ObjectClass)
    C25551 (NCI Thesaurus ObjectClass)
    C1517741 (UMLS 2011AA ObjectClass)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    DeathOccurrenceDate
    Item
    Date of death:
    date
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C28554 (NCI Thesaurus ObjectClass)
    C0011065 (UMLS 2011AA ObjectClass)
    C25275 (NCI Thesaurus Property)
    C2745955 (UMLS 2011AA Property)
    Item
    Main cause of death: (check only one main cause)
    text
    C28554 (NCI Thesaurus ObjectClass)
    C0011065 (UMLS 2011AA ObjectClass)
    C25638 (NCI Thesaurus Property)
    C0392360 (UMLS 2011AA Property)
    C25562 (NCI Thesaurus Property)
    C1542147 (UMLS 2011AA Property)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C25638 (NCI Thesaurus ValueDomain)
    C0392360 (UMLS 2011AA ValueDomain)
    C28554 (NCI Thesaurus ValueDomain)
    C0011065 (UMLS 2011AA ValueDomain)
    CL.8
    Code List
    Main cause of death: (check only one main cause)
    CL Item
    And/or Persistent Recurrent Disease Disease Progression (Disease progression and/or persistent relapse)
    C48928 (NCI Thesaurus)
    C1706528 (UMLS 2011AA)
    C38155 (NCI Thesaurus)
    C0277556 (UMLS 2011AA)
    C17747 (NCI Thesaurus)
    C0242656 (UMLS 2011AA)
    C43623 (NCI Thesaurus)
    C0205322 (UMLS 2011AA)
    CL Item
    Transplantation Relationship Hematopoietic Stem Cell (HSCT related causes)
    C25648 (NCI Thesaurus)
    C0439849 (UMLS 2011AA)
    C12551 (NCI Thesaurus)
    C0018956 (UMLS 2011AA)
    C15342 (NCI Thesaurus)
    C0029216 (UMLS 2011AA)
    CL Item
    New Malignant Neoplasm (New malignancy)
    C25586 (NCI Thesaurus)
    C0205314 (UMLS 2011AA)
    C9305 (NCI Thesaurus)
    C0006826 (UMLS 2011AA)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    CL Item
    Unknown (Unknown)
    C17998 (NCI Thesaurus)
    C0439673 (UMLS 2011AA)
    MainReasonDeathOtherTypeDiagnosisSpecify
    Item
    Main cause of death: Other,specify
    text
    C25638 (NCI Thesaurus ObjectClass)
    C0392360 (UMLS 2011AA ObjectClass)
    C28554 (NCI Thesaurus ObjectClass)
    C0011065 (UMLS 2011AA ObjectClass)
    C25562 (NCI Thesaurus ObjectClass)
    C1542147 (UMLS 2011AA ObjectClass)
    C25284 (NCI Thesaurus Property)
    C0332307 (UMLS 2011AA Property)
    C17649 (NCI Thesaurus Property)
    C0205394 (UMLS 2011AA Property)
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    LastKnownAliveDate
    Item
    Last known date alive:
    date
    C25164 (NCI Thesaurus Property)
    C0011008 (UMLS 2011AA Property)
    C25164 (NCI Thesaurus ValueDomain)
    C0011008 (UMLS 2011AA ValueDomain)
    C25551 (NCI Thesaurus ObjectClass)
    C1517741 (UMLS 2011AA ObjectClass)
    C17177 (NCI Thesaurus ObjectClass)
    C0038952 (UMLS 2011AA ObjectClass)
    Item
    Day of the month is estimated
    text
    C16033 (NCI Thesaurus ObjectClass)
    C1522577 (UMLS 2011AA ObjectClass)
    C25301 (NCI Thesaurus ObjectClass)
    C0439228 (UMLS 2011AA ObjectClass)
    C25498 (NCI Thesaurus Property)
    C0750572 (UMLS 2011AA Property)
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C49488 (NCI Thesaurus ValueDomain)
    C1705108 (UMLS 2011AA ValueDomain)
    C49487 (NCI Thesaurus ValueDomain)
    C1298908 (UMLS 2011AA ValueDomain)
    C48660 (NCI Thesaurus ValueDomain)
    C1272460 (UMLS 2011AA ValueDomain)
    C17998 (NCI Thesaurus ValueDomain)
    C0439673 (UMLS 2011AA ValueDomain)
    C49484 (NCI Thesaurus ValueDomain)
    C1272696 (UMLS 2011AA ValueDomain)
    CL.9
    Code List
    Day of the month is estimated
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    Item Group
    Survival
    Item
    HSCT related causes (Check as many as appropriate )
    text
    C25648 (NCI Thesaurus ObjectClass)
    C0439849 (UMLS 2011AA ObjectClass)
    C28554 (NCI Thesaurus ObjectClass)
    C0011065 (UMLS 2011AA ObjectClass)
    C12551 (NCI Thesaurus ObjectClass)
    C0018956 (UMLS 2011AA ObjectClass)
    C15342 (NCI Thesaurus ObjectClass)
    C0029216 (UMLS 2011AA ObjectClass)
    C25638 (NCI Thesaurus Property)
    C0392360 (UMLS 2011AA Property)
    C25562 (NCI Thesaurus Property)
    C1542147 (UMLS 2011AA Property)
    C25284 (NCI Thesaurus ValueDomain)
    C0332307 (UMLS 2011AA ValueDomain)
    C25638 (NCI Thesaurus ValueDomain)
    C0392360 (UMLS 2011AA ValueDomain)
    C25648 (NCI Thesaurus ValueDomain)
    C0439849 (UMLS 2011AA ValueDomain)
    C28554 (NCI Thesaurus ValueDomain)
    C0011065 (UMLS 2011AA ValueDomain)
    C12551 (NCI Thesaurus ValueDomain)
    C0018956 (UMLS 2011AA ValueDomain)
    C15342 (NCI Thesaurus ValueDomain)
    C0029216 (UMLS 2011AA ValueDomain)
    CL.10
    Code List
    HSCT related causes (Check as many as appropriate )
    CL Item
    Graft Versus Host Disease (GVHD)
    C3063 (NCI Thesaurus)
    C0018133 (UMLS 2011AA)
    CL Item
    Cardiotoxicity (Cardiac toxicity)
    C27994 (NCI Thesaurus)
    C0876994 (UMLS 2011AA)
    CL Item
    Infection (Infection)
    C26726 (NCI Thesaurus)
    C0009450 (UMLS 2011AA)
    CL Item
    Toxicity Pulmonary (Pulmonary toxicity)
    C13304 (NCI Thesaurus)
    C2709248 (UMLS 2011AA)
    C27990 (NCI Thesaurus)
    C0600688 (UMLS 2011AA)
    CL Item
    Graft Rejection (Rejection / poor graft function)
    C75570 (NCI Thesaurus)
    C0018129 (UMLS 2011AA)
    CL Item
    Hepatic Veno-occlusive Disease (VOD)
    C26793 (NCI Thesaurus)
    C0019156 (UMLS 2011AA)
    CL Item
    Other (Other)
    C17649 (NCI Thesaurus)
    C0205394 (UMLS 2011AA)
    Item
    What is the main cause of HSCT related death?
    text
    C25648 (NCI Thesaurus ObjectClass)
    C0439849 (UMLS 2011AA ObjectClass)
    C28554 (NCI Thesaurus ObjectClass)
    C0011065 (UMLS 2011AA ObjectClass)
    C12551 (NCI Thesaurus ObjectClass)
    C0018956 (UMLS 2011AA ObjectClass)
    C15342 (NCI Thesaurus ObjectClass)
    C0029216 (UMLS 2011AA ObjectClass)
    C25638 (NCI Thesaurus Property)
    C0392360 (UMLS 2011AA Property)
    C25562 (NCI Thesaurus Property)
    C1542147 (UMLS 2011AA Property)
    C25180 (NCI Thesaurus ValueDomain)
    C1522602 (UMLS 2011AA ValueDomain)
    C49488 (NCI Thesaurus ValueDomain)
    C1705108 (UMLS 2011AA ValueDomain)
    C49487 (NCI Thesaurus ValueDomain)
    C1298908 (UMLS 2011AA ValueDomain)
    C48660 (NCI Thesaurus ValueDomain)
    C1272460 (UMLS 2011AA ValueDomain)
    C17998 (NCI Thesaurus ValueDomain)
    C0439673 (UMLS 2011AA ValueDomain)
    C49484 (NCI Thesaurus ValueDomain)
    C1272696 (UMLS 2011AA ValueDomain)
    CL.11
    Code List
    What is the main cause of HSCT related death?
    CL Item
    Yes (Yes)
    C49488 (NCI Thesaurus)
    C1705108 (UMLS 2011AA)
    CL Item
    No (No)
    C49487 (NCI Thesaurus)
    C1298908 (UMLS 2011AA)
    HematopoieticStemCellTransplantationRelationshipDeathMainReasonDiagnosisSpecify
    Item
    Specify: (Answer only if the response to CDE 2768637 is "Other".)
    text
    C25648 (NCI Thesaurus ObjectClass)
    C0439849 (UMLS 2011AA ObjectClass)
    C28554 (NCI Thesaurus ObjectClass)
    C0011065 (UMLS 2011AA ObjectClass)
    C12551 (NCI Thesaurus ObjectClass)
    C0018956 (UMLS 2011AA ObjectClass)
    C15342 (NCI Thesaurus ObjectClass)
    C0029216 (UMLS 2011AA ObjectClass)
    C25638 (NCI Thesaurus Property)
    C0392360 (UMLS 2011AA Property)
    C25562 (NCI Thesaurus Property)
    C1542147 (UMLS 2011AA Property)
    C25685 (NCI Thesaurus ValueDomain)
    C1521902 (UMLS 2011AA ValueDomain)
    Item Group
    Author Information
    PersonGiven/FirstName
    Item
    First Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C40974 (NCI Thesaurus Property)
    C1443235 (UMLS 2011AA Property)
    PersonFamily/LastName
    Item
    Last Name
    text
    C25191 (NCI Thesaurus ValueDomain)
    C1547383 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25364 (NCI Thesaurus Property)
    C0600091 (UMLS 2011AA Property)
    C40975 (NCI Thesaurus Property)
    C1301584 (UMLS 2011AA Property)
    ContactPersonLocationTelephoneNumber
    Item
    Phone number:
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25461 (NCI Thesaurus ObjectClass)
    C0337611 (UMLS 2011AA ObjectClass)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25395 (NCI Thesaurus ValueDomain)
    C0039457 (UMLS 2011AA ValueDomain)
    ContactPersonLocationFaxNumber
    Item
    Fax number:
    text
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C25461 (NCI Thesaurus ObjectClass)
    C0337611 (UMLS 2011AA ObjectClass)
    C25341 (NCI Thesaurus Property)
    C0450429 (UMLS 2011AA Property)
    C25337 (NCI Thesaurus ValueDomain)
    C0237753 (UMLS 2011AA ValueDomain)
    C25210 (NCI Thesaurus ValueDomain)
    C0085205 (UMLS 2011AA ValueDomain)
    PersonEmailAddressText
    Item
    E-mail address:
    text
    C25704 (NCI Thesaurus ValueDomain)
    C1527021 (UMLS 2011AA ValueDomain)
    C25190 (NCI Thesaurus ObjectClass)
    C0027361 (UMLS 2011AA ObjectClass)
    C42775 (NCI Thesaurus Property)
    C1705961 (UMLS 2011AA Property)
    Back to the top of the page 

    Help

    Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

    Watch Tutorial