ID

42804

Description

Lymphoma - Transplant Treatment Form Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D5EA8AC6-6F28-703F-E034-0003BA12F5E7

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=D5EA8AC6-6F28-703F-E034-0003BA12F5E7

Keywords

Versions (4)
  1. 9/20/12 9/20/12 -
  2. 1/9/15 1/9/15 - Martin Dugas
  3. 1/9/15 1/9/15 - Martin Dugas
  4. 9/17/21 9/17/21 -
Uploaded on

September 17, 2021

DOI

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License

Creative Commons BY-NC 3.0 Legacy
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Treatment - Lymphoma - Transplant Treatment Form - 2269914v3.0

English

No Instruction available.

1 forms  
  1. StudyEvent: Lymphoma - Transplant Treatment Form
    1. No Instruction available.
Crf Header
Description

Crf Header

Coordinating Group Protocol No.
Description

Protocol ID Coordinating Group

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1711341
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Coordinating Group Code
Description

Coordinating Group Code

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS CUI-1
C1711341
NCI Thesaurus ObjectClass
C17005
UMLS CUI-2
C0805701
NCI Thesaurus ObjectClass-2
C25462
NCI Thesaurus Property
C25364
Protocol Title
Description

Protocol Title

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986303
NCI Thesaurus ObjectClass
C25320
NCI Thesaurus Property
C42774
Patient Study ID
Description

Patient Study ID

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25462
NCI Thesaurus Property-2
C25364
Institution/Affiliate
Description

Institution Name

Data type

text

Alias
NCI Thesaurus ObjectClass
C25454
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass-2
C21541
NCI Thesaurus Property
C25364
NCI Thesaurus ValueDomain
C25191
NCI Thesaurus ValueDomain-2
C21541
Other Patient ID
Description

Trial subject ID Participating Group

Data type

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C2348585
NCI Thesaurus ObjectClass
C16960
UMLS CUI-2
C2347449
NCI Thesaurus Property
C25608
NCI Thesaurus Property-2
C25364
Participating Group Code
Description

ParticipatingGroupIdentifierCode

Data type

text

Alias
NCI Thesaurus ValueDomain
C25162
UMLS 2011AA ValueDomain
C0805701
NCI Thesaurus ObjectClass
C25608
UMLS 2011AA ObjectClass
C0679823
NCI Thesaurus ObjectClass-2
C17005
UMLS 2011AA ObjectClass-2
C1257890
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Name (initials acceptable)
Description

Patient Name

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1299487
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25364
Lymphoma: Form Administration
Description

Lymphoma: Form Administration

Person Completing Form
Description

Person Completing Form

Data type

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1550483
NCI Thesaurus ObjectClass
C25657
NCI Thesaurus Property
C25364
Are data amended? (If data are amended, please circle in red when using paper form)
Description

Data amended

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS CUI-1
C0680532
NCI Thesaurus ObjectClass
C25474
NCI Thesaurus Property
C25416
Lymphoma Transplant: Treatment Plan
Description

Lymphoma Transplant: Treatment Plan

Did the patient receive protocol transplant?
Description

ProtocolTransplantPerformedInd-3

Data type

boolean

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C38000
UMLS 2011AA Property
C0884358
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ObjectClass-2
C42651
UMLS 2011AA ObjectClass-2
C0442711
Date of Admission for Transplant
Description

TransplantAdmissionDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C25385
UMLS 2011AA Property
C0809949
Date of Bone Marrow or Peripheral Blood Stem Cell Infusion
Description

PeripheralBloodStemCellTransplantInfusionDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ObjectClass-2
C12946
UMLS 2011AA ObjectClass-2
C1518999
NCI Thesaurus Property
C15388
UMLS 2011AA Property
C0574032
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25367
Date of Discharge following Transplant
Description

TransplantDischargeDate

Data type

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25367
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C25166
UMLS 2011AA Property
C0030685
Type of Transplant
Description

TransplantProcedureType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C15368
Other specify
Description

TransplantProcedureSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C15368
Type of Donor Match (If allogeneic,)
Description

TransplantDonorMatchingType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C25365
UMLS 2011AA Property
C0678257
NCI Metathesaurus Property
C0150103
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other specify
Description

TransplantDonorMatchingSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C25168
UMLS 2011AA Property
C0040288
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
Source of Cells Transplanted
Description

TransplantCellSourceType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property-2
C25365
UMLS 2011AA Property-2
C0678257
Other specify
Description

TransplantCellSourceSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property-2
C25365
UMLS 2011AA Property-2
C0678257
How were cells manipulated
Description

TransplantCellPreparationType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property-2
C25625
UMLS 2011AA Property-2
C1521827
Other specify
Description

TransplantCellPreparationSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C12508
UMLS 2011AA Property
C0007634
NCI Thesaurus Property-2
C25625
UMLS 2011AA Property-2
C1521827
Technique (If T-cell Depletion,)
Description

TransplantT-LymphocyteslRemovedType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C12476
UMLS 2011AA Property
C0039194
NCI Thesaurus Property-2
C25650
UMLS 2011AA Property-2
C0849355
Other specify
Description

TransplantT-LymphocyteRemovedSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C12476
UMLS 2011AA Property
C0039194
NCI Thesaurus Property-2
C25650
UMLS 2011AA Property-2
C0849355
Number of CD34-positive cells infused (cells/kg x 10^6)
Description

TransplantCD34+CellInfusionDose

Data type

float

Alias
NCI Thesaurus Property
C15388
UMLS 2011AA Property
C0574032
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Metathesaurus Property
C0882849
Number of CD3-positive cells infused (cells/kg x 10^6)
Description

TransplantCD3+CellInfusionDose

Data type

float

Alias
NCI Thesaurus Property
C15388
UMLS 2011AA Property
C0574032
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Metathesaurus Property
C0882828
Lymphoma Transplant: Donor Lymphocyte Infusions
Description

Lymphoma Transplant: Donor Lymphocyte Infusions

Date of DLI
Description

TransplantLymphocyteInfusionDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C15388
UMLS 2011AA Property
C0574032
NCI Thesaurus Property-2
C12535
UMLS 2011AA Property-2
C0024264
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25367
Number of DLI
Description

TransplantLymphocyteInfusionCount

Data type

float

Alias
NCI Thesaurus Property
C15388
UMLS 2011AA Property
C0574032
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property-2
C12535
UMLS 2011AA Property-2
C0024264
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Reason for DLI
Description

TransplantDonorLymphocyteAdministeredReason

Data type

text

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C12535
UMLS 2011AA Property
C0024264
NCI Thesaurus Property-2
C25382
UMLS 2011AA Property-2
C1521801
NCI Thesaurus ValueDomain
C25638
UMLS 2011AA ValueDomain
C0392360
Other specify
Description

TransplantDonorLymphocyteAdministeredSpecify

Data type

text

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C12535
UMLS 2011AA Property
C0024264
NCI Thesaurus Property-2
C25382
UMLS 2011AA Property-2
C1521801
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
Total Number of cells infused (cells/kg x 10^6)
Description

TransplantLymphocyteInfusionTotalDose

Data type

float

Alias
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C15388
UMLS 2011AA Property
C0574032
NCI Thesaurus Property-2
C12535
UMLS 2011AA Property-2
C0024264
NCI Thesaurus ValueDomain
C25304
UMLS 2011AA ValueDomain
C0439810
NCI Thesaurus ValueDomain-2
C25488
UMLS 2011AA ValueDomain-2
C0178602
Number of dendritic cells infused (cells/kg x 10^6)
Description

LymphocyteTransplantDendriticInfusionDose

Data type

float

Alias
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ObjectClass-2
C12535
UMLS 2011AA ObjectClass-2
C0024264
NCI Thesaurus Property
C15388
UMLS 2011AA Property
C0574032
NCI Thesaurus Property-2
C12583
UMLS 2011AA Property-2
C0011306
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
Number of CD34-positive cells infused (cells/kg x 10^6)
Description

TransplantCD34+CellInfusionDose

Data type

float

Alias
NCI Thesaurus Property
C15388
UMLS 2011AA Property
C0574032
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Metathesaurus Property
C0882849
Number of CD3-positive cells infused (cells/kg x 10^6)
Description

TransplantCD3+CellInfusionDose

Data type

float

Alias
NCI Thesaurus Property
C15388
UMLS 2011AA Property
C0574032
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ValueDomain
C25488
UMLS 2011AA ValueDomain
C0178602
NCI Metathesaurus Property
C0882828
Lymphoma Transplant: Allogeneic - Donor Information
Description

Lymphoma Transplant: Allogeneic - Donor Information

Donor's relationship to patient
Description

TransplantDonorPatientRelationshipType

Data type

text

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C16960
UMLS 2011AA Property
C0030705
NCI Metathesaurus Property
CL110661
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other specify
Description

TransplantDonorRelatedSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ValueDomain-2
C25648
UMLS 2011AA ValueDomain-2
C0439849
NCI Thesaurus Property
C25168
UMLS 2011AA Property
C0040288
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
Donor Birth Date
Description

TransplantDonorBirthDate

Data type

date

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C25155
UMLS 2011AA Property
C0005615
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain-2
C25367
Donor Gender
Description

TransplantDonorGenderType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C17357
UMLS 2011AA Property
C0079399
Does donor have any children (including the transplant recipient)
Description

TransplantChildDonorInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus Property
C25168
UMLS 2011AA Property
C0040288
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property-2
C42708
UMLS 2011AA Property-2
C0680063
Does donor have positive antibody titer to cytomegalovirus (CMV)
Description

TransplantDonorCytomegalovirusAntibodyInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C14196
UMLS 2011AA Property
C0010825
NCI Thesaurus Property-2
C16295
UMLS 2011AA Property-2
C0003241
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Does donor have positive antibody titer to Epstein-Barr virus (EBV)
Description

TransplantDonorEpstein-BarrVirusAntibodyInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C14204
UMLS 2011AA Property
C0014644
NCI Thesaurus Property-2
C16295
UMLS 2011AA Property-2
C0003241
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Does donor have positive titer to hepatitis B surface antibody
Description

TransplantDonorAntibodyHepatitisBSurfaceAntigenInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Metathesaurus Property
C0518943
Does donor have positive titer to hepatitis B core antibody
Description

TransplantDonorHepatitisBVirusAntibodyInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C14215
UMLS 2011AA Property
C0019169
NCI Thesaurus Property-2
C16295
UMLS 2011AA Property-2
C0003241
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Does donor have positive titer to hepatitis B surface antigen (HBSAg)
Description

TransplantDonorHepatitisBSurfaceAntigenInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Metathesaurus Property
C0019168
Does donor have positive antibody titer to hepatitis C virus (HCV)
Description

TransplantDonorHepatitisCVirusAntibodyInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C14312
UMLS 2011AA Property
C0220847
NCI Thesaurus Property-2
C16295
UMLS 2011AA Property-2
C0003241
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Does donor have positive antibody titer to herpes simplex virus (HSV)
Description

TransplantDonorHerpesSimplexVirusAntibodyInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C14311
UMLS 2011AA Property
C0206558
NCI Thesaurus Property-2
C16295
UMLS 2011AA Property-2
C0003241
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Does donor have positive antibody titer to human immunodeficiency virus (HIV)
Description

TransplantDonorHumanImmunodeficiencyVirusAntibodyInd-3

Data type

text

Alias
NCI Thesaurus ObjectClass
C25168
UMLS 2011AA ObjectClass
C0040288
NCI Thesaurus ObjectClass-2
C12981
UMLS 2011AA ObjectClass-2
C0332835
NCI Thesaurus Property
C14219
UMLS 2011AA Property
C0019682
NCI Thesaurus Property-2
C16295
UMLS 2011AA Property-2
C0003241
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
Result of Histocompatibility Tests (HLA-A, etc.)
Description

TransplantCompatibleMatchType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C40414
UMLS 2011AA Property
C1524057
Other specify
Description

TransplantCompatibleMatchingSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus Property
C40414
UMLS 2011AA Property
C1524057
Are patient and donor mismatched at HLA-A
Description

HLA-AAntigenTransplantCompatibleInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ObjectClass-2
C28585
UMLS 2011AA ObjectClass-2
C1333899
NCI Thesaurus Property
C40414
UMLS 2011AA Property
C1524057
Are patient and donor mismatched at HLA-B
Description

HLA-BAntigenTransplantCompatibleInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ObjectClass-2
C62778
UMLS 2011AA ObjectClass-2
C1415561
NCI Thesaurus Property
C40414
UMLS 2011AA Property
C1524057
Are patient and donor mismatched at HLA-C
Description

HLA-CAntigensTransplantCompatibleInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ObjectClass-2
C62758
UMLS 2011AA ObjectClass-2
C1415562
NCI Thesaurus Property
C40414
UMLS 2011AA Property
C1524057
Are patient and donor mismatched at HLA-DrB1
Description

HLA-DrB1TransplantCompatibleInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ObjectClass-2
C19409
UMLS 2011AA ObjectClass-2
C1415576
NCI Thesaurus Property
C40414
UMLS 2011AA Property
C1524057
Are patient and donor mismatched at HLA-DQB1
Description

HLA-DQB1TransplantCompatibleInd-3

Data type

text

Alias
NCI Thesaurus ValueDomain
C38148
UMLS 2011AA ValueDomain
C1512699
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Thesaurus ObjectClass-2
C62792
UMLS 2011AA ObjectClass-2
C0019761
NCI Thesaurus Property
C40414
UMLS 2011AA Property
C1524057
Method used for Donor Matching
Description

TransplantMatchingMethodType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
C0150103
Method used for Donor Matching
Description

TransplantMatchingMethodType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
C0150103
Method used for Donor Matching
Description

TransplantMatchingMethodType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
C0150103
Method used for Donor Matching
Description

TransplantMatchingMethodType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
C0150103
Method used for Donor Matching
Description

TransplantMatchingMethodType

Data type

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
C0150103
Other specify
Description

TransplantMatchingMethodSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
C0150103
Other specify
Description

TransplantMatchingMethodSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
C0150103
Other specify
Description

TransplantMatchingMethodSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
C0150103
Other specify
Description

TransplantMatchingMethodSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
C0150103
Other specify
Description

TransplantMatchingMethodSpecify

Data type

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus Property
C16847
UMLS 2011AA Property
C0449851
NCI Thesaurus ObjectClass
C12981
UMLS 2011AA ObjectClass
C0332835
NCI Metathesaurus Property
C0150103
Comments
Description

Comments

Comments
Description

Research Comments

Data type

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
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1 forms
  1. StudyEvent: Lymphoma - Transplant Treatment Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Crf Header
Protocol ID Coordinating Group
Item
Coordinating Group Protocol No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1711341 (UMLS CUI-2)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Coordinating Group Code
Item
Coordinating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C1711341 (UMLS CUI-1)
C17005 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25462 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
Protocol Title
Item
Protocol Title
text
C25191 (NCI Thesaurus ValueDomain)
C2986303 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C42774 (NCI Thesaurus Property)
Patient Study ID
Item
Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25462 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
Institution Name
Item
Institution/Affiliate
text
C25454 (NCI Thesaurus ObjectClass)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass-2)
C25364 (NCI Thesaurus Property)
C25191 (NCI Thesaurus ValueDomain)
C21541 (NCI Thesaurus ValueDomain-2)
Trial subject ID Participating Group
Item
Other Patient ID
text
C25337 (NCI Thesaurus ValueDomain)
C2348585 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C2347449 (UMLS CUI-2)
C25608 (NCI Thesaurus Property)
C25364 (NCI Thesaurus Property-2)
ParticipatingGroupIdentifierCode
Item
Participating Group Code
text
C25162 (NCI Thesaurus ValueDomain)
C0805701 (UMLS 2011AA ValueDomain)
C25608 (NCI Thesaurus ObjectClass)
C0679823 (UMLS 2011AA ObjectClass)
C17005 (NCI Thesaurus ObjectClass-2)
C1257890 (UMLS 2011AA ObjectClass-2)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
Patient Name
Item
Patient Name (initials acceptable)
text
C25191 (NCI Thesaurus ValueDomain)
C1299487 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Item Group
Lymphoma: Form Administration
Person Completing Form
Item
Person Completing Form
text
C25191 (NCI Thesaurus ValueDomain)
C1550483 (UMLS CUI-1)
C25657 (NCI Thesaurus ObjectClass)
C25364 (NCI Thesaurus Property)
Data amended
Item
Are data amended? (If data are amended, please circle in red when using paper form)
boolean
C38148 (NCI Thesaurus ValueDomain)
C0680532 (UMLS CUI-1)
C25474 (NCI Thesaurus ObjectClass)
C25416 (NCI Thesaurus Property)
Item Group
Lymphoma Transplant: Treatment Plan
ProtocolTransplantPerformedInd-3
Item
Did the patient receive protocol transplant?
boolean
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C38000 (NCI Thesaurus Property)
C0884358 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C42651 (NCI Thesaurus ObjectClass-2)
C0442711 (UMLS 2011AA ObjectClass-2)
TransplantAdmissionDate
Item
Date of Admission for Transplant
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C25385 (NCI Thesaurus Property)
C0809949 (UMLS 2011AA Property)
PeripheralBloodStemCellTransplantInfusionDate
Item
Date of Bone Marrow or Peripheral Blood Stem Cell Infusion
date
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C12946 (NCI Thesaurus ObjectClass-2)
C1518999 (UMLS 2011AA ObjectClass-2)
C15388 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
TransplantDischargeDate
Item
Date of Discharge following Transplant
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C25166 (NCI Thesaurus Property)
C0030685 (UMLS 2011AA Property)
Item
Type of Transplant
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
CL.3
Code List
Type of Transplant
CL Item
Allogeneic (Allogeneic)
CL Item
Nonmyeloablative (Nonmyeloablative)
CL Item
Autologous (Autologous)
C28000 (NCI Thesaurus)
C0439859 (UMLS 2011AA)
CL Item
Syngeneic (Syngeneic)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
TransplantProcedureSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C15368 (NCI Thesaurus Property)
Item
Type of Donor Match (If allogeneic,)
text
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C25365 (NCI Thesaurus Property)
C0678257 (UMLS 2011AA Property)
C0150103 (NCI Metathesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.4
Code List
Type of Donor Match (If allogeneic,)
CL Item
Matched Sibling Or Family Member (Matched sibling or family member)
CL Item
Matched Unrelated Donor (Matched unrelated donor)
CL Item
Mismatched Sibling Or Family Member (Mismatched sibling or family member)
CL Item
Mismatched Unrelated Donor (Mismatched unrelated donor)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
TransplantDonorMatchingSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25168 (NCI Thesaurus Property)
C0040288 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
Item
Source of Cells Transplanted
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property-2)
C0678257 (UMLS 2011AA Property-2)
CL.5
Code List
Source of Cells Transplanted
CL Item
Bone Marrow (Bone marrow)
C12431 (NCI Thesaurus)
C0005953 (UMLS 2011AA)
CL Item
Bone Marrow And Pbsc (Bone marrow and PBSC)
CL Item
Peripheral Blood Stem Cells (Peripheral blood stem cells)
CL Item
Cord Blood (Cord blood)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
TransplantCellSourceSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25365 (NCI Thesaurus Property-2)
C0678257 (UMLS 2011AA Property-2)
Item
How were cells manipulated
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25625 (NCI Thesaurus Property-2)
C1521827 (UMLS 2011AA Property-2)
CL.6
Code List
How were cells manipulated
CL Item
T-cell Depletion (T-cell depletion)
C15699 (NCI Thesaurus)
C0677960 (UMLS 2011AA)
CL Item
Red Cell Depletion (Red cell depletion)
CL Item
Plasma Depletion (Plasma depletion)
CL Item
Cd34 Positive Selection To Purge Malignant Cells (CD34 positive selection to purge malignant cells)
CL Item
Direct Purging Of Malignant Cells (not By Cd34+ Selection) (Direct purging of malignant cells (not by CD34+ selection))
CL Item
Cryopreservation (Cryopreservation)
C16475 (NCI Thesaurus)
C0010405 (UMLS 2011AA)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
TransplantCellPreparationSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C12508 (NCI Thesaurus Property)
C0007634 (UMLS 2011AA Property)
C25625 (NCI Thesaurus Property-2)
C1521827 (UMLS 2011AA Property-2)
Item
Technique (If T-cell Depletion,)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C12476 (NCI Thesaurus Property)
C0039194 (UMLS 2011AA Property)
C25650 (NCI Thesaurus Property-2)
C0849355 (UMLS 2011AA Property-2)
CL.7
Code List
Technique (If T-cell Depletion,)
CL Item
Monoclonal Antibody (Monoclonal antibody)
C20401 (NCI Thesaurus)
C0003250 (UMLS 2011AA)
CL Item
Immunotoxin (Immunotoxin)
C575 (NCI Thesaurus)
C0021084 (UMLS 2011AA)
CL Item
Immunomagnetic Beads (Immunomagnetic beads)
CL Item
Centrifugal Elutriation (Centrifugal elutriation)
CL Item
Lectin Depletion (Lectin depletion)
CL Item
Cd34 Selection (column) (CD34 selection (column))
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
TransplantT-LymphocyteRemovedSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C12476 (NCI Thesaurus Property)
C0039194 (UMLS 2011AA Property)
C25650 (NCI Thesaurus Property-2)
C0849355 (UMLS 2011AA Property-2)
TransplantCD34+CellInfusionDose
Item
Number of CD34-positive cells infused (cells/kg x 10^6)
float
C15388 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C0882849 (NCI Metathesaurus Property)
TransplantCD3+CellInfusionDose
Item
Number of CD3-positive cells infused (cells/kg x 10^6)
float
C15388 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C0882828 (NCI Metathesaurus Property)
Item Group
Lymphoma Transplant: Donor Lymphocyte Infusions
TransplantLymphocyteInfusionDate
Item
Date of DLI
date
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C15388 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA Property)
C12535 (NCI Thesaurus Property-2)
C0024264 (UMLS 2011AA Property-2)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
TransplantLymphocyteInfusionCount
Item
Number of DLI
float
C15388 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C12535 (NCI Thesaurus Property-2)
C0024264 (UMLS 2011AA Property-2)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item
Reason for DLI
text
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C12535 (NCI Thesaurus Property)
C0024264 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C25638 (NCI Thesaurus ValueDomain)
C0392360 (UMLS 2011AA ValueDomain)
CL.8
Code List
Reason for DLI
CL Item
Planned Per Protocol (Planned per protocol)
CL Item
Due To Relapse (Due to relapse)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
TransplantDonorLymphocyteAdministeredSpecify
Item
Other specify
text
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C12535 (NCI Thesaurus Property)
C0024264 (UMLS 2011AA Property)
C25382 (NCI Thesaurus Property-2)
C1521801 (UMLS 2011AA Property-2)
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
TransplantLymphocyteInfusionTotalDose
Item
Total Number of cells infused (cells/kg x 10^6)
float
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C15388 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA Property)
C12535 (NCI Thesaurus Property-2)
C0024264 (UMLS 2011AA Property-2)
C25304 (NCI Thesaurus ValueDomain)
C0439810 (UMLS 2011AA ValueDomain)
C25488 (NCI Thesaurus ValueDomain-2)
C0178602 (UMLS 2011AA ValueDomain-2)
LymphocyteTransplantDendriticInfusionDose
Item
Number of dendritic cells infused (cells/kg x 10^6)
float
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C12535 (NCI Thesaurus ObjectClass-2)
C0024264 (UMLS 2011AA ObjectClass-2)
C15388 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA Property)
C12583 (NCI Thesaurus Property-2)
C0011306 (UMLS 2011AA Property-2)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
TransplantCD34+CellInfusionDose
Item
Number of CD34-positive cells infused (cells/kg x 10^6)
float
C15388 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C0882849 (NCI Metathesaurus Property)
TransplantCD3+CellInfusionDose
Item
Number of CD3-positive cells infused (cells/kg x 10^6)
float
C15388 (NCI Thesaurus Property)
C0574032 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C25488 (NCI Thesaurus ValueDomain)
C0178602 (UMLS 2011AA ValueDomain)
C0882828 (NCI Metathesaurus Property)
Item Group
Lymphoma Transplant: Allogeneic - Donor Information
Item
Donor's relationship to patient
text
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C16960 (NCI Thesaurus Property)
C0030705 (UMLS 2011AA Property)
CL110661 (NCI Metathesaurus Property)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.9
Code List
Donor's relationship to patient
CL Item
Sibling (Sibling)
C25204 (NCI Thesaurus)
C0037047 (UMLS 2011AA)
CL Item
Identical Twin (or Multiple) (Identical twin (or multiple))
CL Item
Fraternal Twin (or Multiple) (Fraternal twin (or multiple))
CL Item
Not Related (Not related)
C25648 (NCI Thesaurus)
C0439849 (UMLS 2011AA)
C25594 (NCI Thesaurus-3)
C1518422 (UMLS 2011AA-4)
CL Item
Parent (Parent)
CL Item
Child (Child)
C16423 (NCI Thesaurus)
C0008059 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
TransplantDonorRelatedSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C25648 (NCI Thesaurus ValueDomain-2)
C0439849 (UMLS 2011AA ValueDomain-2)
C25168 (NCI Thesaurus Property)
C0040288 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
TransplantDonorBirthDate
Item
Donor Birth Date
date
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C25155 (NCI Thesaurus Property)
C0005615 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain-2)
Item
Donor Gender
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C17357 (NCI Thesaurus Property)
C0079399 (UMLS 2011AA Property)
CL.10
Code List
Donor Gender
CL Item
Male (Male)
C20197 (NCI Thesaurus)
C0086582 (UMLS 2011AA)
CL Item
Female (Female)
C16576 (NCI Thesaurus)
C0086287 (UMLS 2011AA)
Item
Does donor have any children (including the transplant recipient)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25168 (NCI Thesaurus Property)
C0040288 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C42708 (NCI Thesaurus Property-2)
C0680063 (UMLS 2011AA Property-2)
CL.11
Code List
Does donor have any children (including the transplant recipient)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does donor have positive antibody titer to cytomegalovirus (CMV)
text
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C14196 (NCI Thesaurus Property)
C0010825 (UMLS 2011AA Property)
C16295 (NCI Thesaurus Property-2)
C0003241 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.12
Code List
Does donor have positive antibody titer to cytomegalovirus (CMV)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does donor have positive antibody titer to Epstein-Barr virus (EBV)
text
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C14204 (NCI Thesaurus Property)
C0014644 (UMLS 2011AA Property)
C16295 (NCI Thesaurus Property-2)
C0003241 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.13
Code List
Does donor have positive antibody titer to Epstein-Barr virus (EBV)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does donor have positive titer to hepatitis B surface antibody
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C0518943 (NCI Metathesaurus Property)
CL.14
Code List
Does donor have positive titer to hepatitis B surface antibody
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does donor have positive titer to hepatitis B core antibody
text
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C14215 (NCI Thesaurus Property)
C0019169 (UMLS 2011AA Property)
C16295 (NCI Thesaurus Property-2)
C0003241 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.15
Code List
Does donor have positive titer to hepatitis B core antibody
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does donor have positive titer to hepatitis B surface antigen (HBSAg)
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C0019168 (NCI Metathesaurus Property)
CL.16
Code List
Does donor have positive titer to hepatitis B surface antigen (HBSAg)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does donor have positive antibody titer to hepatitis C virus (HCV)
text
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C14312 (NCI Thesaurus Property)
C0220847 (UMLS 2011AA Property)
C16295 (NCI Thesaurus Property-2)
C0003241 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.17
Code List
Does donor have positive antibody titer to hepatitis C virus (HCV)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does donor have positive antibody titer to herpes simplex virus (HSV)
text
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C14311 (NCI Thesaurus Property)
C0206558 (UMLS 2011AA Property)
C16295 (NCI Thesaurus Property-2)
C0003241 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.18
Code List
Does donor have positive antibody titer to herpes simplex virus (HSV)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Does donor have positive antibody titer to human immunodeficiency virus (HIV)
text
C25168 (NCI Thesaurus ObjectClass)
C0040288 (UMLS 2011AA ObjectClass)
C12981 (NCI Thesaurus ObjectClass-2)
C0332835 (UMLS 2011AA ObjectClass-2)
C14219 (NCI Thesaurus Property)
C0019682 (UMLS 2011AA Property)
C16295 (NCI Thesaurus Property-2)
C0003241 (UMLS 2011AA Property-2)
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
CL.19
Code List
Does donor have positive antibody titer to human immunodeficiency virus (HIV)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Result of Histocompatibility Tests (HLA-A, etc.)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C40414 (NCI Thesaurus Property)
C1524057 (UMLS 2011AA Property)
CL.20
Code List
Result of Histocompatibility Tests (HLA-A, etc.)
CL Item
Matched 1 Of 6 (Matched 1 of 6)
CL Item
Matched 2 Of 6 (Matched 2 of 6)
CL Item
Matched 3 Of 6 (Matched 3 of 6)
CL Item
Matched 4 Of 6 (Matched 4 of 6)
CL Item
Matched 5 Of 6 (Matched 5 of 6)
CL Item
Matched 6 Of 6 (Matched 6 of 6)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
TransplantCompatibleMatchingSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C40414 (NCI Thesaurus Property)
C1524057 (UMLS 2011AA Property)
Item
Are patient and donor mismatched at HLA-A
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C28585 (NCI Thesaurus ObjectClass-2)
C1333899 (UMLS 2011AA ObjectClass-2)
C40414 (NCI Thesaurus Property)
C1524057 (UMLS 2011AA Property)
CL.21
Code List
Are patient and donor mismatched at HLA-A
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Are patient and donor mismatched at HLA-B
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C62778 (NCI Thesaurus ObjectClass-2)
C1415561 (UMLS 2011AA ObjectClass-2)
C40414 (NCI Thesaurus Property)
C1524057 (UMLS 2011AA Property)
CL.23
Code List
Are patient and donor mismatched at HLA-B
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Are patient and donor mismatched at HLA-C
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C62758 (NCI Thesaurus ObjectClass-2)
C1415562 (UMLS 2011AA ObjectClass-2)
C40414 (NCI Thesaurus Property)
C1524057 (UMLS 2011AA Property)
CL.25
Code List
Are patient and donor mismatched at HLA-C
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Are patient and donor mismatched at HLA-DrB1
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C19409 (NCI Thesaurus ObjectClass-2)
C1415576 (UMLS 2011AA ObjectClass-2)
C40414 (NCI Thesaurus Property)
C1524057 (UMLS 2011AA Property)
CL.27
Code List
Are patient and donor mismatched at HLA-DrB1
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Are patient and donor mismatched at HLA-DQB1
text
C38148 (NCI Thesaurus ValueDomain)
C1512699 (UMLS 2011AA ValueDomain)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C62792 (NCI Thesaurus ObjectClass-2)
C0019761 (UMLS 2011AA ObjectClass-2)
C40414 (NCI Thesaurus Property)
C1524057 (UMLS 2011AA Property)
CL.29
Code List
Are patient and donor mismatched at HLA-DQB1
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Unknown (Unknown)
C17998 (NCI Thesaurus)
C0439673 (UMLS 2011AA)
Item
Method used for Donor Matching
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C0150103 (NCI Metathesaurus Property)
CL.30
Code List
Method used for Donor Matching
CL Item
Serology (Serology)
CL Item
Dna (DNA)
C0012854 (NCI Metathesaurus)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Item
Method used for Donor Matching
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C0150103 (NCI Metathesaurus Property)
CL.30
Code List
Method used for Donor Matching
CL Item
Serology (Serology)
CL Item
Dna (DNA)
C0012854 (NCI Metathesaurus)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Item
Method used for Donor Matching
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C0150103 (NCI Metathesaurus Property)
CL.30
Code List
Method used for Donor Matching
CL Item
Serology (Serology)
CL Item
Dna (DNA)
C0012854 (NCI Metathesaurus)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Item
Method used for Donor Matching
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C0150103 (NCI Metathesaurus Property)
CL.30
Code List
Method used for Donor Matching
CL Item
Serology (Serology)
CL Item
Dna (DNA)
C0012854 (NCI Metathesaurus)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
Item
Method used for Donor Matching
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C0150103 (NCI Metathesaurus Property)
CL.30
Code List
Method used for Donor Matching
CL Item
Serology (Serology)
CL Item
Dna (DNA)
C0012854 (NCI Metathesaurus)
CL Item
Other (Other)
C17649 (NCI Thesaurus)
C0205394 (UMLS 2011AA)
TransplantMatchingMethodSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C0150103 (NCI Metathesaurus Property)
TransplantMatchingMethodSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C0150103 (NCI Metathesaurus Property)
TransplantMatchingMethodSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C0150103 (NCI Metathesaurus Property)
TransplantMatchingMethodSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C0150103 (NCI Metathesaurus Property)
TransplantMatchingMethodSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C16847 (NCI Thesaurus Property)
C0449851 (UMLS 2011AA Property)
C12981 (NCI Thesaurus ObjectClass)
C0332835 (UMLS 2011AA ObjectClass)
C0150103 (NCI Metathesaurus Property)
Item Group
Comments
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
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