Information: Detta är inte den senaste versionen av datamodellen. Du hittar en versionsöversikt till vänster under versioner. Den senaste versionen hittar du här.
Information:
Fel:
ID
42171
Beskrivning
ODM form derived from EBMT Allograft. please refer to: http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx
Länk
Nyckelord
Versioner (4)
- 2016-07-14 2016-07-14 -
- 2016-08-21 2016-08-21 -
- 2021-04-13 2021-04-13 - Dr. rer. medic Philipp Neuhaus
- 2021-09-20 2021-09-20 -
Uppladdad den
13 april 2021
DOI
För en begäran logga in.
Licens
Creative Commons BY-NC 3.0
Modellkommentarer :
Här kan du kommentera modellen. Med hjälp av pratbubblor i Item-grupperna och Item kan du lägga in specifika kommentarer.
Itemgroup-kommentar för :
Item-kommentar för :
Du måste vara inloggad för att kunna ladda ner formulär. Var vänlig logga in eller registrera dig utan kostnad.
EBMT Allograft
Similar models
EBMT Allograft
- StudyEvent: ODM
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
CL Item
Negative (Negative )
C0205160 (UMLS CUI-1)
CL Item
Positive (Positive )
C1446409 (UMLS CUI-1)
CL Item
Not evaluated (Not evaluated )
C3846720 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
CL Item
Negative (Negative )
C0205160 (UMLS CUI-1)
CL Item
Positive (Positive )
C1446409 (UMLS CUI-1)
CL Item
Not evaluated (Not evaluated )
C3846720 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
CL Item
Negative (Negative )
C0205160 (UMLS CUI-1)
CL Item
Positive (Positive )
C1446409 (UMLS CUI-1)
CL Item
Not evaluated (Not evaluated )
C3846720 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative)
CL Item
Positive (Positive)
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative)
CL Item
Positive (Positive)
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
Item
if other Antibodies in the patient
integer
C0205394 (UMLS CUI [1])
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Specify (Specify)
Item Group
PRE-TRANSPLANT HISTORY OF DOCUMENTED INVASIVE FUNGAL INFECTION SINCE INITIAL DIAGNOSIS
Item
PRE-TRANSPLANT HISTORY OF DOCUMENTED INVASIVE FUNGAL INFECTION SINCE INITIAL DIAGNOSIS
integer
C0026946 (UMLS CUI [1])
Code List
PRE-TRANSPLANT HISTORY OF DOCUMENTED INVASIVE FUNGAL INFECTION SINCE INITIAL DIAGNOSIS
CL Item
No (No)
C1298908 (UMLS CUI-1)
CL Item
Yes (Yes)
C1705108 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
CL Item
Yes (Yes )
CL Item
No (No)
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Unknown (Unknown)
CL Item
Yes (Yes )
CL Item
No (No )
CL Item
Unknown (Unknown)
Other
Item
Other
boolean
C0205394 (UMLS CUI [1])
Other
Item
Other if yes, please specify
integer
C0205394 (UMLS CUI [1])
CL Item
Karnofsky (Karnofsky)
C0206065 (UMLS CUI-1)
CL Item
Lansky (Lansky)
C1522275 (UMLS CUI-1)
CL Item
Not evaluated (Not evaluated)
C3846720 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
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)
Weight
Item
Weight
float
C0005910 (UMLS CUI [1])
Height
Item
Height
float
C0005890 (UMLS CUI [1])
Multiple donors
Item
Multiple donors
boolean
C0013018 (UMLS CUI [1])
Number of donors or different stem cell products of same donor or cord blood units
Item
different stem cell products of same donor or cord blood units
float
C0038250 (UMLS CUI [1])
Item
SOURCE OF STEM CELLS FOR THIS DONOR/PRODUCT
integer
C0038250 (UMLS CUI [1,1])
C0449416 (UMLS CUI [1,2])
C0449416 (UMLS CUI [1,2])
CL Item
Bone marrow (Bone marrow)
CL Item
Peripheral blood (Peripheral blood)
CL Item
Cord blood (Cord blood)
Identification of Donor or Cord Blood Unit given by the centre
Item
Identification of Donor or Cord Blood Unit
integer
C1550613 (UMLS CUI [1])
Number in the infusion order
Item
Number in the infusion order
integer
C0574032 (UMLS CUI [1])
CL Item
HLA-identical sibling (may include non-monozygotic twin) (HLA-identical sibling (may include non-monozygotic twin))
CL Item
Syngeneic (monozygotic twin) (Syngeneic (monozygotic twin))
CL Item
HLA-matched other relative (HLA-matched other relative)
CL Item
HLA-mismatched relative:Degree of allele mismatch (HLA-mismatched relative:Degree of allele mismatch)
CL Item
1 HLA antigen mismatch ALLMISRL (1 HLA antigen mismatch ALLMISRL)
CL Item
> 2 HLA antigen mismatch (> 2 HLA antigen mismatch)
CL Item
Unrelated donor (Unrelated donor)
Name of the Donor registry
Item
Name of the Donor registry
integer
C1549696 (UMLS CUI [1])
BMDW / WMDA code for the donor registry (up to 4 characters)
Item
BMDW / WMDA code for the donor registry (up to 4 characters)
integer
C2987198 (UMLS CUI [1])
Name of the Cord blood bank
Item
Name of the Cord blood bank
integer
C0005770 (UMLS CUI [1])
Eurocord code for the cord blood bank
Item
Eurocord code for the cord blood bank
integer
C0005770 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
C0805701 (UMLS CUI [1,2])
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
match (0)
CL Item
one mismatch (1)
CL Item
2 mismatches (2)
CL Item
not evaluated (N/E)
CL Item
A (A)
CL Item
B (B)
CL Item
AB (AB)
CL Item
O (O)
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
CL Item
Male (1)
C1706180 (UMLS CUI-1)
CL Item
Female (2)
C0015780 (UMLS CUI-1)
Item Group
STATUS OF THE DONOR OR CORD BLOOD UNIT BEFORE HSCT
CL Item
Negative (Negative )
C0205160 (UMLS CUI-1)
CL Item
Positive (Positive )
C1446409 (UMLS CUI-1)
CL Item
Not evaluated (Not evaluated )
C3846720 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
CL Item
Negative (Negative )
C0205160 (UMLS CUI-1)
CL Item
Positive (Positive )
C1446409 (UMLS CUI-1)
CL Item
Not evaluated (Not evaluated )
C3846720 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
CL Item
Negative (Negative )
C0205160 (UMLS CUI-1)
CL Item
Positive (Positive )
C1446409 (UMLS CUI-1)
CL Item
Not evaluated (Not evaluated )
C3846720 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative)
CL Item
Positive (Positive)
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative)
CL Item
Positive (Positive)
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Not evaluated (Not evaluated )
CL Item
Unknown (Unknown)
Item
if other Antibodies in the patient
integer
C0205394 (UMLS CUI [1])
CL Item
Negative (Negative )
CL Item
Positive (Positive )
CL Item
Specify (Specify)
Date of harvest or cord blood collection
Item
Date of harvest or cord blood collection
date
C1512335 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Laboratory / Hospital
Item
Laboratory / Hospital
integer
C0022877 (UMLS CUI [1,1])
C0019994 (UMLS CUI [1,2])
C0019994 (UMLS CUI [1,2])
Unit
Item
Unit
integer
C1519795 (UMLS CUI [1])
telephone number
Item
Contact number
integer
C1515258 (UMLS CUI [1])
Technique
Item
Technique Used
integer
C0034925 (UMLS CUI [1,1])
C0449851 (UMLS CUI [1,2])
C0449851 (UMLS CUI [1,2])
Serology (antigenic) HLA typing
Item
Serology (antigenic) HLA typing done
boolean
C0242318 (UMLS CUI [1])
DNA (Allelic/molecular) HLA typing done
Item
DNA (Allelic/molecular) HLA typing done
boolean
C0242318 (UMLS CUI [1])
Item
DNA (Allelic/molecular) HLA typing done: Locus
integer
C1321760 (UMLS CUI [1])
CL Item
A (A)
CL Item
B (B)
CL Item
C (C)
CL Item
DRB1 (DRB1)
CL Item
DQB1 (DQB1)
CL Item
DPB1 (DPB1)
HLA string
Item
HLA string
integer
C1547402 (UMLS CUI [1,1])
C0019721 (UMLS CUI [1,2])
C0019721 (UMLS CUI [1,2])
NMDP code
Item
NMDP code
integer
C1882036 (UMLS CUI [1,1])
C1827636 (UMLS CUI [1,2])
C1827636 (UMLS CUI [1,2])
Serology (antigenic) HLA typing done
Item
Serology (antigenic) HLA typing done
boolean
C0242318 (UMLS CUI [1])
CL Item
A (A)
C0019728 (UMLS CUI-1)
CL Item
B (B)
C0019737 (UMLS CUI-1)
CL Item
C (C)
C0019751 (UMLS CUI-1)
CL Item
DRB1 (DRB1)
C0122040 (UMLS CUI-1)
CL Item
DQB1 (DQB1)
C0122020 (UMLS CUI-1)
CL Item
DPB1 (DPB1)
C0555918 (UMLS CUI-1)
Identification of donor or Cord Blood Unit given by the centre
Item
Identification of donor or Cord Blood Unit given by the centre
integer
C1827636 (UMLS CUI [1])
Number in the infusion order
Item
Number in the infusion order (if applicable)
text
C0237753 (UMLS CUI [1])
GRAFT MANIPULATION EX-VIVO (INCLUDING T-CELL DEPLETION)
Item
GRAFT MANIPULATION EX-VIVO (INCLUDING T-CELL DEPLETION)
boolean
C0677960 (UMLS CUI [1])
CL Item
No (No )
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Item
if negative selection, specify
integer
C2347338 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,2])
CL Item
B-cell depletion by MoAB (B-cell depletion by MoAB )
C1171324 (UMLS CUI-1)
CL Item
NK cell depletion by MoAB (NK cell depletion by MoAB )
C0022688 (UMLS CUI-1)
CL Item
Elutriation (Elutriation )
C0872136 (UMLS CUI-1)
CL Item
Other (Other)
C0205394 (UMLS CUI-1)
CL Item
T-cell depletion by MoAB (do not enter (T-cell depletion by MoAB (do not enter )
C0677960 (UMLS CUI-1)
Item
if positive selection, splease specify:
integer
C2347644 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,2])
Code List
if positive selection, splease specify:
CL Item
No (No)
C1298908 (UMLS CUI-1)
CL Item
Yes: Monoclonal antibodies (Yes: Monoclonal antibodies)
C3542957 (UMLS CUI-1)
CL Item
unknown (unknown)
C0439673 (UMLS CUI-1)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
CL Item
CD 34+ (CD 34+ )
C3538723 (UMLS CUI-1)
CL Item
Other (Other)
C0205394 (UMLS CUI-1)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Item
GENE MANIPULATION (gene transfer/transduction)
integer
C0947647 (UMLS CUI [1])
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Identification of donor or Cord Blood Unit given by the centre
Item
IF MULTIPLE DONORS: Identification of donor or Cord Blood Unit given by the centre (please, use same ID as in the preceding sheets)
text
Number in the infusion order
Item
Number in the infusion order (if applicable)
text
C0237753 (UMLS CUI [1])
CL Item
Intravenous (IV) (Intravenous (IV))
CL Item
intrabone / intramedullary (intrabone / intramedullary)
CL Item
Other, specify (Other, specify)
CL Item
unknown (unknown)
Route of infusion: If other, please specify:
Item
Route of infusion: If other, please specify:
integer
C1827465 (UMLS CUI [1])
CL Item
DMSO (DMSO)
CL Item
Wash (Rubinstein/New York) (Wash (Rubinstein/New York))
CL Item
Other, specify (Other, specify)
Infusion method: if other, please specify
Item
Infusion method: if other, please specify
integer
C0574032 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,2])
Item
Tests performed after thawing of an aliquot on
integer
C1521902 (UMLS CUI [1])
Code List
Tests performed after thawing of an aliquot on
CL Item
Contiguous segment (Contiguous segment )
C1511492 (UMLS CUI-1)
CL Item
Reference bag (Reference bag )
C0034925 (UMLS CUI-1)
CL Item
unknown (unknown)
C0439673 (UMLS CUI-1)
CL Item
7-AAD (7-AAD)
C0049832 (UMLS CUI-1)
CL Item
Acridine orange-ethidium iodide (Acridine orange-ethidium iodide)
C0001185 (UMLS CUI-1)
CL Item
Trypan blue (Tryptan blue)
C0041213 (UMLS CUI-1)
CL Item
Other, specify (Other, specify)
C1299220 (UMLS CUI-1)
CL Item
Acridine orange-ethidium bromide (Acridine orange-ethidium bromide)
C0001185 (UMLS CUI-1)
CL Item
unknown (unknown)
C0439673 (UMLS CUI-1)
Viability of all cells
Item
Viability of all cells
float
C1516362 (UMLS CUI [1])
Viability of CD34+ cells
Item
Viability of CD34+ cells
float
C1516362 (UMLS CUI [1,1])
C0882849 (UMLS CUI [1,2])
C0882849 (UMLS CUI [1,2])
Item Group
CELLS INFUSED FROM THIS DONOR AND STEM CELL SOURCE COMBINATION
Item
Bone Marrow: Total number of cells actually infused
integer
C2145394 (UMLS CUI [1,1])
C0005953 (UMLS CUI [1,2])
C0005953 (UMLS CUI [1,2])
Code List
Bone Marrow: Total number of cells actually infused
CL Item
CD 34+ (cells/kg*) (1)
CL Item
Nucleated cells (/kg*) (2)
CL Item
T-cells (CD 3+) (cells/kg*) (3)
Item
Bone Marrow: Total number of cells actually infused, specify:
integer
C2145394 (UMLS CUI [1,1])
C0005953 (UMLS CUI [1,2])
C0005953 (UMLS CUI [1,2])
CL Item
Not evaluated (Not evaluated )
CL Item
unknown (unknown)
Item
Peripheral Blood: Total number of cells actually infused
integer
C0229664 (UMLS CUI [1,1])
C2145394 (UMLS CUI [1,2])
C2145394 (UMLS CUI [1,2])
Code List
Peripheral Blood: Total number of cells actually infused
CL Item
T-cells (CD 3+) (cells/kg*) (1)
CL Item
Nucleated cells (/kg*) (2)
CL Item
CD 34+ (cells/kg*) (3)
Item
Peripheral Blood: Total number of cells actually infused
integer
C0229664 (UMLS CUI [1,1])
C2145394 (UMLS CUI [1,2])
C2145394 (UMLS CUI [1,2])
Code List
Peripheral Blood: Total number of cells actually infused
CL Item
unknown (1)
CL Item
not evluated (2)
Item
Cord Blood: Total number of cellsactually infused
integer
C0162371 (UMLS CUI [1,1])
C2145394 (UMLS CUI [1,2])
C2145394 (UMLS CUI [1,2])
Code List
Cord Blood: Total number of cellsactually infused
CL Item
CD 34+ (cells/kg*) (1)
C0054953 (UMLS CUI-1)
CL Item
Nucleated cells (/kg*) (2)
C1180059 (UMLS CUI-1)
CL Item
T-cells (CD 3+) (cells/kg*) (3)
C0039194 (UMLS CUI-1)
Item
Cord Blood: Total number of cellsa ctually infused
integer
C0162371 (UMLS CUI [1,1])
C2145394 (UMLS CUI [1,2])
C2145394 (UMLS CUI [1,2])
CL Item
Not evaluated (Not evaluated )
CL Item
unknown (unknown)
Chronological number
Item
Chronological number of HSCT for this patient
integer
C1318453 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
Item
Donor the same as for previous HSCT?
integer
C0013018 (UMLS CUI [1,1])
C0472699 (UMLS CUI [1,2])
C0472699 (UMLS CUI [1,2])
CL Item
No (No )
CL Item
Yes (Yes )
CL Item
Previous HSCT(s) autologous (Previous HSCT(s) autologous)
Date of previous HSCT
Item
Date of previous HSCT
date
C0018956 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
CL Item
Allo (Allo)
CL Item
Auto (Auto)
CL Item
Relapse/progression after previous HSCT (Relapse/progression after previous HSCT)
CL Item
Graft failure after allo BMT (Graft failure after allo BMT)
CL Item
Other (Other)
Item
HSCT part of a multiple sequential graft protocol
integer
C0442711 (UMLS CUI [1])
Code List
HSCT part of a multiple sequential graft protocol
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Type of multiple graft protocol
Item
Type of multiple graft protocol
integer
C0442711 (UMLS CUI [1])
Graft number in the protocol
Item
Graft number in the protocol
integer
C1961139 (UMLS CUI [1])
total number of HSCTs in the program
Item
total number of HSCTs in the program
integer
C0449788 (UMLS CUI [1,1])
C0472699 (UMLS CUI [1,2])
C0472699 (UMLS CUI [1,2])
PREPARATIVE (CONDITIONING) REGIMEN GIVEN
Item
PREPARATIVE (CONDITIONING) REGIMEN GIVEN
boolean
C1882454 (UMLS CUI [1])
Item
Was regimen intended to be myeloablative
integer
C1882454 (UMLS CUI [1,1])
C1513784 (UMLS CUI [1,2])
C1513784 (UMLS CUI [1,2])
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
CL Item
Age of recipient (Age of recipient)
CL Item
Comorbid conditions (Comorbid conditions)
CL Item
Prior HSCT (Prior HSCT)
CL Item
Protocol driven (Protocol driven)
CL Item
Other, specify (Other, specify)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
NAME OF DRUG
Item
NAME OF DRUG
text
C3273235 (UMLS CUI [1])
CUMULATIVE DOSE
Item
PRESCRIBED CUMULATIVE DOSE AS PER PROTOCOL (DAILY DOSE BY NUMBER OF DAYS)
integer
C2986497 (UMLS CUI [1])
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
CL Item
mCi (1)
CL Item
mBq (2)
CL Item
Oral (Oral )
CL Item
IV (IV )
CL Item
Both (Both)
CL Item
Horse (Horse )
CL Item
Rabbit (Rabbit )
CL Item
Other, specify (Other, specify)
CL Item
No (No )
CL Item
Yes (Yes )
CL Item
Unknown (Unknown)
Total dose
Item
Total dose (Gy)
float
C2919490 (UMLS CUI [1])
Number of fractions
Item
Number of fractions
float
C0454266 (UMLS CUI [1])
radiation days
Item
radiation days
integer
C3693616 (UMLS CUI [1])
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
CL Item
No (No )
CL Item
Yes (Yes )
CL Item
Unknown (Unknown)
Item Group
TREATMENT DURING THE IMMEDIATE POST-TRANSPLANT PERIOD
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
nknown (nknown)
GROWTH FACTORS: If yes, please specify
Item
GROWTH FACTORS: If yes, please specify
text
C0018284 (UMLS CUI [1,1])
C4035158 (UMLS CUI [1,2])
C4035158 (UMLS CUI [1,2])
Date started
Item
Date started
date
C3173309 (UMLS CUI [1])
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Date of first infusion
Item
Date of first infusion
date
C0574032 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Item
CELLULAR THERAPY: if yes, specify:
integer
C0302189 (UMLS CUI [1,1])
C1521902 (UMLS CUI [1,2])
C1521902 (UMLS CUI [1,2])
CL Item
Donor lymphocyte infusion (DLI) (only lymphocytes from same donor(s) as HSCT) (Donor lymphocyte infusion (DLI) (only lymphocytes from same donor(s) as HSCT))
CL Item
Mesenchymal cells (Mesenchymal cells)
CL Item
Other (Other)
CL Item
Unknown (Unknown)
Nucleated cells
Item
Nucleated cells
float
C1180059 (UMLS CUI [1])
CL Item
Not evaluated (Not evaluated)
CL Item
unknown (unknown)
CD 34+
Item
CD 34+ (cells/kg*)
integer
C3538723 (UMLS CUI [1])
CL Item
Not evaluated (1)
CL Item
unknown (2)
CD 3+
Item
CD 3+ (cells/kg*)
float
C0483189 (UMLS CUI [1])
CL Item
Not evaluated (1)
CL Item
unknown (2)
All cells
Item
All cells (cells/kg*) (non DLI only)
float
C2322965 (UMLS CUI [1])
Chronological number of this cell therapy for this patient
Item
Chronological number of this cell therapy for this patient
integer
C0302189 (UMLS CUI [1,1])
C0449788 (UMLS CUI [1,2])
C0449788 (UMLS CUI [1,2])
CL Item
Planned/protocol (Planned/protocol )
CL Item
Treatment for disease (Treatment for disease)
CL Item
Loss/decreased chimaerism (Loss/decreased chimaerism )
CL Item
Mixed chimaerism (Mixed chimaerism)
CL Item
Treatment of GvHD (Treatment of GvHD )
CL Item
Treatment viral infection (Treatment viral infection)
CL Item
Treatment PTLD, EBV lymphoma (Treatment PTLD, EBV lymphoma)
CL Item
Other (Other)
Number of infusions within 10 weeks
Item
Number of infusions within 10 weeks count only infusions that are part of same regimen and given for the same indication
integer
C0449788 (UMLS CUI [1,1])
C0574032 (UMLS CUI [1,2])
C0574032 (UMLS CUI [1,2])
Item
GVHD PREVENTION IN THE RECIPIENT (THERAPEUTIC IMMUNOSUPPRESSION)
integer
C0018133 (UMLS CUI [1,1])
C0199176 (UMLS CUI [1,2])
C0199176 (UMLS CUI [1,2])
Code List
GVHD PREVENTION IN THE RECIPIENT (THERAPEUTIC IMMUNOSUPPRESSION)
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
CL Item
Cyclosporine (Cyclosporine)
CL Item
Methotrexate (Methotrexate)
CL Item
ATG/ALG (if started after day 0) (ATG/ALG (if started after day 0))
CL Item
Corticosteroids (if started after day 0) (Corticosteroids (if started after day 0))
CL Item
Mycophenolate (Mycophenolate)
CL Item
Tacrolimus (Tacrolimus)
CL Item
Monoclonal antibodies, specify (Monoclonal antibodies, specify)
CL Item
Extra-corporeal photopheresis (ECP) (Extra-corporeal photopheresis (ECP))
CL Item
Other (Other)
Monoclonal antibodies
Item
Monoclonal antibodies, specify
integer
C3542957 (UMLS CUI [1])
Drugs: If Other, please specify
Item
Drugs: If Other, please specify
integer
C0013227 (UMLS CUI [1,1])
C4035158 (UMLS CUI [1,2])
C4035158 (UMLS CUI [1,2])
CL Item
Yes (Yes)
CL Item
No reconstitution (No reconstitution)
CL Item
Lost graft (Lost graft)
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Never below this level (Never below this level)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Never below this level (3)
Date last assessment
Item
Date last assessment
date
C2985720 (UMLS CUI [1])
Date of graft failure
Item
Date of graft failure
date
C1262018 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
CL Item
Full (donor >95 %) (Full (donor >95 %) )
CL Item
Mixed (partial) (Mixed (partial))
CL Item
Autologous reconstitution (recipient >95 %) (Autologous reconstitution (recipient >95 %) )
CL Item
Aplasia (Aplasia)
CL Item
Not evaluated (Not evaluated)
Item Group
DATE(S) AND RESULTS OF ALL TESTS DONE FOR ALL DONORS
undefined item
Item
text
Date of test
Item
Date of test
date
Identification
Item
Identification of donor or Cord Blood Unit given by the centre
text
C1718162 (UMLS CUI [1])
Number in the infusion order
Item
Number in the infusion order (if applicable)
text
C0237753 (UMLS CUI [1])
Bone marrow
Item
Cell type on which test was performed (% Donor Cells): BM
float
C0005953 (UMLS CUI [1])
PB mononuclear cells (PBMC)
Item
Cell type on which test was performed (% Donor cells): PB mononuclear cells (PBMC)
float
C1321301 (UMLS CUI [1])
T-cell
Item
Cell type on which test was performed
float
B-Cells
Item
Cell type on which test was performed (% Donor cells): B-Cells
float
C0004561 (UMLS CUI [1])
Red blood cells
Item
Cell type on which test was performed (% Donor cells): Red blood cells
float
C0014772 (UMLS CUI [1])
Monocytes
Item
Cell type on which test was performed (% Donor cells): Monocytes
float
C0026473 (UMLS CUI [1])
PMNs (neutrophils)
Item
Cell type on which test was performed (% Donor cells): PMNs (neutrophils)
float
C0200633 (UMLS CUI [1])
Lymphocytes, NOS
Item
Cell type on which test was performed (% Donor cells): Lymphocytes, NOS
float
C0024264 (UMLS CUI [1])
Myeloid cells, NOS
Item
Cell type on which test was performed (% Donor cells): Myeloid cells, NOS
float
C0887899 (UMLS CUI [1])
Other cell type - value
Item
Cell type on which test was performed (% Donor cells): Other
float
C0449475 (UMLS CUI [1,1])
C1522609 (UMLS CUI [1,2])
C1522609 (UMLS CUI [1,2])
CL Item
FISH (FISH)
CL Item
Molecular (Molecular)
CL Item
Cytogenetic (Cytogenetic)
CL Item
ABO group (ABO group)
CL Item
Other (Other)
CL Item
unknown (unknown)
CL Item
No (1)
CL Item
Growth factors GRFAIGRF (2)
CL Item
Subsequent transplant (please complete a new transplant form) (3)
CL Item
AUTOgraft (must have prior conditioning) (4)
CL Item
ALLOgraft (5)
CL Item
Autologous PBSC re-infusion (no preparative treatment or conditioning) (6)
CL Item
Autologous BM re-infusion (no preparative treatment or conditioning) (7)
CL Item
Other (8)
CL Item
grade 0 (Absent) (1)
CL Item
grade I (2)
CL Item
grade II (3)
CL Item
grade III (4)
CL Item
grade IV (5)
CL Item
Not evaluated (6)
Date of onset
Item
Date of onset
date
C0574845 (UMLS CUI [1])
Item
Stage skin
integer
C0856825 (UMLS CUI [1,1])
C1306673 (UMLS CUI [1,2])
C1306673 (UMLS CUI [1,3])
C1306673 (UMLS CUI [1,2])
C1306673 (UMLS CUI [1,3])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
Not evaluated (6)
CL Item
unknown (7)
Item
Stage liver
integer
C0856825 (UMLS CUI [1,1])
C1306673 (UMLS CUI [1,2])
C0023884 (UMLS CUI [1,3])
C1306673 (UMLS CUI [1,2])
C0023884 (UMLS CUI [1,3])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
Not evaluated (6)
CL Item
unknown (7)
Item
Stage gut
integer
C0856825 (UMLS CUI [1,1])
C1306673 (UMLS CUI [1,2])
C0021853 (UMLS CUI [1,3])
C1306673 (UMLS CUI [1,2])
C0021853 (UMLS CUI [1,3])
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
Not evaluated (6)
CL Item
unknown (7)
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])
Treatment
Item
Treatment
boolean
CL Item
Corticosteroids (Corticosteroids)
CL Item
ATG/ALG (ATG/ALG)
CL Item
MoAB (MoAB)
CL Item
Other (Other)
INFECTION RELATED COMPLICATIONS
Item
INFECTION RELATED COMPLICATIONS
boolean
C0009450 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])
C0009566 (UMLS CUI [1,2])
CL Item
Bacteraemia/ fungemia / viremia / parasites (1)
CL Item
Septic shock (2)
CL Item
ARDS (3)
CL Item
Multiorgan failure due to infection (4)
CL Item
Pneumonia (5)
CL Item
Hepatitis (6)
CL Item
CNS infection (7)
CL Item
Gut infection (8)
CL Item
Retinitis (9)
CL Item
Cystitis (10)
CL Item
Other (11)
Item
NON INFECTION RELATED COMPLICATIONS
integer
C0009566 (UMLS CUI [1])
CL Item
No complications (1)
CL Item
Yes (2)
Item
Specify: Idiopathic pneumonia syndrome
text
C1504431 (UMLS CUI [1])
CL Item
Yes (Yes)
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
CL Item
No (No )
CL Item
Unknown (Unknown)
Item
Specify: Haemorrhagic cystitis, non infectious
text
C0085692 (UMLS CUI [1])
CL Item
Yes (Yes )
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Unknown (Unknown)
Item
Multiorgan failure, non infectious
integer
C0026766 (UMLS CUI [1])
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Specify: HSCT-associated microangiopathy
text
C0155765 (UMLS CUI [1])
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Unknown (Unknown)
Item
Specify: Renal failure requiring dialysis
text
C0035078 (UMLS CUI [1])
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Unknown (Unknown)
Item
Specify: Haemolytic anaemia due to blood group
text
C0002878 (UMLS CUI [1])
CL Item
Yes (Yes)
CL Item
No (No)
CL Item
Unknown (Unknown)
Other type of infection
Item
Other type of infection
boolean
C0457463 (UMLS CUI [1])
Idiopathic pneumonia syndrome date
Item
Idiopathic pneumonia syndrome date
date
C1504431 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Date VOD
Item
Date VOD
date
C0948441 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Date Haemorrhagic cystitis, non infectious
Item
Date Haemorrhagic cystitis, non infectious
date
C0085692 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Date ARDS, non infectious
Item
Date ARDS, non infectious
date
C0035222 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Date Multiorgan failure, non infectious
Item
Date Multiorgan failure, non infectious
date
C0026766 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Date HSCT-associated microangiopathy
Item
Date HSCT-associated microangiopathy
date
C0155765 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Date Renal failure requiring dialysis
Item
Date Renal failure requiring dialysis
date
C0035078 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
DAte Haemolytic anaemia due to blood group
Item
DAte Haemolytic anaemia due to blood group
date
C0002878 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
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])
LastContactDate
Item
Date of Last Contact
date
C0011008 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
C1517741 (UMLS CUI [1,4])
C0011008 (UMLS CUI [1,2])
C1705415 (UMLS CUI [1,3])
C1517741 (UMLS CUI [1,4])
CL Item
No (1)
CL Item
Yes, First Episode (2)
CL Item
Yes, Recurrence (3)
Date of Onset
Item
Onset
date
C0574845 (UMLS CUI [1])
CL Item
limited (1)
CL Item
Extensive (2)
CL Item
not evaluated (3)
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)
Item
Relapse or progression
integer
C0035020 (UMLS CUI [1])
C0242656 (UMLS CUI [2])
C0242656 (UMLS CUI [2])
CL Item
Previously reported (1)
CL Item
No (2)
CL Item
yes (3)
CL Item
Continuous progression since transplant (4)
CL Item
Unknown (5)
RELAPSE OR PROGRESSION: If yes, date diagnosed
Item
RELAPSE OR PROGRESSION: If yes, date diagnosed
date
C0035020 (UMLS CUI [1])
C0242656 (UMLS CUI [2])
C2316983 (UMLS CUI [3])
C0242656 (UMLS CUI [2])
C2316983 (UMLS CUI [3])
Item
Cinical/haematological relapse or progression
integer
C0018939 (UMLS CUI [1,1])
C0205210 (UMLS CUI [1,2])
C0205210 (UMLS CUI [1,2])
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Cinical/haematological relapse or progression
Item
Date assessed
date
Cinical/haematological relapse or progression
Item
Date first seen
date
Item
Cytogenetic relapse or progression
integer
C0010802 (UMLS CUI [1])
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Cytogenetic relapse or progression: Date assessed
Item
Cytogenetic relapse or progression: Date assessed
date
C0010802 (UMLS CUI [1,1])
C0035020 (UMLS CUI [1,2])
C2985720 (UMLS CUI [1,3])
C0035020 (UMLS CUI [1,2])
C2985720 (UMLS CUI [1,3])
Cytogenetic relapse or progression: Date first seen
Item
Cytogenetic relapse or progression: Date first seen
date
C0035020 (UMLS CUI [1,1])
C3483766 (UMLS CUI [1,2])
C3483766 (UMLS CUI [1,2])
Item
Molecular relapse or progression
integer
C0026376 (UMLS CUI [1])
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Molecular relapse or progression: date assessed
Item
date
C0035020 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
Molecular relapse or progression: Date first seen
Item
Molecular relapse or progression: Date first seen
date
C3483766 (UMLS CUI [1,1])
C0035020 (UMLS CUI [1,2])
C0035020 (UMLS CUI [1,2])
Item
Clinical/haematological
integer
C0018939 (UMLS CUI [1,1])
C0205210 (UMLS CUI [1,2])
C0205210 (UMLS CUI [1,2])
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
Date of Evaluation
Item
Last date evaluated/Last date assessed
date
C2985720 (UMLS CUI [1])
CL Item
No (1)
CL Item
Yes: Considered disease relapse/progression No (2)
CL Item
Yes: Considered disease relapse/progression Yes (3)
CL Item
Yes: Considered disease relapse/progression Not evaluated (4)
Last date assessed
Item
Last date assessed
date
CL Item
No (No)
CL Item
yes (yes)
CL Item
No Considered disease relapse/progression (No Considered disease relapse/progression)
CL Item
Yes Considered disease relapse/progression (Yes Considered disease relapse/progression)
CL Item
Not evaluated (Not evaluated)
CL Item
alive (0)
CL Item
dead (1)
CL Item
Karnofsky (Karnofsky)
CL Item
Lansky (Lansky)
CL Item
Not evaluated (Not evaluated)
CL Item
Unknown (Unknown)
CL Item
100 (Normal, NED) (1)
CL Item
10 (Moribund) (10)
CL Item
Not evaluated (11)
CL Item
Unknown (12)
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
Relapse or progression (1)
CL Item
Secondary malignancy (including lymphoproliferative disease) (2)
CL Item
Transplantation related cause (3)
CL Item
Unknown (4)
CL Item
Other (5)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): GvHD
text
C0007465 (UMLS CUI [1,1])
C0018133 (UMLS CUI [1,2])
C0018133 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): GvHD
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Interstitial Pneumonitis
text
C0007465 (UMLS CUI [1,1])
C0206061 (UMLS CUI [1,2])
C0206061 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Interstitial Pneumonitis
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Pulmonary toxicity
text
C0007465 (UMLS CUI [1,1])
C0919924 (UMLS CUI [1,2])
C0919924 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Pulmonary toxicity
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
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)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Haemorrhage
text
C0007465 (UMLS CUI [1,1])
C0019080 (UMLS CUI [1,2])
C0019080 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Haemorrhage
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Cardiac toxicity
text
C0007465 (UMLS CUI [1,1])
C0876994 (UMLS CUI [1,2])
C0876994 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Cardiac toxicity
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Central nervous system toxicity
text
C0007465 (UMLS CUI [1,1])
C3160947 (UMLS CUI [1,2])
C3160947 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Central nervous system toxicity
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Gastro intestinal toxicity
text
C0007465 (UMLS CUI [1,1])
C1142499 (UMLS CUI [1,2])
C1142499 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Gastro intestinal toxicity
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Skin toxicity
text
C0007465 (UMLS CUI [1,1])
C1167791 (UMLS CUI [1,2])
C1167791 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Skin toxicity
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Renal failure
text
C0007465 (UMLS CUI [1,1])
C0035078 (UMLS CUI [1,2])
C0035078 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Renal failure
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
Item
If dead and HSCT related cause of death, specify (check as many as apppropriate): Multiple organ failure
text
C0007465 (UMLS CUI [1,1])
C0026766 (UMLS CUI [1,2])
C0026766 (UMLS CUI [1,2])
Code List
If dead and HSCT related cause of death, specify (check as many as apppropriate): Multiple organ failure
CL Item
No (No )
CL Item
Unknown (Unknown)
CL Item
Yes (Yes)
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])
CL Item
Hispanic or Latino (1)
CL Item
Not Hispanic or Latino (2)
CL Item
White (1)
CL Item
Black (2)
CL Item
Asian (3)
CL Item
American Indian or Alaska Native (4)
CL Item
Native Hawaiian or Pacific Native (5)
CL Item
Other (6)
COMORBID CONDITIONS
Item
COMORBID CONDITIONS
boolean
C1275743 (UMLS CUI [1])
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No )
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No )
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes )
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
yes (yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
comorbidity
Item
other comorbidity, please specify
text
C0009488 (UMLS CUI [1])