Information:
Error:
ID
44116
Description
ODM form derived from Amyloidosis EBMT refer to: http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx
Link
Keywords
Versions (4)
- 6/19/16 6/19/16 -
- 8/20/16 8/20/16 -
- 4/10/21 4/10/21 - Ahmed Rafee, MD
- 9/20/21 9/20/21 -
Copyright Holder
folgt
Uploaded on
September 20, 2021
DOI
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License
Creative Commons BY 4.0
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EBMT Amyloidosis
Similar models
EBMT Amyloidosis
- StudyEvent: ODM
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
integer
C2348585 (UMLS CUI [1,1])
C3826859 (UMLS CUI [1,2])
C3826859 (UMLS CUI [1,2])
Hospital
Item
Name of the hospital
text
C0019994 (UMLS CUI [1])
Unit
Item
Unit
integer
C1519795 (UMLS CUI [1])
Contact person
Item
Name of contact person
text
C0337611 (UMLS CUI [1])
Telephone
Item
Telephone number
integer
C1515258 (UMLS CUI [1])
Fax
Item
Fax
integer
C1549619 (UMLS CUI [1])
E-Mail
Item
E-Mail
integer
C1705961 (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])
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])
Unique Identification Code (UIC)
Item
Unique Identification Code (UIC)
integer
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number or Code
Item
Hospital Unique Patient Number or Code
text
C1827636 (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])
CL Item
Male (1)
C1706180 (UMLS CUI-1)
CL Item
Female (2)
C0086287 (UMLS CUI-1)
ABO Group
Item
ABO Group
integer
C0000778 (UMLS CUI [1])
Rh factor
Item
Rh factor
boolean
C0035403 (UMLS CUI [1])
Date of diagnosis
Item
Date of diagnosis
date
C2316983 (UMLS CUI [1])
Item
Check the disease for which this transplant was performed
integer
C0277554 (UMLS CUI [1])
CL Item
Acute Leukaemia (Acute Leukaemia)
C0085669 (UMLS CUI-1)
CL Item
Acute Myelogenous Leukaemia (AML) (Acute Myelogenous Leukaemia (AML))
C0023467 (UMLS CUI-1)
CL Item
Acute Lymphoblastic Leukaemia (ALL) (Acute Lymphoblastic Leukaemia (ALL))
C0023449 (UMLS CUI-1)
CL Item
Secondary Acute Leukaemia (do not use if transformed from MDS/MPN) (Secondary Acute Leukaemia (do not use if transformed from MDS/MPN))
C0856053 (UMLS CUI-1)
CL Item
Chronic Leukaemia (Chronic Leukaemia)
C0856053 (UMLS CUI-1)
CL Item
Chronic Myeloid Leukaemia (CML) (Chronic Myeloid Leukaemia (CML))
C0023473 (UMLS CUI-1)
CL Item
Chronic Lymphocytic Leukaemia (Chronic Lymphocytic Leukaemia)
C0023434 (UMLS CUI-1)
CL Item
Lymphoma (Lymphoma)
C0024299 (UMLS CUI-1)
CL Item
Non Hodgkin (Non Hodgkin)
C0024305 (UMLS CUI-1)
CL Item
Myeloma/ Plasma cell disorder (Myeloma/ Plasma cell disorder)
C0026764 (UMLS CUI-1)
CL Item
Solid Tumour (Solid Tumour)
C0006826 (UMLS CUI-1)
CL Item
Myelodysplastic syndromes (Myelodysplastic syndromes)
C0280450 (UMLS CUI-1)
CL Item
MDS (MDS)
C3463824 (UMLS CUI-1)
CL Item
MD/ MPN (MD/ MPN)
C1292778 (UMLS CUI-1)
CL Item
Myeloproliferative neoplasm (Myeloproliferative neoplasm)
C1333046 (UMLS CUI-1)
CL Item
Bone marrow failure including Aplastic anaemia (Bone marrow failure including Aplastic anaemia)
C0002874 (UMLS CUI-1)
CL Item
Inherited disorders (Inherited disorders)
C0019247 (UMLS CUI-1)
CL Item
Primary immune deficiencies (Primary immune deficiencies)
C0398686 (UMLS CUI-1)
CL Item
Metabolic disorders (Metabolic disorders)
C0025517 (UMLS CUI-1)
CL Item
Histiocytic disorders (Histiocytic disorders)
C0398597 (UMLS CUI-1)
CL Item
Autoimmune disease (Autoimmune disease)
C0004364 (UMLS CUI-1)
CL Item
Juvenile Idiopathic Arthritis (Juvenile Idiopathic Arthritis)
C1444841 (UMLS CUI-1)
CL Item
Multiple Sclerosis (Multiple Sclerosis)
C0026769 (UMLS CUI-1)
CL Item
Systemic Lupus (Systemic Lupus)
C0024141 (UMLS CUI-1)
CL Item
Systemic Sclerosis (Systemic Sclerosis)
C0036421 (UMLS CUI-1)
CL Item
Other diagnosis (Other diagnosis)
C0205394 (UMLS CUI-1)
CL Item
Hodgkin´s Disease (Hodgkin´s Disease)
C0019829 (UMLS CUI-1)
CL Item
Haemoglobinopathies (Haemoglobinopathies)
C0019045 (UMLS CUI-1)
Item
Has the information requested in this section been submitted with a previous HSCT registration for this patient?
integer
C2348568 (UMLS CUI [1])
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 3, Pre-HSCT Treatment (1)
CL Item
No: proceed with this section (2)
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
Item
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
boolean
C1959632 (UMLS CUI [1])
Item
In case of EVIDENCE OF UNDERLYING PLASMA CELL DISORDER, please specify:
integer
Code List
In case of EVIDENCE OF UNDERLYING PLASMA CELL DISORDER, please specify:
CL Item
Monoclonal Gammopathy (Monoclonal Gammopathy)
C1136085 (UMLS CUI-1)
CL Item
Multiple Myeloma (Multiple Myeloma)
C0026764 (UMLS CUI-1)
CL Item
Other B-cell malignancy (Other B-cell malignancy)
C1868683 (UMLS CUI-1)
If Other B-cell malignancy, specify
Item
If Other B-cell malignancy, specify
text
CL Item
IgG (1)
C0202087 (UMLS CUI-1)
CL Item
IgA (2)
C0202083 (UMLS CUI-1)
CL Item
IgD (3)
C0577612 (UMLS CUI-1)
CL Item
IgE (4)
C0020846 (UMLS CUI-1)
CL Item
IgM (5)
C0202084 (UMLS CUI-1)
CL Item
Absent (6)
C0332197 (UMLS CUI-1)
CL Item
Not evaluated (7)
C3846720 (UMLS CUI-1)
Item
PLASMA CELL DISORDER light chain
integer
C1959632 (UMLS CUI [1,1])
C0021038 (UMLS CUI [1,2])
C0021038 (UMLS CUI [1,2])
CL Item
Kappa (1)
CL Item
Lambda (2)
CL Item
Absent (3)
CL Item
Not evaluated (4)
Item
If Multiple myeloma: Stage at diagnosis (Salmon and Durie) A
integer
C0278722 (UMLS CUI [1])
Code List
If Multiple myeloma: Stage at diagnosis (Salmon and Durie) A
CL Item
I (I)
CL Item
II (II)
CL Item
III (III)
If Multiple myeloma: Stage at diagnosis (Salmon and Durie) B
Item
If Multiple myeloma: Stage at diagnosis (Salmon and Durie) B
boolean
C0278722 (UMLS CUI [1,1])
C0026764 (UMLS CUI [1,2])
C0026764 (UMLS CUI [1,2])
CL Item
Excluded (1)
C1277606 (UMLS CUI-1)
CL Item
Not evaluated (2)
C3846720 (UMLS CUI-1)
Item
DIAGNOSIS OF AMYLOIDOSIS via Immunohistochemistry
integer
C0021044 (UMLS CUI [1,1])
C0740340 (UMLS CUI [1,2])
C0740340 (UMLS CUI [1,2])
CL Item
Done (Done)
CL Item
Not evaluated (Not evaluated)
Item
CLINICAL AND LABORATORY DATA
integer
C1516606 (UMLS CUI [1,1])
C1254595 (UMLS CUI [1,2])
C1254595 (UMLS CUI [1,2])
CL Item
Serum creatinine (1)
C0201976 (UMLS CUI-1)
CL Item
Hb (g/dL) (2)
C0019046 (UMLS CUI-1)
CL Item
Total urinary protein excretion (mg/24 h) (3)
C0033687 (UMLS CUI-1)
CL Item
Total urinary albumin excretion (mg/24 h) (4)
C2362049 (UMLS CUI-1)
CL Item
Serum calcium (mmol/L) (5)
C0036785 (UMLS CUI-1)
CL Item
Serum albumin (g/L) (6)
C0036773 (UMLS CUI-1)
CL Item
Serum alkaline phosphatase (IU/L) (7)
C0428334 (UMLS CUI-1)
CL Item
Serum bilirubin (8)
C1278039 (UMLS CUI-1)
CL Item
NT-proBNP (ng/L) (9)
C0754710 (UMLS CUI-1)
CL Item
Serum c-Troponin T (μg/L) (10)
C0077404 (UMLS CUI-1)
BM aspirate
Item
BM aspirate: % plasmacytosis
float
C0857285 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
C0085663 (UMLS CUI [1,2])
BM trephine
Item
BM trephine % plasmacytosis
float
C0398526 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
C0085663 (UMLS CUI [1,2])
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
C1532873 (UMLS CUI [1,1])
C3516447 (UMLS CUI [1,2])
C3516447 (UMLS CUI [1,2])
CL Item
Negative (1)
CL Item
Positive (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Not evaluated (1)
CL Item
Not evaluated (1)
CL Item
Negative (1)
CL Item
Positive (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
integer
C0004965 (UMLS CUI [1])
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
C0005149 (UMLS CUI [1])
CL Item
Normal (1)
C0205307 (UMLS CUI-1)
CL Item
Lytic lesion (2)
C0221204 (UMLS CUI-1)
CL Item
Not evaluated (3)
C3846720 (UMLS CUI-1)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
CL Item
Absent (1)
CL Item
Present (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Absent (1)
CL Item
Present (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Absent (1)
CL Item
Present (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Dominant organ(s) involved (Dominant organ(s) involved)
C1527180 (UMLS CUI-1)
CL Item
Additional organ involvement (Additional organ involvement)
C0457576 (UMLS CUI-1)
CL Item
Biopsy (Biopsy)
C0005558 (UMLS CUI-1)
CL Item
No involvement (No involvement)
C1517677 (UMLS CUI-1)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
integer
C1148377 (UMLS CUI [1])
Code List
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
CL Item
Not evaluated (1)
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
CL Item
not done (99)
LVEF
Item
Left Ventricular Ejection Fraction
float
C0428772 (UMLS CUI [1])
Interventricular septal wall thickness
Item
Interventricular septal wall thickness
float
C0801204 (UMLS CUI [1])
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Other evidence of gastrointestinal involvement
Item
If other evidence of gastrointestinal involvement, please specify
integer
C0521362 (UMLS CUI [1])
CL Item
Normal (Normal )
CL Item
Abnormal ( Abnormal )
CL Item
Not evaluated or failed ( Not evaluated or failed )
CL Item
Unknown ( Unknown)
Neurological exam
Item
Neurological exam: If abnormal: Specify abnormality
integer
C0027853 (UMLS CUI [1])
CL Item
grade I (1)
CL Item
grade II (2)
CL Item
grade III (3)
CL Item
grade IV (4)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Other sites
Item
Clinical evidence for involvement of other sites
text
C0012634 (UMLS CUI [1,1])
C0450429 (UMLS CUI [1,2])
C0450429 (UMLS CUI [1,2])
WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?
Item
WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?
boolean
C0420262 (UMLS CUI [1])
Chemotherapy
Item
Chemotherapy
boolean
C0392920 (UMLS CUI [1])
CL Item
Chemotherapy regimen (Chemotherapy regimen)
CL Item
Number of cycles (Number of cycles)
Modality
Item
If Other Modality, please specify
integer
C0695347 (UMLS CUI [1])
DATE OF HSCT
Item
DATE OF HSCT
date
C2584899 (UMLS CUI [1])
HSCT TYPE
Item
HSCT TYPE Allogeneic:
boolean
C1515895 (UMLS CUI [1])
Autologous: Date of 1st collection or pheresis
Item
Autologous: Date of 1st collection or pheresis
date
C2584899 (UMLS CUI [1])
Item Group
STATUS OF DISEASE AT COLLECTION (AUTOGRAFTS ONLY)
CL Item
At diagnosis (At diagnosis )
CL Item
CR1 ( CR1 )
C0677874 (UMLS CUI-1)
CL Item
CR2 ( CR2 )
C0677874 (UMLS CUI-1)
CL Item
>CR2 ( >CR2 VNUMSTM)
C0677874 (UMLS CUI-1)
CL Item
PR1 ( PR1 )
C1521726 (UMLS CUI-1)
CL Item
PR2 (PR2 )
C1521726 (UMLS CUI-1)
CL Item
>PR2 ( >PR2 )
C1521726 (UMLS CUI-1)
CL Item
MR (MR)
CL Item
No change ( No change )
C0442739 (UMLS CUI-1)
CL Item
Progression ( Progression )
C0242656 (UMLS CUI-1)
CL Item
Unknown ( Unknown)
C0439673 (UMLS CUI-1)
CL Item
Response (2)
C0521982 (UMLS CUI-1)
CL Item
No change (3)
C0442739 (UMLS CUI-1)
CL Item
Progression (4)
C0242656 (UMLS CUI-1)
CL Item
Unknown (5)
C0439673 (UMLS CUI-1)
Item Group
STATUS OF DISEASE AT START OF CONDITIONING FOR BMT
Item
Haematological status
integer
C0279810 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
C0449438 (UMLS CUI [1,2])
CL Item
At diagnosis (At diagnosis )
CL Item
CR1 (CR1 )
C0449438 (UMLS CUI-1)
CL Item
CR2 ( CR2 )
C0449438 (UMLS CUI-1)
CL Item
>CR2 ( >CR2 )
C0449438 (UMLS CUI-1)
CL Item
PR1 ( PR1 )
C1521726 (UMLS CUI-1)
CL Item
PR2 ( PR2 )
C1521726 (UMLS CUI-1)
CL Item
>PR2 ( >PR2 )
C1521726 (UMLS CUI-1)
CL Item
MR ( MR)
CL Item
No change ( No change )
C0443172 (UMLS CUI-1)
CL Item
Progression (Progression )
C0242656 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
CL Item
Response (2)
C0521982 (UMLS CUI-1)
CL Item
No change (3)
C0442739 (UMLS CUI-1)
CL Item
Progression (4)
C0242656 (UMLS CUI-1)
CL Item
Unknown (5)
C0439673 (UMLS CUI-1)
Hb
Item
Hb
float
C0019046 (UMLS CUI [1])
Item
CLINICAL AND LABORATORY DATA
integer
C1516606 (UMLS CUI [1,1])
C1254595 (UMLS CUI [1,2])
C1254595 (UMLS CUI [1,2])
CL Item
Serum creatinine (1)
C0201976 (UMLS CUI-1)
CL Item
Hb (g/dL) (2)
C0019046 (UMLS CUI-1)
CL Item
Total urinary protein excretion (mg/24 h) (3)
C0033687 (UMLS CUI-1)
CL Item
Total urinary albumin excretion (mg/24 h) (4)
C2362049 (UMLS CUI-1)
CL Item
Serum calcium (mmol/L) (5)
C0036785 (UMLS CUI-1)
CL Item
Serum albumin (g/L) (6)
C0036773 (UMLS CUI-1)
CL Item
Serum alkaline phosphatase (IU/L) (7)
C0428334 (UMLS CUI-1)
CL Item
Serum bilirubin (8)
C1278039 (UMLS CUI-1)
CL Item
NT-proBNP (ng/L) (9)
C0754710 (UMLS CUI-1)
CL Item
Serum c-Troponin T (μg/L) (10)
C0077404 (UMLS CUI-1)
BM aspirate
Item
BM aspirate: % plasmacytosis
float
C0857285 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
C0085663 (UMLS CUI [1,2])
BM trephine
Item
BM trephine % plasmacytosis
float
C0398526 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
C0085663 (UMLS CUI [1,2])
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
C1532873 (UMLS CUI [1,1])
C3516447 (UMLS CUI [1,2])
C3516447 (UMLS CUI [1,2])
CL Item
Negative (1)
CL Item
Positive (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Not evaluated (1)
CL Item
Not evaluated (1)
CL Item
Negative (1)
CL Item
Positive (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
integer
C0004965 (UMLS CUI [1])
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
C0005149 (UMLS CUI [1])
CL Item
Dominant organ(s) involved (Dominant organ(s) involved)
C1527180 (UMLS CUI-1)
CL Item
Additional organ involvement (Additional organ involvement)
C0457576 (UMLS CUI-1)
CL Item
Biopsy (Biopsy)
C0005558 (UMLS CUI-1)
CL Item
No involvement (No involvement)
C1517677 (UMLS CUI-1)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
integer
C1148377 (UMLS CUI [1])
Code List
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
CL Item
Not evaluated (1)
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
CL Item
not done (99)
LVEF
Item
Left Ventricular Ejection Fraction
float
C0428772 (UMLS CUI [1])
Interventricular septal wall thickness
Item
Interventricular septal wall thickness
float
C0801204 (UMLS CUI [1])
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Other evidence of gastrointestinal involvement
Item
If other evidence of gastrointestinal involvement, please specify
integer
C0521362 (UMLS CUI [1])
CL Item
Normal (Normal )
CL Item
Abnormal ( Abnormal )
CL Item
Not evaluated or failed ( Not evaluated or failed )
CL Item
Unknown ( Unknown)
Neurological exam
Item
Neurological exam: If abnormal: Specify abnormality
integer
C0027853 (UMLS CUI [1])
CL Item
grade I (1)
CL Item
grade II (2)
CL Item
grade III (3)
CL Item
grade IV (4)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Other sites
Item
Clinical evidence for involvement of other sites
text
C0012634 (UMLS CUI [1,1])
C0450429 (UMLS CUI [1,2])
C0450429 (UMLS CUI [1,2])
Item
BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS
text
Code List
BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS
CL Item
CR1 (CR1 )
CL Item
CR2 ( CR2 )
CL Item
>CR2 ( >CR2)
CL Item
PR1 (PR1 )
CL Item
PR2 (PR2 )
CL Item
>PR2 ( >PR2 )
CL Item
MR ( MR)
CL Item
No change (No change )
CL Item
Progression ( Progression )
CL Item
Not evaluable (Not evaluable )
CL Item
Unknown ( Unknown)
DATE RESPONSE ACHIEVED OR ASSESSED
Item
DATE RESPONSE ACHIEVED OR ASSESSED
date
Item
CLINICAL AND LABORATORY DATA
integer
C1516606 (UMLS CUI [1,1])
C1254595 (UMLS CUI [1,2])
C1254595 (UMLS CUI [1,2])
CL Item
Serum creatinine (1)
C0201976 (UMLS CUI-1)
CL Item
Hb (g/dL) (2)
C0019046 (UMLS CUI-1)
CL Item
Total urinary protein excretion (mg/24 h) (3)
C0033687 (UMLS CUI-1)
CL Item
Total urinary albumin excretion (mg/24 h) (4)
C2362049 (UMLS CUI-1)
CL Item
Serum calcium (mmol/L) (5)
C0036785 (UMLS CUI-1)
CL Item
Serum albumin (g/L) (6)
C0036773 (UMLS CUI-1)
CL Item
Serum alkaline phosphatase (IU/L) (7)
C0428334 (UMLS CUI-1)
CL Item
Serum bilirubin (8)
C1278039 (UMLS CUI-1)
CL Item
NT-proBNP (ng/L) (9)
C0754710 (UMLS CUI-1)
CL Item
Serum c-Troponin T (μg/L) (10)
C0077404 (UMLS CUI-1)
Serum creatinine
Item
Serum creatinine
float
C0201976 (UMLS CUI [1])
Creatinine clearance (mL/min)
Item
Creatinine clearance (mL/min)
float
C0373595 (UMLS CUI [1])
Total urinary protein excretion (mg/24 h)
Item
Total urinary protein excretion (mg/24 h)
float
C3897352 (UMLS CUI [1])
Total urinary albumin excretion (mg/24 h)
Item
Total urinary albumin excretion (mg/24 h)
float
C0585937 (UMLS CUI [1])
Serum NT-pro-BNP (ng/L)
Item
Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
float
Serum c-Troponin T (μg/L)
Item
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
float
BM aspirate
Item
BM aspirate: % plasmacytosis
float
C0857285 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
C0085663 (UMLS CUI [1,2])
BM trephine
Item
BM trephine % plasmacytosis
float
C0398526 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
C0085663 (UMLS CUI [1,2])
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
C1532873 (UMLS CUI [1,1])
C3516447 (UMLS CUI [1,2])
C3516447 (UMLS CUI [1,2])
CL Item
Negative (1)
CL Item
Positive (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Not evaluated (1)
CL Item
Not evaluated (1)
CL Item
Negative (1)
CL Item
Positive (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
integer
C0004965 (UMLS CUI [1])
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
C0005149 (UMLS CUI [1])
Item Group
ORGAN-SPECIFIC RESPONSES AT 100 DAYS AFTER HSCT
CL Item
Response (1)
CL Item
No response/stable disease (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable (4)
CL Item
Not evaluated/not applicable (5)
CL Item
Unknown (6)
Liver span in ultrasound or CT scan
Item
Liver Liver span in ultrasound or CT scan (cm craniocaudal diameter)
float
CL Item
Response (1)
CL Item
No response/stable disease (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable (4)
CL Item
Not evaluated/not applicable (5)
CL Item
Unknown (6)
CL Item
I (I)
CL Item
II (II)
CL Item
III (III)
CL Item
IV (IV)
CL Item
Unknown (Unknown)
Left ventricular ejection fraction
Item
Left ventricular ejection fraction
float
Interventricular septal wall thickness
Item
Interventricular septal wall thickness (mean # mm in echocardiogram)
float
CL Item
Response (Response )
CL Item
No response/stable disease ( No response/stable disease )
CL Item
Progressive disease ( Progressive disease)
CL Item
Not evaluable ( Not evaluable )
CL Item
Not evaluated/not applicable ( Not evaluated/not applicable )
CL Item
Unknown ( Unknown)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Response (1)
CL Item
No response/stable disease (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable (4)
CL Item
Not evaluated/not applicable (5)
CL Item
Unknown (6)
Item
Neurological exam Peripheral neuropathy (Compare current situation to situation before HSCT)
integer
Code List
Neurological exam Peripheral neuropathy (Compare current situation to situation before HSCT)
CL Item
Improved (1)
CL Item
Worsened (2)
CL Item
Unchanged (3)
CL Item
Unknown (4)
Item
PNP severity Peripheral neuropathy (Compare current situation to situation before HSCT)
integer
Code List
PNP severity Peripheral neuropathy (Compare current situation to situation before HSCT)
CL Item
grade I (1)
CL Item
grade II (2)
CL Item
grade III (3)
CL Item
grade IV (4)
Item
PN response Peripheral neuropathy (Compare current situation to situation before HSCT)
integer
Code List
PN response Peripheral neuropathy (Compare current situation to situation before HSCT)
CL Item
Response (Response )
CL Item
Unknown (Unknown)
CL Item
No response/stable disease (No response/stable disease )
CL Item
Progressive disease (Progressive disease)
CL Item
Not evaluable (Not evaluable )
CL Item
Not evaluated/not applicable (Not evaluated/not applicable )
CL Item
Response (Response )
CL Item
No response/stable disease (No response/stable disease )
CL Item
Progressive disease (Progressive disease)
CL Item
Not evaluable (Not evaluable )
CL Item
Not evaluated/not applicable (Not evaluated/not applicable )
CL Item
Unknown (Unknown)
Clinical evidence for involvement of new sites
Item
Clinical evidence for involvement of new sites Evidence of new organ involvement
text
KARNOFSKY
Item
KARNOFSKY
text
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))
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])
Initialen
Item
Initials
text
C2986440 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Date of HSCT
Item
Date of HSCT
date
C2584899 (UMLS CUI [1])
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
Code List
Complete haematological remission obtained after the HSCT in the absence of additional disease treatment
CL Item
Previously reported (1)
CL Item
Yes, date (2)
CL Item
No (3)
CL Item
Unknown (4)
Item Group
GRAFT VERSUS HOST DISEASE (GvHD) SINCE LAST REPORT
Item
Maximum Grade of Acute GVHD
text
C0856825 (UMLS CUI [1,1])
C0806909 (UMLS CUI [1,2])
C0441800 (UMLS CUI [1,3])
C1561607 (UMLS CUI [1,4])
C0806909 (UMLS CUI [1,2])
C0441800 (UMLS CUI [1,3])
C1561607 (UMLS CUI [1,4])
CL Item
Agvhd Grade 0 (0)
CL Item
Agvhd Grade I (I)
CL Item
Agvhd Grade Ii (II)
CL Item
Agvhd Grade Iii (III)
CL Item
Agvhd Grade Iv (IV)
CL Item
Agvhd Present, Grade Unknown (Present, grade unknown)
CL Item
New onset (1)
CL Item
Recurrent (2)
CL Item
Persistent (3)
CL Item
Unexplained (Unexplained)
C0439673 (UMLS CUI-1)
CL Item
Tapering (Tapering)
C0441640 (UMLS CUI-1)
CL Item
DLI (DLI)
C1512034 (UMLS CUI-1)
Date onset of this episode
Item
Date onset of this episode (if new or recurrent)
date
C0574845 (UMLS CUI [1])
CL Item
Stage skin (1)
C1610605 (UMLS CUI-1)
CL Item
Stage liver (2)
C1610054 (UMLS CUI-1)
CL Item
Stage gut (3)
C0856825 (UMLS CUI-1)
C0017178 (UMLS CUI-2)
C0017178 (UMLS CUI-2)
CL Item
No (1)
CL Item
Yes (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])
C1514893 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Present continously since last reported episode (Present continously since last reported episode)
CL Item
Resolved (Resolved)
CL Item
First episode (1)
C0439615 (UMLS CUI-1)
CL Item
Recurrence (2)
C0034897 (UMLS CUI-1)
cGvHD Date of onset
Item
cGvHD Date of onset
date
C0867389 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
CL Item
limited (1)
CL Item
Extensive (2)
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)
Date of Resolution
Item
If resolved, specify the date of resolution:
date
C1514893 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Infection related complications
Item
Infection related complications
boolean
C0009450 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])
C0009566 (UMLS CUI [1,2])
Item
Bacteraemia / fungemia / viremia / parasites
integer
C0004610 (UMLS CUI [1])
C0085082 (UMLS CUI [2])
C0042749 (UMLS CUI [3])
C0030498 (UMLS CUI [4])
C0085082 (UMLS CUI [2])
C0042749 (UMLS CUI [3])
C0030498 (UMLS CUI [4])
CL Item
Pathogen (1)
CL Item
Date (2)
CL Item
Pathogen (1)
CL Item
Date (2)
CL Item
Pathogen (1)
CL Item
Date (2)
Item
Multiorgan failure due to infection
integer
C0026766 (UMLS CUI [1])
CL Item
Pathogen (1)
CL Item
Date (2)
CL Item
Pathogen (1)
CL Item
Date (2)
CL Item
Pathogen (1)
CL Item
Date (2)
CL Item
Pathogen (1)
CL Item
Pathogen (1)
CL Item
Date (2)
CL Item
Pathogen (1)
CL Item
Date (2)
Skin infection
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
CL Item
Pathogen (1)
CL Item
Date (2)
CL Item
Pathogen (1)
CL Item
Date (2)
CL Item
Pathogen (1)
CL Item
Date (2)
Non infection related complications
Item
Non infection related complications
boolean
C0009566 (UMLS CUI [1])
Item
CTC grade Cardiovascular
integer
C0007226 (UMLS CUI [1,1])
C1516728 (UMLS CUI [1,2])
C1516728 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Cardiovascular
Item
Date Cardiovascular
date
C0007222 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
Cardiovascular comments
Item
Cardiovascular comments
integer
C0947611 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
C0007222 (UMLS CUI [1,2])
Item
CTC grade Dermatologic
integer
C1516728 (UMLS CUI [1,1])
C0205489 (UMLS CUI [1,2])
C0205489 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Dermatologic
Item
Date Dermatologic
date
C0205489 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
Dermatologic
Item
Comments
text
C0947611 (UMLS CUI [1,1])
C0205489 (UMLS CUI [1,2])
C0205489 (UMLS CUI [1,2])
Item
CTC grade Gastrointestinal
integer
C1516728 (UMLS CUI [1,1])
C0521362 (UMLS CUI [1,2])
C0521362 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Gastrointestinal
Item
Date Gastrointestinal
date
C0521362 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
Gastrointestinal Comments
Item
Gastrointestinal Comments
text
C0521362 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
C0947611 (UMLS CUI [1,2])
Item
CTC grade Haemorrhage
integer
C1516728 (UMLS CUI [1,1])
C0019080 (UMLS CUI [1,2])
C0019080 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Haemorrhage
Item
Date Haemorrhage
date
C1516728 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
Haemorrhage Comments
Item
Haemorrhage Comments
text
C1516728 (UMLS CUI [1])
Item
CTC grade Hepatic
integer
C1516728 (UMLS CUI [1,1])
C0205054 (UMLS CUI [1,2])
C0205054 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Hepatic
Item
Date Hepatic
date
C1516728 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
Hepatic Comments
Item
Hepatic Comments
text
C1516728 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
C0947611 (UMLS CUI [1,2])
Item
CTC grade Neurologic
integer
C1516728 (UMLS CUI [1,1])
C0205494 (UMLS CUI [1,2])
C0205494 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Neurologic
Item
Date Neurologic
date
C1516728 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
Neurologic Comments
Item
Neurologic Comments
text
C2316983 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
C0947611 (UMLS CUI [1,2])
Item
CTC grade Pulmonary
integer
C1516728 (UMLS CUI [1,1])
C0024109 (UMLS CUI [1,2])
C0024109 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Pulmonary Date
Item
Pulmonary Date
date
C1516728 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
Pulmonary Comments
Item
Pulmonary Comments
text
C1516728 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
C0947611 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Renal Date
Item
Renal Date
date
C0022646 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
Renal Comments
Item
Renal Comments
text
C0022646 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
C0947611 (UMLS CUI [1,2])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date of other Type
Item
Date of other Type
date
C2316983 (UMLS CUI [1,1])
C0220886 (UMLS CUI [1,2])
C0220886 (UMLS CUI [1,2])
Comments of Other type
Item
Comments of Other type
text
C0220886 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
C0947611 (UMLS CUI [1,2])
CL Item
No (No)
C1298908 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
CL Item
Not evaluated (Not evaluated)
C3846720 (UMLS CUI-1)
CL Item
Full (donor >95 %) (1)
CL Item
Mixed (partial) (2)
CL Item
Autologous reconstitution (recipient >95 %) (3)
CL Item
Aplasia (4)
CL Item
Not evaluated (5)
Item Group
GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM
Date of Test
Item
Date of Test
date
C0011008 (UMLS CUI [1])
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])
Item
Cell type on which test was performed BM
integer
C0449475 (UMLS CUI [1,1])
C0022885 (UMLS CUI [1,2])
C0022885 (UMLS CUI [1,2])
CL Item
Bone marrow (1)
C0005953 (UMLS CUI-1)
CL Item
PB mononuclear cells (PBMC) (2)
C1321301 (UMLS CUI-1)
CL Item
T-cell (3)
C0039194 (UMLS CUI-1)
CL Item
B-cells (4)
C0004561 (UMLS CUI-1)
CL Item
Red blood cells (5)
C0014772 (UMLS CUI-1)
CL Item
Monocytes (6)
C0026473 (UMLS CUI-1)
CL Item
PMNs (neutrophils) (7)
C0200633 (UMLS CUI-1)
CL Item
Lymphocytes (8)
C0024264 (UMLS CUI-1)
CL Item
Myeloid cells (9)
C0887899 (UMLS CUI-1)
CL Item
Other (10)
C0205394 (UMLS CUI-1)
CL Item
FISH (FISH)
C0162789 (UMLS CUI-1)
CL Item
Molecular (Molecular)
C0026376 (UMLS CUI-1)
CL Item
Cytogenetic (Cytogenetic)
C0010802 (UMLS CUI-1)
CL Item
ABO group (ABO group)
C0000778 (UMLS CUI-1)
CL Item
Other (Other)
C0205394 (UMLS CUI-1)
CL Item
unknown (unknown)
C0439673 (UMLS CUI-1)
Item
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
integer
C3266877 (UMLS CUI [1])
C0024314 (UMLS CUI [2])
C0027022 (UMLS CUI [3])
C0024314 (UMLS CUI [2])
C0027022 (UMLS CUI [3])
Code List
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
CL Item
Previously reported (1)
C0205309 (UMLS CUI-1)
CL Item
Yes (2)
C1705108 (UMLS CUI-1)
CL Item
No at date of this follow-up (3)
C1298908 (UMLS CUI-1)
Date of diagnosis
Item
Date of diagnosis
date
C2316983 (UMLS CUI [1,1])
C1274082 (UMLS CUI [1,2])
C1274082 (UMLS CUI [1,2])
Item
Diagnosis Secondary Malignant Neoplasm
integer
C0011900 (UMLS CUI [1,1])
C2939419 (UMLS CUI [1,2])
C2939419 (UMLS CUI [1,2])
CL Item
AML (1)
C0023467 (UMLS CUI-1)
CL Item
MDS (2)
C3463824 (UMLS CUI-1)
CL Item
Lymphoproliferative disorder (3)
C0024314 (UMLS CUI-1)
CL Item
Other (4)
C0205394 (UMLS CUI-1)
If other diagnosis, please specify
Item
If other diagnosis, please specify
text
C0011900 (UMLS CUI [1,1])
C2939419 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
C2939419 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Date started
Item
Date started
date
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
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)
Item
Disease status before this cellular therapy
integer
C0012634 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0012634 (UMLS CUI [1,2])
CL Item
CR (1)
CL Item
Not in CR (2)
CL Item
Not evaluated (3)
CL Item
Donor lymphocyte infusion (DLI) (1)
CL Item
Mesenchymal cells (2)
CL Item
Other (3)
CL Item
Unknown (4)
Item
If DLI, specify the number of cells infused by type: Nucleated cells
text
C1180059 (UMLS CUI [1])
CL Item
Evaluated (Evaluated)
CL Item
Not evaluated (Not evaluated)
CL Item
unknown (unknown)
Item
Number of cells infused by type
integer
C2145394 (UMLS CUI [1])
CL Item
Nucleated cells (1)
CL Item
CD 34+ (2)
CL Item
CD 3+ (3)
Item
Total number of cells
text
C0007584 (UMLS CUI [1,1])
C2145394 (UMLS CUI [1,2])
C2145394 (UMLS CUI [1,2])
CL Item
Evaluated (Evaluated)
CL Item
Not Evaluated (Not Evaluated)
CL Item
Unknown (Unknown)
Chronological number
Item
Chronological number of this cell therapy for this patient
float
C2348184 (UMLS CUI [1])
Item
Indication (check all that apply)
text
C3146298 (UMLS CUI [1,1])
C0302189 (UMLS CUI [1,2])
C0302189 (UMLS CUI [1,2])
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)
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])
C0750480 (UMLS CUI [1,2])
Item
Maximum Grade of Acute GVHD
text
C0856825 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
C0441800 (UMLS CUI [1,2])
CL Item
Agvhd Grade 0 (0)
CL Item
Agvhd Grade I (I)
CL Item
Agvhd Grade Ii (II)
CL Item
Agvhd Grade Iii (III)
CL Item
Agvhd Grade Iv (IV)
CL Item
Agvhd Present, Grade Unknown (Present, grade unknown)
Item
Disease treatment (apart from donor cell infusion or other type of cell therapy)
integer
C0087111 (UMLS CUI [1])
Code List
Disease treatment (apart from donor cell infusion or other type of cell therapy)
CL Item
No (1)
CL Item
Yes: Planned (planned before HSCT took place) (2)
CL Item
Yes: Not planned (for relapse/progression or persistent disease) (3)
Item Group
FIRST EVIDENCE OF DISEASE WORSENING SINCE LAST HSCT
CL Item
Previously reported (Previously reported)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Continuous worsening since HSCT (Continuous worsening since HSCT)
CL Item
Unknown (Unknown)
EVIDENCE OF DISEASE ACTIVITY
Item
If yes, date first noted
date
C0544450 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
C2316983 (UMLS CUI [1,2])
Item
HAEMATOLOGICAL DISEASE STATUS
integer
C0018939 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
C0449438 (UMLS CUI [1,2])
CL Item
Complete remission (Complete remission)
CL Item
Partial remission (Partial remission)
CL Item
Stable disease (Stable disease)
CL Item
Progression (Progression)
CL Item
Not evaluable (Not evaluable)
CL Item
Unknown (Unknown)
CL Item
Response (1)
CL Item
Non Response (2)
CL Item
Progression (3)
CL Item
Not evaluable (4)
CL Item
Unknown (5)
Item
CLINICAL AND LABORATORY DATA
integer
C1516606 (UMLS CUI [1,1])
C1254595 (UMLS CUI [1,2])
C1254595 (UMLS CUI [1,2])
CL Item
Serum creatinine (1)
C0201976 (UMLS CUI-1)
CL Item
Hb (g/dL) (2)
C0019046 (UMLS CUI-1)
CL Item
Total urinary protein excretion (mg/24 h) (3)
C0033687 (UMLS CUI-1)
CL Item
Total urinary albumin excretion (mg/24 h) (4)
C2362049 (UMLS CUI-1)
CL Item
Serum calcium (mmol/L) (5)
C0036785 (UMLS CUI-1)
CL Item
Serum albumin (g/L) (6)
C0036773 (UMLS CUI-1)
CL Item
Serum alkaline phosphatase (IU/L) (7)
C0428334 (UMLS CUI-1)
CL Item
Serum bilirubin (8)
C1278039 (UMLS CUI-1)
CL Item
NT-proBNP (ng/L) (9)
C0754710 (UMLS CUI-1)
CL Item
Serum c-Troponin T (μg/L) (10)
C0077404 (UMLS CUI-1)
BM aspirate
Item
BM aspirate: % plasmacytosis
float
C0857285 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
C0085663 (UMLS CUI [1,2])
BM trephine
Item
BM trephine % plasmacytosis
float
C0398526 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
C0085663 (UMLS CUI [1,2])
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
C1532873 (UMLS CUI [1,1])
C3516447 (UMLS CUI [1,2])
C3516447 (UMLS CUI [1,2])
CL Item
Negative (1)
CL Item
Positive (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Not evaluated (1)
CL Item
Not evaluated (1)
CL Item
Negative (1)
CL Item
Positive (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
integer
C0004965 (UMLS CUI [1])
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
C0005149 (UMLS CUI [1])
CL Item
Response (1)
CL Item
No response/stable disease (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable (4)
CL Item
Not evaluated/not applicable (5)
CL Item
Unknown (6)
Liver span in ultrasound or CT scan
Item
Liver span (cm craniocaudal diameter)
float
CL Item
Response (Response)
CL Item
No response/stable disease (No response/stable disease)
CL Item
Progressive disease (Progressive disease)
CL Item
Not evaluable (Not evaluable)
CL Item
Not evaluated/not applicable (Not evaluated/not applicable)
CL Item
Unknown (Unknown)
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
CL Item
unknown (5)
LVEF
Item
Left Ventricular Ejection Fraction
float
C0428772 (UMLS CUI [1])
Interventricular septal wall thickness
Item
Interventricular septal wall thickness (mean # mm in echocardiogram)
float
C0225870 (UMLS CUI [1])
CL Item
Response (1)
CL Item
No response/stable disease (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable (4)
CL Item
Not evaluated/not applicable (5)
CL Item
Unknown (6)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
CL Item
Response (1)
CL Item
No response/stable disease (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable (4)
CL Item
Not evaluated/not applicable (5)
CL Item
Unknown (6)
CL Item
Improved (1)
CL Item
Worsened (2)
CL Item
Unchanged (3)
CL Item
Unknown (4)
CL Item
grade I (1)
CL Item
grade II (2)
CL Item
grade III (3)
CL Item
grade IV (4)
CL Item
Response (1)
CL Item
No response/stable disease (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable (4)
CL Item
Not evaluated/not applicable (5)
CL Item
Unknown (6)
CL Item
Response (1)
CL Item
No response/stable disease (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable (4)
CL Item
Not evaluated/not applicable (5)
CL Item
Unknown (6)
Evidence of new organ involvement
Item
Evidence of new organ involvement
text
C0457576 (UMLS CUI [1])
Item
Has patient or partner become pregnant after this HSCT?
integer
Code List
Has patient or partner become pregnant after this HSCT?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
alive (0)
CL Item
dead (1)
CL Item
Karnofsky (1)
CL Item
Lansky (2)
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)
CL Item
Due to amyloidosis (progression of disease) (1)
C0002726 (UMLS CUI-1)
C0007465 (UMLS CUI-2)
C0007465 (UMLS CUI-2)
CL Item
Secondary malignancy (including lymphoproliferative disease) (2)
C0007465 (UMLS CUI-1)
C3266877 (UMLS CUI-2)
C3266877 (UMLS CUI-2)
CL Item
HSCT related cause (3)
C0007465 (UMLS CUI-1)
C0472699 (UMLS CUI-2)
C0472699 (UMLS CUI-2)
CL Item
unknown (4)
C0439673 (UMLS CUI-1)
C0007465 (UMLS CUI-2)
C0007465 (UMLS CUI-2)
CL Item
other (5)
C0007465 (UMLS CUI-1)
C0439673 (UMLS CUI-2)
C0439673 (UMLS CUI-2)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Interstitial pneumonitis Cause of death
integer
C0007465 (UMLS CUI [1,1])
C0206061 (UMLS CUI [1,2])
C0206061 (UMLS CUI [1,2])
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
Pulmonary toxicity Cause
integer
C0007465 (UMLS CUI [1,1])
C0919924 (UMLS CUI [1,2])
C0919924 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
bacterial (1)
CL Item
viral (2)
CL Item
fungal (3)
CL Item
parasitic (4)
CL Item
unknown (5)
Item
Rejection / poor graft function
integer
C0018129 (UMLS CUI [1])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Veno-Occlusive disease (VOD)
integer
C0007465 (UMLS CUI [1,1])
C0948441 (UMLS CUI [1,2])
C0948441 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Central nervous system toxicity
integer
C0007465 (UMLS CUI [1,1])
C3160947 (UMLS CUI [1,2])
C3160947 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Gastro intestinal toxicity
integer
C0007465 (UMLS CUI [1,1])
C1142499 (UMLS CUI [1,2])
C1142499 (UMLS CUI [1,2])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other
Item
If other HSCT related cause, please specify
text
Comments
Item
Comments
text
C0947611 (UMLS CUI [1])
IDENTIFICATION & SIGNATURE
Item
IDENTIFICATION & SIGNATURE
text
C0205396 (UMLS CUI [1,1])
C1519316 (UMLS CUI [1,2])
C1519316 (UMLS CUI [1,2])
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