ID

42711

Description

ODM form derived from 14pp EBMT Solid Tumors 11SoTu.pdf refer to: http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx

Link

http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx

Keywords

Versions (3)
  1. 4/5/16 4/5/16 -
  2. 7/27/16 7/27/16 -
  3. 9/17/21 9/17/21 -
Uploaded on

September 17, 2021

DOI

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License

Creative Commons BY-NC 3.0
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EBMT Solid Tumors

English

EBMT Solid Tumors

1 forms  
  1. StudyEvent: ODM
    1. EBMT Solid Tumors
EBMT FORM GENERAL INFORMATION
Description

EBMT FORM GENERAL INFORMATION

EBMT FORM GENERAL INFORMATION
Description

EBMT FORM GENERAL INFORMATION

Data type

integer

Alias
UMLS CUI [1,1]
C3826859
UMLS CUI [1,2]
C1508263
Hospital
Description

Klinik

Data type

text

Alias
UMLS CUI [1]
C0019994
Unit
Description

Unit

Data type

integer

Alias
UMLS CUI [1]
C1519795
Name of contact person
Description

Contact person

Data type

text

Alias
UMLS CUI [1]
C0337611
Telephone
Description

Patient phone number

Data type

text

Alias
UMLS CUI [1]
C1515258
Fax
Description

Fax

Data type

integer

Alias
UMLS CUI [1]
C1549619
E-mail address of contact number
Description

E-mail

Data type

text

Alias
UMLS CUI [1]
C1705961
Date of this report
Description

Date of this report

Data type

date

Alias
UMLS CUI [1]
C1302584
STUDY/TRIAL
Description

STUDY/TRIAL

Patient following national / international study / trial
Description

Patient in Trial

Data type

integer

Alias
UMLS CUI [1]
C1997894
Name of study / trial
Description

Name of study / trial

Data type

integer

Alias
UMLS CUI [1]
C0008976
PATIENT
Description

PATIENT

To be entered only if patient previously reported
Description

Unique Identification Code (UIC)

Data type

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number or Code
Description

Hospital Unique Patient Number or Code

Data type

text

Alias
UMLS CUI [1]
C1827636
First name(s)_surname(s)
Description

Initials

Data type

text

Alias
UMLS CUI [1]
C2986440
Date of Birth
Description

Date of Birth

Data type

date

Alias
UMLS CUI [1]
C0421451
Sex
Description

Sex

Data type

text

Alias
UMLS CUI [1]
C0079399
ABO Group
Description

ABO Group

Data type

text

Alias
UMLS CUI [1]
C0000778
Rh factor
Description

Rh factor

Data type

integer

Alias
UMLS CUI [1]
C0035403
DISEASE
Description

DISEASE

Date of diagnosis
Description

Date of diagnosis

Data type

date

Alias
UMLS CUI [1]
C2316983
Check the disease for which this transplant was performed
Description

Primary Disease Diagnosis

Data type

integer

Alias
UMLS CUI [1]
C0277554
SOLID TUMOURS
Description

SOLID TUMOURS

INITIAL DIAGNOSIS
Description

INITIAL DIAGNOSIS

Data type

integer

Alias
UMLS CUI [1]
C0011900
INITIAL DIAGNOSIS: if other specify
Description

INITIAL DIAGNOSIS

Data type

integer

Alias
UMLS CUI [1,1]
C0011900
UMLS CUI [1,2]
C3845569
Clinical TNM classification Tumor
Description

Clinical TNM classification Tumor

Data type

integer

Alias
UMLS CUI [1]
C0809869
Clinical TNM classification Tumor Nodes
Description

Clinical TNM classification Tumor Nodes

Data type

integer

Alias
UMLS CUI [1,1]
C0809869
UMLS CUI [1,2]
C0024204
Clinical TNM classification Metastases
Description

For metastases, 0 indicates “No metastasis”, 1 indicates “Metastasis” and X indicates “Not evaluable

Data type

integer

Alias
UMLS CUI [1,1]
C0027627
UMLS CUI [1,2]
C0809869
Disease-specific staging
Description

Disease-specific staging

Data type

integer

Alias
UMLS CUI [1]
C0449385
HISTOLOGICAL SUBCLASSIFICATION Describe
Description

HISTOLOGICAL SUBCLASSIFICATION Describe

Data type

text

BREAST CARCINOMA ONLY
Description

BREAST Cancer

Data type

integer

Alias
UMLS CUI [1]
C0678222
RECEPTOR STATUS Estrogen (ER)
Description

RECEPTOR STATUS Estrogen (ER)

Data type

integer

Alias
UMLS CUI [1]
C0279758
RECEPTOR STATUS positive: Values
Description

RECEPTOR STATUS Estrogen (ER)

Data type

float

Alias
UMLS CUI [1]
C1719706
RECEPTOR STATUS Progesterone (PgR)
Description

RECEPTOR STATUS Progesterone (PgR)

Data type

integer

Alias
UMLS CUI [1]
C1514471
Progesterone Receptor Status positive: Values
Description

RECEPTOR STATUS Progesterone (PgR)

Data type

float

Alias
UMLS CUI [1,1]
C1514471
UMLS CUI [1,2]
C0279759
RECEPTOR STATUS HER2/neu (c-erb-B2)
Description

RECEPTOR STATUS HER2/neu (c-erb-B2)

Data type

integer

Alias
UMLS CUI [1]
C1512413
If RECEPTOR STATUS HER2/neu (c-erb-B2) positiv :
Description

RECEPTOR STATUS HER2/neu (c-erb-B2)

Data type

integer

Alias
UMLS CUI [1]
C2348909
HISTOLOGICAL SUBCLASSIFICATION FOR BREAST CARCINOMA
Description

HISTOLOGICAL SUBCLASSIFICATION FOR BREAST CARCINOMA

Number of positive Axillary lymph nodes
Description

Axillary lymph nodes

Data type

float

Alias
UMLS CUI [1,1]
C0729594
UMLS CUI [1,2]
C0746319
Number of examined Axillary lymph nodes
Description

Axillary lymph nodes

Data type

float

Alias
UMLS CUI [1]
C0807728
Axillary lymph nodes Not evaluated
Description

Axillary lymph nodes

Data type

integer

Alias
UMLS CUI [1,1]
C0220825
UMLS CUI [1,2]
C0398420
S.B.R. (Scarff-Bloom-Richardson)
Description

S.B.R. (Scarff-Bloom-Richardson)

Data type

integer

Alias
UMLS CUI [1]
C3828224
Ductal carcinoma
Description

Ductal carcinoma

Data type

integer

Alias
UMLS CUI [1]
C1527349
Lobular carcinoma
Description

Lobular carcinoma

Data type

integer

Alias
UMLS CUI [1]
C0279563
CYTOGENETICS
Description

CYTOGENETICS

CHROMOSOME ANALYSIS
Description

CHROMOSOME ANALYSIS

Data type

integer

Alias
UMLS CUI [1]
C0200867
CHROMOSOME ANALYSIS
Description

CHROMOSOME ANALYSIS

Data type

integer

Alias
UMLS CUI [1]
C0200867
Molecular markers
Description

Molecular markers

Data type

integer

Alias
UMLS CUI [1]
C0005516
TREATMENT GIVEN BEFORE THIS HSCT
Description

TREATMENT GIVEN BEFORE THIS HSCT

Treatment given
Description

if no: Includes a) Patients who have no surgery and go on to have high dose chemotherapy followed immediately by HSCT, or sequential chemotherapy, as the 1st line treatment; or b) Subsequent HSCT within a multiple/ sequential chemotherapy HSCT procedure if yes: Includes surgery or any other treatment, including chemotherapy, given prior to the HSCT and which is not considered part of the preparative (conditioning) regimen

Data type

integer

Alias
UMLS CUI [1]
C0580351
FIRST LINE TREATMENT
Description

FIRST LINE TREATMENT

1st line treatment started
Description

treatment start date

Data type

date

Alias
UMLS CUI [1]
C3173309
Did the first-line treatment include HSCT
Description

HSCT

Data type

integer

Alias
UMLS CUI [1]
C0472699
if the first-line treatment include HSCT
Description

Upfront (treatment started with a program including high dose chemotherapy followed by HSCT or high dose sequential chemotherapy; adjuvant excluded) Adjuvant (HSCT done in adjuvant-setting)

Data type

integer

Alias
UMLS CUI [1]
C0472699
Modality
Description

Modality

Data type

integer

Alias
UMLS CUI [1]
C0695347
Drugs
Description

Drugs

Data type

integer

Alias
UMLS CUI [1]
C0392920
if other drugs
Description

Drugs

Data type

text

If breast cancer, type of surgery
Description

Modality Surgery

Data type

text

if other Modality
Description

Modality

Data type

text

Status of disease after first line treatment (best response)
Description

Status of disease after first line treatment (best response)

Data type

text

Criteria used for evaluation
Description

Criteria used for evaluation

Data type

text

ADDITIONAL LINES OF TREATMENT BEFORE THIS HSCT FOR RELAPSED/REFRACTORY DISEASE
Description

Treatment given

Data type

text

TREATMENT HISTORY BEFORE HSCT
Description

TREATMENT HISTORY BEFORE HSCT

Date of HSCT
Description

Date of HSCT

Data type

date

Alias
UMLS CUI [1]
C2584899
Total number of lines before this HSCT
Description

TREATMENT SUMMARY

Data type

integer

Alias
UMLS CUI [1]
C0577303
Modality used at least once Chemotherapy
Description

Chemotherapy

Data type

integer

Alias
UMLS CUI [1]
C0392920
Modality used at least once Surgery
Description

Surgery

Data type

integer

Alias
UMLS CUI [1]
C0543467
Modality used at least once Radiotherapy
Description

Radiotherapy

Data type

integer

Alias
UMLS CUI [1]
C1522449
Modality used at least once other
Description

Modality

Data type

integer

Alias
UMLS CUI [1]
C0695347
STATUS OF DISEASE AT HSCT
Description

STATUS OF DISEASE AT HSCT

STATUS OF DISEASE AT HSCT
Description

STATUS OF DISEASE AT HSCT

Data type

integer

Alias
UMLS CUI [1,1]
C1704632
UMLS CUI [1,2]
C0472699
if CR please specify
Description

if CR please specify

Data type

integer

Alias
UMLS CUI [1]
C0677874
if Relapse please specify
Description

if Relapse please specify

Data type

integer

Alias
UMLS CUI [1]
C0035020
Complete remission (CR) Number
Description

Complete remission (CR) Number

Data type

integer

Alias
UMLS CUI [1,1]
C0237753
UMLS CUI [1,2]
C0677874
Complete relapse Number
Description

Complete relapse Number

Data type

integer

Alias
UMLS CUI [1,1]
C2347944
UMLS CUI [1,2]
C0237753
SENSITIVITY TO CHEMOTHERAPY
Description

(complete only for relapse)

Data type

integer

Alias
UMLS CUI [1]
C2363824
Organ(s) involved
Description

Organ involved

Data type

integer

Alias
UMLS CUI [1]
C0449953
Primary site affected
Description

Primary site affected

Data type

integer

Alias
UMLS CUI [1]
C0449695
ADDITIONAL TREATMENT POST-HSCT
Description

ADDITIONAL TREATMENT POST-HSCT

Additional Disease Treatment
Description

Additional Disease Treatment

Data type

boolean

Alias
UMLS CUI [1]
C1706712
if ADDITIONAL DISEASE TREATMENT
Description

ADDITIONAL DISEASE TREATMENT

Data type

integer

Alias
UMLS CUI [1]
C1706712
BEST DISEASE RESPONSE AT 100 DAYS POST-HSCT
Description

BEST DISEASE RESPONSE AT 100 DAYS POST-HSCT

BEST RESPONSE AT 100 DAYS AFTER HSCT
Description

BEST RESPONSE AT 100 DAYS AFTER HSCT

Data type

text

Alias
UMLS CUI [1]
C2986560
Date of Evaluation
Description

LesionAssessmentDate

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0221198
UMLS CUI [1,3]
C0031809
FORMS TO BE FILLED IN
Description

FORMS TO BE FILLED IN

TYPE OF TRANSPLANT
Description

TYPE OF TRANSPLANT

Data type

text

Alias
UMLS CUI [1,1]
C0559189
UMLS CUI [1,2]
C0040739
it other type of transplant contact the EBMT Central Registry Office for instructions
Description

TYPE OF TRANSPLANT

Data type

text

Alias
UMLS CUI [1,1]
C0559189
UMLS CUI [1,2]
C0040739
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Similar models

EBMT Solid Tumors

1 forms
  1. StudyEvent: ODM
    1. EBMT Solid Tumors
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
EBMT FORM GENERAL INFORMATION
EBMT FORM GENERAL INFORMATION
Item
EBMT FORM GENERAL INFORMATION
integer
C3826859 (UMLS CUI [1,1])
C1508263 (UMLS CUI [1,2])
Klinik
Item
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])
Patient phone number
Item
Telephone
text
C1515258 (UMLS CUI [1])
Fax
Item
Fax
integer
C1549619 (UMLS CUI [1])
E-mail
Item
E-mail address of contact number
text
C1705961 (UMLS CUI [1])
Date of this report
Item
Date of this report
date
C1302584 (UMLS CUI [1])
Item Group
STUDY/TRIAL
Item
Patient following national / international study / trial
integer
C1997894 (UMLS CUI [1])
Patient in Trial
Code List
Patient following national / international study / trial
CL Item
No (1)
C1298908 (UMLS CUI-1)
CL Item
Yes (2)
C1705108 (UMLS CUI-1)
CL Item
Not evaluated (3)
C3846720 (UMLS CUI-1)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
Name of study / trial
Item
Name of study / trial
integer
C0008976 (UMLS CUI [1])
Item Group
PATIENT
Unique Identification Code (UIC)
Item
To be entered only if patient previously reported
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number or Code
Item
Hospital Unique Patient Number or Code
text
C1827636 (UMLS CUI [1])
Initials
Item
First name(s)_surname(s)
text
C2986440 (UMLS CUI [1])
Date of Birth
Item
Date of Birth
date
C0421451 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Sex
Code List
Sex
CL Item
Male (1)
C1706180 (UMLS CUI-1)
CL Item
Female (2)
C0086287 (UMLS CUI-1)
ABO Group
Item
ABO Group
text
C0000778 (UMLS CUI [1])
Item
Rh factor
integer
C0035403 (UMLS CUI [1])
Rh factor
Code List
Rh factor
CL Item
Absent (1)
C2699077 (UMLS CUI-1)
CL Item
Present (2)
C2699078 (UMLS CUI-1)
CL Item
Not evaluated (3)
C3846720 (UMLS CUI-1)
Item Group
DISEASE
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])
Primary Disease Diagnosis
Code List
Check the disease for which this transplant was performed
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
Hodgkin´s Disease (Hodgkin´s Disease)
C0019829 (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
Haemoglobinopathies (Haemoglobinopathiy)
C0019045 (UMLS CUI-1)
CL Item
Other diagnosis (Other diagnosis)
C0205394 (UMLS CUI-1)
Item Group
SOLID TUMOURS
Item
INITIAL DIAGNOSIS
integer
C0011900 (UMLS CUI [1])
INITIAL DIAGNOSIS
Code List
INITIAL DIAGNOSIS
CL Item
Bone sarcoma (excluding Ewing sarcoma/PNET) (1)
C0029463 (UMLS CUI-1)
CL Item
Central nervous system tumors (include CNS PNET) (2)
C0085136 (UMLS CUI-1)
CL Item
Colorectal (3)
C0555952 (UMLS CUI-1)
CL Item
Ewing sarcoma/PNET, extra-skeletal (4)
C0553580 (UMLS CUI-1)
CL Item
Ewing sarcoma/PNET, skeletal (5)
C0585474 (UMLS CUI-1)
CL Item
Germ cell tumour, extragonadal only (6)
C0205851 (UMLS CUI-1)
CL Item
Hepatobiliary (7)
C0267792 (UMLS CUI-1)
CL Item
Lung cancer, non-small cell (8)
C0007131 (UMLS CUI-1)
CL Item
Lung cancer, small cell (9)
C0149925 (UMLS CUI-1)
CL Item
Medulloblastoma (10)
C0025149 (UMLS CUI-1)
CL Item
Melanoma (11)
C0025202 (UMLS CUI-1)
CL Item
Other, specify (12)
C1299220 (UMLS CUI-1)
CL Item
Breast cancer (13)
C0678222 (UMLS CUI-1)
CL Item
Neuroblastoma (14)
C0027819 (UMLS CUI-1)
CL Item
Ovarian cancer (15)
C0029925 (UMLS CUI-1)
CL Item
Pancreas (16)
C0030274 (UMLS CUI-1)
CL Item
Prostate (17)
C0033572 (UMLS CUI-1)
CL Item
Renal cell (18)
C0007134 (UMLS CUI-1)
CL Item
Retinoblastoma (19)
C0035335 (UMLS CUI-1)
CL Item
Rhabdomyosarcoma (20)
C0035412 (UMLS CUI-1)
CL Item
Soft tissue sarcoma (21)
C0334449 (UMLS CUI-1)
CL Item
Testicular cancer (22)
C0153594 (UMLS CUI-1)
CL Item
Thymoma (23)
C0040100 (UMLS CUI-1)
CL Item
Wilms tumour (24)
C0027708 (UMLS CUI-1)
INITIAL DIAGNOSIS
Item
INITIAL DIAGNOSIS: if other specify
integer
C0011900 (UMLS CUI [1,1])
C3845569 (UMLS CUI [1,2])
Item
Clinical TNM classification Tumor
integer
C0809869 (UMLS CUI [1])
Clinical TNM classification Tumor
Code List
Clinical TNM classification Tumor
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
X (6)
CL Item
not evaluated (7)
Item
Clinical TNM classification Tumor Nodes
integer
C0809869 (UMLS CUI [1,1])
C0024204 (UMLS CUI [1,2])
Clinical TNM classification Tumor Nodes
Code List
Clinical TNM classification Tumor Nodes
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
X (5)
CL Item
not evaluated (6)
CL Item
unknown (7)
Item
Clinical TNM classification Metastases
integer
C0027627 (UMLS CUI [1,1])
C0809869 (UMLS CUI [1,2])
Clinical TNM classification Metastases
Code List
Clinical TNM classification Metastases
CL Item
0 (1)
CL Item
1 (2)
CL Item
X (3)
CL Item
not evaluated (4)
CL Item
unknown (5)
Item
Disease-specific staging
integer
C0449385 (UMLS CUI [1])
OR Disease-specific staging
Code List
Disease-specific staging
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
HISTOLOGICAL SUBCLASSIFICATION Describe
Item
HISTOLOGICAL SUBCLASSIFICATION Describe
text
Item
BREAST CARCINOMA ONLY
integer
C0678222 (UMLS CUI [1])
BREAST CARCINOMA ONLY
Code List
BREAST CARCINOMA ONLY
CL Item
Inflammatory (1)
C0333348 (UMLS CUI-1)
CL Item
Non-inflammatory (2)
C0006142 (UMLS CUI-1)
C0442743 (UMLS CUI-2)
Item
RECEPTOR STATUS Estrogen (ER)
integer
C0279758 (UMLS CUI [1])
RECEPTOR STATUS Estrogen (ER)
Code List
RECEPTOR STATUS Estrogen (ER)
CL Item
Negative (1)
CL Item
Not evaluated (2)
CL Item
Positive (3)
CL Item
Unknown (4)
CL Item
Not evaluated (5)
CL Item
Unknown (6)
RECEPTOR STATUS Estrogen (ER)
Item
RECEPTOR STATUS positive: Values
float
C1719706 (UMLS CUI [1])
Item
RECEPTOR STATUS Progesterone (PgR)
integer
C1514471 (UMLS CUI [1])
RECEPTOR STATUS Progesterone (PgR)
Code List
RECEPTOR STATUS Progesterone (PgR)
CL Item
Negative (1)
C0205160 (UMLS CUI-1)
CL Item
Not evaluated (2)
C3846720 (UMLS CUI-1)
CL Item
Positive (3)
C1446409 (UMLS CUI-1)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
CL Item
Not evaluated (5)
C3846720 (UMLS CUI-1)
CL Item
 ( )
RECEPTOR STATUS Progesterone (PgR)
Item
Progesterone Receptor Status positive: Values
float
C1514471 (UMLS CUI [1,1])
C0279759 (UMLS CUI [1,2])
Item
RECEPTOR STATUS HER2/neu (c-erb-B2)
integer
C1512413 (UMLS CUI [1])
RECEPTOR STATUS HER2/neu (c-erb-B2)
Code List
RECEPTOR STATUS HER2/neu (c-erb-B2)
CL Item
Negative (1)
C0205160 (UMLS CUI-1)
CL Item
Positive (2)
C1446409 (UMLS CUI-1)
CL Item
Not evaluated (3)
C3846720 (UMLS CUI-1)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
Item
If RECEPTOR STATUS HER2/neu (c-erb-B2) positiv :
integer
C2348909 (UMLS CUI [1])
RECEPTOR STATUS HER2/neu (c-erb-B2)
Code List
If RECEPTOR STATUS HER2/neu (c-erb-B2) positiv :
CL Item
IHC 3+ (1)
CL Item
IHC 2+ and FISH + (2)
CL Item
Unknown (3)
Item Group
HISTOLOGICAL SUBCLASSIFICATION FOR BREAST CARCINOMA
Axillary lymph nodes
Item
Number of positive Axillary lymph nodes
float
C0729594 (UMLS CUI [1,1])
C0746319 (UMLS CUI [1,2])
Axillary lymph nodes
Item
Number of examined Axillary lymph nodes
float
C0807728 (UMLS CUI [1])
Axillary lymph nodes
Item
Axillary lymph nodes Not evaluated
integer
C0220825 (UMLS CUI [1,1])
C0398420 (UMLS CUI [1,2])
Item
S.B.R. (Scarff-Bloom-Richardson)
integer
C3828224 (UMLS CUI [1])
S.B.R. (Scarff-Bloom-Richardson)
Code List
S.B.R. (Scarff-Bloom-Richardson)
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
not evaluated (4)
CL Item
unknown (5)
Item
Ductal carcinoma
integer
C1527349 (UMLS CUI [1])
Ductal carcinoma
Code List
Ductal carcinoma
CL Item
yes (1)
C1705108 (UMLS CUI-1)
CL Item
no (2)
C1298908 (UMLS CUI-1)
CL Item
not evaluated (3)
C3846720 (UMLS CUI-1)
CL Item
unknown (4)
C0439673 (UMLS CUI-1)
Item
Lobular carcinoma
integer
C0279563 (UMLS CUI [1])
Lobular carcinoma
Code List
Lobular carcinoma
CL Item
yes (1)
CL Item
no (2)
CL Item
not evaluated (3)
CL Item
unknown (4)
Item Group
CYTOGENETICS
Item
CHROMOSOME ANALYSIS
integer
C0200867 (UMLS CUI [1])
CHROMOSOME ANALYSIS
Code List
CHROMOSOME ANALYSIS
CL Item
Normal (1)
CL Item
Abnormal (2)
CL Item
Not done (3)
CL Item
Unknown (4)
Item
CHROMOSOME ANALYSIS
integer
C0200867 (UMLS CUI [1])
CHROMOSOME ANALYSIS
Code List
CHROMOSOME ANALYSIS
CL Item
If aberrations, notify chromosomal aberrations (e.g. tri/monosomy) and/or other results, in clear (1)
Item
Molecular markers
integer
C0005516 (UMLS CUI [1])
Molecular markers
Code List
Molecular markers
CL Item
Evaluated: Absent  (1)
CL Item
Evaluated: Present (2)
CL Item
Not evaluated (3)
CL Item
unknown (4)
Item Group
TREATMENT GIVEN BEFORE THIS HSCT
Item
Treatment given
integer
C0580351 (UMLS CUI [1])
Treatment given
Code List
Treatment given
CL Item
no (1)
CL Item
yes (2)
Item Group
FIRST LINE TREATMENT
treatment start date
Item
1st line treatment started
date
C3173309 (UMLS CUI [1])
Item
Did the first-line treatment include HSCT
integer
C0472699 (UMLS CUI [1])
Did the first-line treatment include HSCT
Code List
Did the first-line treatment include HSCT
CL Item
yes (1)
CL Item
no (2)
Item
if the first-line treatment include HSCT
integer
C0472699 (UMLS CUI [1])
if the first-line treatment include HSCT
Code List
if the first-line treatment include HSCT
CL Item
Upfront (1)
CL Item
Adjuvant (2)
C1298675 (UMLS CUI-1)
Item
Modality
integer
C0695347 (UMLS CUI [1])
Modality
Code List
Modality
CL Item
Chemotherapy (1)
CL Item
Adjuvant Chemotherapy (2)
CL Item
Neoadjuvant Chemotherapy (3)
CL Item
Surgery (4)
CL Item
Radiotherapy (5)
CL Item
Other (6)
Item
Drugs
integer
C0392920 (UMLS CUI [1])
Drugs
Code List
Drugs
CL Item
Anthracyclines (1)
C0282564 (UMLS CUI-1)
CL Item
Taxanes (2)
C3541958 (UMLS CUI-1)
CL Item
Platinum compounds (3)
C3536920 (UMLS CUI-1)
CL Item
Antimetabolites (4)
C0003376 (UMLS CUI-1)
CL Item
Cyclophosphamide or other alkylating agents (5)
C0010583 (UMLS CUI-1)
CL Item
Vinca Alkaloids (6)
C0042672 (UMLS CUI-1)
CL Item
Etoposide (7)
C0015133 (UMLS CUI-1)
CL Item
Other (8)
C0205394 (UMLS CUI-1)
Drugs
Item
if other drugs
text
Item
If breast cancer, type of surgery
text
Modality Surgery
Code List
If breast cancer, type of surgery
CL Item
Mastectomy (1)
CL Item
Conservative (2)
Modality
Item
if other Modality
text
Item
Status of disease after first line treatment (best response)
text
Status of disease after first line treatment (best response)
Code List
Status of disease after first line treatment (best response)
CL Item
Complete Remission (1)
CL Item
Partial Remission (2)
CL Item
Not Evaluable (3)
CL Item
Stable Disease (4)
CL Item
Refractory Disease (5)
Item
Criteria used for evaluation
text
Criteria used for evaluation
Code List
Criteria used for evaluation
CL Item
WHO criteria (1)
CL Item
RECIST criteria (2)
Item
ADDITIONAL LINES OF TREATMENT BEFORE THIS HSCT FOR RELAPSED/REFRACTORY DISEASE
text
ADDITIONAL LINES OF TREATMENT BEFORE THIS HSCT FOR RELAPSED/REFRACTORY DISEASE
Code List
ADDITIONAL LINES OF TREATMENT BEFORE THIS HSCT FOR RELAPSED/REFRACTORY DISEASE
CL Item
no (1)
CL Item
yes (2)
Item Group
TREATMENT HISTORY BEFORE HSCT
Date of HSCT
Item
Date of HSCT
date
C2584899 (UMLS CUI [1])
Item
Total number of lines before this HSCT
integer
C0577303 (UMLS CUI [1])
TREATMENT SUMMARY
Code List
Total number of lines before this HSCT
CL Item
1 (1)
CL Item
2 (2)
CL Item
3 (3)
CL Item
4 (4)
CL Item
>4 (5)
CL Item
unknown (6)
Item
Modality used at least once Chemotherapy
integer
C0392920 (UMLS CUI [1])
Modality used at least once Chemotherapy
Code List
Modality used at least once Chemotherapy
CL Item
no (1)
C1298908 (UMLS CUI-1)
CL Item
yes (2)
C1705108 (UMLS CUI-1)
CL Item
unknown (3)
C0439673 (UMLS CUI-1)
Item
Modality used at least once Surgery
integer
C0543467 (UMLS CUI [1])
Modality used at least once Surgery
Code List
Modality used at least once Surgery
CL Item
no (1)
CL Item
yes (2)
CL Item
unknown (3)
Item
Modality used at least once Radiotherapy
integer
C1522449 (UMLS CUI [1])
Modality used at least once Radiotherapy
Code List
Modality used at least once Radiotherapy
CL Item
no (1)
CL Item
yes (2)
CL Item
unknown (3)
Item
Modality used at least once other
integer
C0695347 (UMLS CUI [1])
Modality used at least once other
Code List
Modality used at least once other
CL Item
no (1)
CL Item
yes (2)
CL Item
unknown (3)
Item Group
STATUS OF DISEASE AT HSCT
Item
STATUS OF DISEASE AT HSCT
integer
C1704632 (UMLS CUI [1,1])
C0472699 (UMLS CUI [1,2])
STATUS OF DISEASE AT HSCT
Code List
STATUS OF DISEASE AT HSCT
CL Item
Adjuvant (1)
CL Item
Never treated (upfront) (2)
CL Item
Primary refractory (3)
CL Item
Complete remission (CR) (4)
CL Item
1st Partial remission (PR1) (5)
CL Item
Relapse (6)
CL Item
Progressive disease (PD) (7)
Item
if CR please specify
integer
C0677874 (UMLS CUI [1])
STATUS OF DISEASE AT HSCT
Code List
if CR please specify
CL Item
Confirmed (1)
CL Item
Unconfirmed (CRU*) (2)
CL Item
Unknown (3)
Item
if Relapse please specify
integer
C0035020 (UMLS CUI [1])
STATUS OF DISEASE AT HSCT
Code List
if Relapse please specify
CL Item
Local (1)
C0205276 (UMLS CUI-1)
CL Item
Metastatic (2)
C0036525 (UMLS CUI-1)
Item
Complete remission (CR) Number
integer
C0237753 (UMLS CUI [1,1])
C0677874 (UMLS CUI [1,2])
undefined item
Code List
Complete remission (CR) Number
CL Item
1st (1)
CL Item
2nd (2)
CL Item
3rd or higher (3)
Item
Complete relapse Number
integer
C2347944 (UMLS CUI [1,1])
C0237753 (UMLS CUI [1,2])
Complete relapse Number
Code List
Complete relapse Number
CL Item
1st (1)
CL Item
2nd (2)
CL Item
3rd or higher (3)
Item
SENSITIVITY TO CHEMOTHERAPY
integer
C2363824 (UMLS CUI [1])
SENSITIVITY TO CHEMOTHERAPY
Code List
SENSITIVITY TO CHEMOTHERAPY
CL Item
Sensitive (SR:>50% response) (1)
C1522640 (UMLS CUI-1)
CL Item
Resistant (RR:<50% response) (2)
C0332325 (UMLS CUI-1)
CL Item
Untreated (3)
C0332155 (UMLS CUI-1)
Item
Organ(s) involved
integer
C0449953 (UMLS CUI [1])
Organ(s) involved
Code List
Organ(s) involved
CL Item
Nodes Below Diaphragm (1)
C0230210 (UMLS CUI-1)
C0024204 (UMLS CUI-2)
CL Item
Bone marrow (2)
C0005953 (UMLS CUI-1)
CL Item
CNS (3)
C3714787 (UMLS CUI-1)
CL Item
Mediastinum (4)
C0025066 (UMLS CUI-1)
CL Item
Soft Tissue (5)
C0225317 (UMLS CUI-1)
CL Item
Gastrointestinal tract (6)
C0017189 (UMLS CUI-1)
CL Item
Liver (7)
C0023884 (UMLS CUI-1)
CL Item
Nodes Above Diaphragm (8)
C0024204 (UMLS CUI-1)
CL Item
Bone (9)
C0265917 (UMLS CUI-1)
CL Item
Lungs (10)
C0024109 (UMLS CUI-1)
CL Item
Heart (11)
C0018787 (UMLS CUI-1)
CL Item
Skin (12)
C1123023 (UMLS CUI-1)
CL Item
Urogenital tract (13)
C0042066 (UMLS CUI-1)
CL Item
Ovaries/Testes (14)
C0545968 (UMLS CUI-1)
Item
Primary site affected
integer
C0449695 (UMLS CUI [1])
Primary site affected
Code List
Primary site affected
CL Item
yes (1)
CL Item
no (2)
Item Group
ADDITIONAL TREATMENT POST-HSCT
Additional Disease Treatment
Item
Additional Disease Treatment
boolean
C1706712 (UMLS CUI [1])
Item
if ADDITIONAL DISEASE TREATMENT
integer
C1706712 (UMLS CUI [1])
ADDITIONAL DISEASE TREATMENT
Code List
if ADDITIONAL DISEASE TREATMENT
CL Item
Planned (planned before HSCT took place) (1)
CL Item
Not planned (for relapse/progression or persistent disease) (2)
Item Group
BEST DISEASE RESPONSE AT 100 DAYS POST-HSCT
Item
BEST RESPONSE AT 100 DAYS AFTER HSCT
text
C2986560 (UMLS CUI [1])
BEST RESPONSE AT 100 DAYS AFTER HSCT
Code List
BEST RESPONSE AT 100 DAYS AFTER HSCT
CL Item
Complete Remission (1)
C0677874 (UMLS CUI-1)
CL Item
Very Good Partial Remission (2)
C4053871 (UMLS CUI-1)
CL Item
Partial Remission (>50%) (3)
C1521726 (UMLS CUI-1)
CL Item
Not Evaluable (4)
C1883425 (UMLS CUI-1)
CL Item
Stable Disease (5)
C0677946 (UMLS CUI-1)
CL Item
Progressive Disease (6)
C1335499 (UMLS CUI-1)
CL Item
Minor Response (>25% and <50%) (7)
C4050513 (UMLS CUI-1)
LesionAssessmentDate
Item
Date of Evaluation
date
C0011008 (UMLS CUI [1,1])
C0221198 (UMLS CUI [1,2])
C0031809 (UMLS CUI [1,3])
Item Group
FORMS TO BE FILLED IN
Item
TYPE OF TRANSPLANT
text
C0559189 (UMLS CUI [1,1])
C0040739 (UMLS CUI [1,2])
TYPE OF TRANSPLANT
Code List
TYPE OF TRANSPLANT
CL Item
AUTOgraft, proceed to Autograft form (1)
CL Item
ALLOgraft or Syngeneic graft, proceed to Allograft form (2)
CL Item
Other (3)
TYPE OF TRANSPLANT
Item
it other type of transplant contact the EBMT Central Registry Office for instructions
text
C0559189 (UMLS CUI [1,1])
C0040739 (UMLS CUI [1,2])
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