ID
43882
Beskrivning
ODM form derived from 16pp General Info EBMT Lymphoma 04. please refer to: http://www.ebmt.org/Contents/Data-Management/Registrystructure/MED-ABdatacollectionforms/Pages/MED-AB-data-collection-forms.aspx
Länk
Nyckelord
Versioner (3)
- 2017-09-27 2017-09-27 -
- 2017-09-27 2017-09-27 -
- 2021-09-20 2021-09-20 -
Uppladdad den
20 september 2021
DOI
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Creative Commons BY-NC 3.0
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General Info EBMT Lymphoma
16pp General Info EBMT Lymphoma 04
- StudyEvent: ODM
Beskrivning
GENERAL INFORMATION Patient
Beskrivning
To be entered only if patient previously reported
Datatyp
integer
Alias
- UMLS CUI [1]
- C2348585
Beskrivning
Hospital Unique Patient Number or Code
Datatyp
integer
Alias
- UMLS CUI [1]
- C2926025
Beskrivning
First name(s)_surname(s)
Datatyp
text
Alias
- UMLS CUI [1]
- C2986440
Beskrivning
Date of birth
Datatyp
date
Alias
- UMLS CUI [1]
- C0421451
Beskrivning
Sex
Datatyp
text
Alias
- UMLS CUI [1]
- C0079399
Beskrivning
ABO Group
Datatyp
integer
Alias
- UMLS CUI [1]
- C0000778
Beskrivning
Rh factor
Datatyp
integer
Alias
- UMLS CUI [1]
- C0035403
Beskrivning
DISEASE
Beskrivning
Date of diagnosis
Datatyp
date
Alias
- UMLS CUI [1]
- C2316983
Beskrivning
Check the disease for which this transplant was performed
Datatyp
integer
Alias
- UMLS CUI [1]
- C0277554
Beskrivning
LYMPHOMA INITIAL DIAGNOSIS
Beskrivning
Has the information requested in this section been submitted with a previous transplant registration for this patient?
Datatyp
integer
Alias
- UMLS CUI [1]
- C0421512
Beskrivning
Non Hodgkin Lymphoma (NHL)
Datatyp
integer
Alias
- UMLS CUI [1]
- C0024305
Beskrivning
Transformed from another type of lymphoma at HSCT?
Datatyp
boolean
Alias
- UMLS CUI [1]
- C0854868
Beskrivning
Mature T-cell & NK-cell Neoplasms
Datatyp
integer
Alias
- UMLS CUI [1]
- C1336554
Beskrivning
HODGKIN LYMPHOMAS
Datatyp
integer
Alias
- UMLS CUI [1]
- C0019829
Beskrivning
ANN ARBOR STAGING FOR ADULT NON-BURKITT'S PATIENTS, MURPHY STAGE FOR BURKITT'S DISEASE AND PAEDIATRIC PATIENTS.
Datatyp
text
Alias
- UMLS CUI [1]
- C1300072
Beskrivning
Systemic symptoms
Datatyp
text
Alias
- UMLS CUI [1]
- C2039684
Beskrivning
DISEASE INVOLVEMENT AT DIAGNOSIS
Datatyp
integer
Alias
- UMLS CUI [1]
- C1272779
Beskrivning
LDH LEVELS
Datatyp
integer
Alias
- UMLS CUI [1]
- C0022917
Beskrivning
Specific sites of involvement
Datatyp
integer
Alias
- UMLS CUI [1]
- C2046538
Beskrivning
TREATMENT GIVEN BEFORE THE 1ST TRANSPLANT
Beskrivning
Has the information requested in this section been submitted with a previous transplant registration for this patient?
Datatyp
integer
Alias
- UMLS CUI [1]
- C1514821
Beskrivning
WAS THE PATIENT TREATED BEFORE THE 1ST TRANSPLANT PROCEDURE?
Datatyp
integer
Alias
- UMLS CUI [1]
- C0040732
Beskrivning
Sequential number of this treatment
Datatyp
integer
Alias
- UMLS CUI [1]
- C0087111
Beskrivning
Modality Chemo/drug/agent
Datatyp
text
Alias
- UMLS CUI [1]
- C0695347
Beskrivning
If MoAB, radiolabelled
Datatyp
text
Alias
- UMLS CUI [1]
- C0392292
Beskrivning
Radiotherapy
Datatyp
boolean
Alias
- UMLS CUI [1]
- C1522449
Beskrivning
Response to this line of therapy
Datatyp
integer
Alias
- UMLS CUI [1]
- C0521982
Beskrivning
ADDITIONAL TREATMENT GIVEN BEFORE THE 1ST TRANSPLANT?
Datatyp
text
Alias
- UMLS CUI [1]
- C1706712
Beskrivning
Pharmacotherapy
Datatyp
boolean
Alias
- UMLS CUI [1]
- C0013216
Beskrivning
Regimen
Datatyp
integer
Alias
- UMLS CUI [1]
- C0392920
Beskrivning
Radiotherapy
Datatyp
boolean
Alias
- UMLS CUI [1]
- C1522449
Beskrivning
Response to this line of therapy
Datatyp
text
Alias
- UMLS CUI [1]
- C0871261
Beskrivning
DISEASE HISTORY BEFORE HSCT
Beskrivning
Date of transplant
Datatyp
date
Alias
- UMLS CUI [1,1]
- C0472699
- UMLS CUI [1,2]
- C0011008
Beskrivning
(since diagnosis if 1st transplant, or since last reported transplant)
Datatyp
integer
Alias
- UMLS CUI [1]
- C1708063
Beskrivning
Modality used at least once
Datatyp
integer
Alias
- UMLS CUI [1]
- C0695347
Beskrivning
Splenectomy
Datatyp
boolean
Alias
- UMLS CUI [1]
- C0037995
Beskrivning
TYPE OF RELAPSE
Datatyp
integer
Alias
- UMLS CUI [1]
- C0205336
Beskrivning
CR achieved before the 1st transplant
Datatyp
integer
Alias
- UMLS CUI [1]
- C0677874
Beskrivning
TO BE COMPLETED ONLY IF PATIENT HAD A CR BEFORE THE 1ST TRANSPLANT
Datatyp
integer
Alias
- UMLS CUI [1]
- C0035020
Beskrivning
STATUS OF DISEASE AT HSCT
Beskrivning
If patient has ever achieved Complete remission
Datatyp
integer
Alias
- UMLS CUI [1]
- C0677874
Beskrivning
RELAPSE
Datatyp
boolean
Alias
- UMLS CUI [1]
- C0277556
Beskrivning
TYPE OF RELAPSE
Datatyp
integer
Alias
- UMLS CUI [1,1]
- C0035020
- UMLS CUI [1,2]
- C0035020
Beskrivning
If patient has never achieved a Complete remission
Datatyp
integer
Alias
- UMLS CUI [1]
- C0677874
Beskrivning
NUMBER OF THIS PR
Datatyp
text
Alias
- UMLS CUI [1]
- C1521726
Beskrivning
DISEASE INVOLVEMENT AT TRANSPLANT
Datatyp
text
Alias
- UMLS CUI [1]
- C0012634
Beskrivning
(if patient in CR at HSCT, indicate “No mass”)
Datatyp
text
Alias
- UMLS CUI [1]
- C3272927
Beskrivning
Specific sites of disease
Datatyp
integer
Alias
- UMLS CUI [1]
- C0027653
Beskrivning
Number of relapses in the last 12 months unknown
Datatyp
integer
Alias
- UMLS CUI [1,1]
- C0035020
- UMLS CUI [1,2]
- C0237753
Beskrivning
ADDITIONAL TREATMENT POST-HSCT
Beskrivning
Additional Disease Treatment
Datatyp
integer
Alias
- UMLS CUI [1]
- C1706712
Beskrivning
Date started
Datatyp
date
Alias
- UMLS CUI [1]
- C2712338
Beskrivning
Modality
Datatyp
integer
Alias
- UMLS CUI [1]
- C0695347
Beskrivning
Radiotherapy
Datatyp
integer
Alias
- UMLS CUI [1]
- C1522449
Beskrivning
BEST DISEASE RESPONSE AT 100 DAYS POST-HSCT
Beskrivning
BEST RESPONSE AT 100 DAYS AFTER TRANSPLANTATION
Datatyp
integer
Alias
- UMLS CUI [1]
- C1704632
Beskrivning
If Complete remission: Date of CR
Datatyp
date
Alias
- UMLS CUI [1,1]
- C4050094
- UMLS CUI [1,2]
- C2316983
Beskrivning
FORMS TO BE FILLED IN
Similar models
16pp General Info EBMT Lymphoma 04
- StudyEvent: ODM
C3826859 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,2])
C0237753 (UMLS CUI [1,2])
C0677874 (UMLS CUI-2)
C0032743 (UMLS CUI-2)
C2316983 (UMLS CUI [1,2])