ID

44114

Descripción

DOCUMENTED PATHOGENS (Use this table for guidance on the pathogens of interest) Bacteria: S. pneumoniae, Other gram positive (i.e.: other streptococci, staphylococci, listeria …),Haemophilus influenzae, Other gram negative (i.e.: E. coli klebsiella, proteus, serratia, pseudomonas …), Legionella sp, Mycobacteria sp, Other Fungi: Candida sp, Aspergillus sp, Pneumocystis carinii, Other Parasites: Toxoplasma gondii, Other Viruses: HSV, VZV, EBV, CMV, HHV-6, RSV. Other respiratory virus (influenza, parainfluenza, rhinovirus), Adenovirus, HBV, HCV, HIV,Papovavirus, Parvovirus, Other

Palabras clave

Versiones (3)
  1. 19/6/16 19/6/16 -
  2. 10/4/21 10/4/21 - Ahmed Rafee, MD
  3. 20/9/21 20/9/21 -
Titular de derechos de autor

Folgt

Subido en

20 de septiembre de 2021

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY 4.0
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18pp EBMT Amyloidosis

Inglés

18pp EBMT Amyloidosis

1 formularios  
  1. StudyEvent: ODM
    1. 18pp EBMT Amyloidosis
GENERAL INFORMATION TEAM
Descripción

GENERAL INFORMATION TEAM

EBMT Centre Identification Code (CIC)
Descripción

EBMT Centre Identification Code (CIC)

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C2348585
UMLS CUI [1,2]
C3826859
Name of the hospital
Descripción

Hospital

Tipo de datos

text

Alias
UMLS CUI [1]
C0019994
Unit
Descripción

Unit

Tipo de datos

integer

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

Contact person

Tipo de datos

text

Alias
UMLS CUI [1]
C0337611
Telephone number
Descripción

Telephone

Tipo de datos

integer

Alias
UMLS CUI [1]
C1515258
Fax
Descripción

Fax

Tipo de datos

integer

Alias
UMLS CUI [1]
C1549619
E-Mail
Descripción

E-Mail

Tipo de datos

integer

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

Date of this report

Tipo de datos

date

Alias
UMLS CUI [1]
C1302584
Patient following national / international study / trial
Descripción

Patient in Trial

Tipo de datos

integer

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

Name of study / trial

Tipo de datos

text

Alias
UMLS CUI [1]
C0008976
GENERAL INFORMATION PATIENT
Descripción

GENERAL INFORMATION PATIENT

Unique Identification Code (UIC)
Descripción

To be entered only if patient previously reported

Tipo de datos

integer

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

Hospital Unique Patient Number or Code

Tipo de datos

text

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

Initials

Tipo de datos

text

Alias
UMLS CUI [1]
C2986440
Date of birth
Descripción

Date of birth

Tipo de datos

date

Alias
UMLS CUI [1]
C0421451
Sex
Descripción

Sex

Tipo de datos

text

Alias
UMLS CUI [1]
C0079399
ABO Group
Descripción

ABO Group

Tipo de datos

integer

Alias
UMLS CUI [1]
C0000778
Rh factor Donor a
Descripción

Rh factor

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0035403
UMLS CUI [1,2]
C0013018
DISEASE
Descripción

DISEASE

Date of diagnosis
Descripción

Date of diagnosis

Tipo de datos

date

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

Primary Disease Diagnosis

Tipo de datos

integer

Alias
UMLS CUI [1]
C0277554
AL AMYLOIDOSIS INITIAL DIAGNOSIS
Descripción

AL AMYLOIDOSIS INITIAL DIAGNOSIS

Has the information requested in this section been submitted with a previous HSCT registration for this patient?
Descripción

SubmittedPreviously

Tipo de datos

integer

Alias
UMLS CUI [1]
C2348568
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
Descripción

EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1959632
In case of EVIDENCE OF UNDERLYING PLASMA CELL DISORDER, please specify:
Descripción

if yes

Tipo de datos

integer

If Other B-cell malignancy, specify
Descripción

EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

Tipo de datos

text

Select one as applicable
Descripción

EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

Tipo de datos

integer

Select one as applicable
Descripción

EVIDENCE OF UNDERLYING PLASMA CELL DISORDER

Tipo de datos

integer

If Multiple myeloma: Stage at diagnosis (Salmon and Durie) A
Descripción

If Multiple myeloma: Stage at diagnosis (Salmon and Durie) A

Tipo de datos

integer

Alias
UMLS CUI [1]
C0278722
If Multiple myeloma: Stage at diagnosis (Salmon and Durie) B
Descripción

If Multiple myeloma: Stage at diagnosis (Salmon and Durie) B

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0278722
UMLS CUI [1,2]
C0026764
DIAGNOSIS OF AMYLOIDOSIS
Descripción

Methods Hereditary Amyloidosis

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0740340
UMLS CUI [1,2]
C1550352
DIAGNOSIS OF AMYLOIDOSIS via Immunohistochemistry
Descripción

DIAGNOSIS OF AMYLOIDOSIS via Immunohistochemistry

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0021044
UMLS CUI [1,2]
C0740340
CLINICAL AND LABORATORY DATA
Descripción

CLINICAL AND LABORATORY DATA

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516606
UMLS CUI [1,2]
C1254595
BM aspirate: % plasmacytosis
Descripción

BM aspirate

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1,1]
C0857285
UMLS CUI [1,2]
C0085663
%
BM trephine % plasmacytosis
Descripción

BM trephine

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1,1]
C0398526
UMLS CUI [1,2]
C0085663
%
Monoclonal Ig in serum
Descripción

Monoclonal Ig in serum

Tipo de datos

float

Unidades de medida
  • g/L
Alias
UMLS CUI [1,1]
C1532873
UMLS CUI [1,2]
C3516447
g/L
Immunofixation of serum
Descripción

Immunofixation of serum

Tipo de datos

integer

Alias
UMLS CUI [1]
C1271678
Free Kappa light chains in serum
Descripción

Kappa light chains

Tipo de datos

integer

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0443743
Lambda light chains
Descripción

Lambda light chains

Tipo de datos

integer

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0021037
Immunofixation of urine
Descripción

Immunofixation of urine

Tipo de datos

integer

Alias
UMLS CUI [1]
C1271641
Monoclonal light chains in urine
Descripción

Monoclonal light chains in urine

Tipo de datos

integer

Unidades de medida
  • g/24h
Alias
UMLS CUI [1]
C0004965
g/24h
Serum Beta2 microglobulin
Descripción

Serum Beta2 microglobulin

Tipo de datos

float

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0859328
mg/L
Bone structure (X-ray)
Descripción

Bone structure (X-ray)

Tipo de datos

integer

Alias
UMLS CUI [1]
C0262950
Macroglossia
Descripción

Typical clinical symptoms

Tipo de datos

integer

Alias
UMLS CUI [1]
C0024421
Periorbital bleeding
Descripción

Typical clinical symptoms

Tipo de datos

integer

Alias
UMLS CUI [1]
C3203729
Shoulder pad sign
Descripción

Typical clinical symptoms

Tipo de datos

integer

Alias
UMLS CUI [1]
C0231656
ORGAN INVOLVEMENT AT DIAGNOSIS
Descripción

ORGAN INVOLVEMENT AT DIAGNOSIS

Soft Tissues
Descripción

Soft Tissue

Tipo de datos

integer

Alias
UMLS CUI [1]
C0037578
Gastrointestinal Tract
Descripción

Gastrointestinal Tract

Tipo de datos

integer

Alias
UMLS CUI [1]
C0017189
Heart
Descripción

Heart

Tipo de datos

integer

Alias
UMLS CUI [1]
C0018787
Liver
Descripción

Liver

Tipo de datos

integer

Alias
UMLS CUI [1]
C0023884
Kidney
Descripción

Kidney

Tipo de datos

integer

Alias
UMLS CUI [1]
C0022646
Peripheral nerves
Descripción

Peripheral nerves

Tipo de datos

integer

Alias
UMLS CUI [1]
C1557517
Autonomic nerves
Descripción

Autonomic nerves

Tipo de datos

integer

Alias
UMLS CUI [1]
C0206250
if other, please specify
Descripción

ORGAN INVOLVEMENT AT DIAGNOSIS

Tipo de datos

integer

Alias
UMLS CUI [1]
C0457577
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
Descripción

Liver span in ultrasound or CT scan

Tipo de datos

integer

Alias
UMLS CUI [1]
C1148377
NYHA class
Descripción

NYHA class

Tipo de datos

integer

Alias
UMLS CUI [1]
C1275491
Left Ventricular Ejection Fraction
Descripción

LVEF

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1]
C0428772
%
Interventricular septal wall thickness
Descripción

(mean # mm in echocardiogram)

Tipo de datos

float

Unidades de medida
  • mm
Alias
UMLS CUI [1]
C0801204
mm
Weight loss
Descripción

Weight loss

Tipo de datos

integer

Alias
UMLS CUI [1]
C1262477
Malabsorption
Descripción

Malabsorption

Tipo de datos

integer

Alias
UMLS CUI [1]
C0024523
GI bleeding
Descripción

GI Bleeding

Tipo de datos

integer

Alias
UMLS CUI [1]
C0017181
If other evidence of gastrointestinal involvement, please specify
Descripción

Other evidence of gastrointestinal involvement

Tipo de datos

integer

Alias
UMLS CUI [1]
C0521362
Neurological exam
Descripción

Neurological exam

Tipo de datos

text

Alias
UMLS CUI [1]
C0027853
Neurological exam: If abnormal: Specify abnormality
Descripción

Neurological exam

Tipo de datos

integer

Alias
UMLS CUI [1]
C0027853
PNP severity
Descripción

PNP severity

Tipo de datos

integer

Alias
UMLS CUI [1]
C0152025
Orthostatic hypotension
Descripción

Orthostatic hypotension

Tipo de datos

integer

Alias
UMLS CUI [1]
C0020651
Intractable diarrhoea
Descripción

Intractable diarrhoea

Tipo de datos

integer

Alias
UMLS CUI [1]
C1857276
Inflexible pulse rate
Descripción

Inflexible pulse rate

Tipo de datos

integer

Alias
UMLS CUI [1]
C0232117
Clinical evidence for involvement of other sites
Descripción

Other sites

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0012634
UMLS CUI [1,2]
C0450429
PRE-HSCT TREATMENT
Descripción

PRE-HSCT TREATMENT

WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?
Descripción

WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0420262
Chemotherapy
Descripción

Chemotherapy

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0392920
Modality Chemotherapy
Descripción

Modality Chemotherapy

Tipo de datos

integer

If Other Modality, please specify
Descripción

Modality

Tipo de datos

integer

Alias
UMLS CUI [1]
C0695347
HSCT
Descripción

HSCT

DATE OF HSCT
Descripción

DATE OF HSCT

Tipo de datos

date

Alias
UMLS CUI [1]
C2584899
HSCT TYPE Allogeneic:
Descripción

proceed to “Status at Start of Conditioning” on page 4

Tipo de datos

boolean

Alias
UMLS CUI [1]
C1515895
Autologous: Date of 1st collection or pheresis
Descripción

Autologous: Date of 1st collection or pheresis

Tipo de datos

date

Alias
UMLS CUI [1]
C2584899
STATUS OF DISEASE AT COLLECTION (AUTOGRAFTS ONLY)
Descripción

STATUS OF DISEASE AT COLLECTION (AUTOGRAFTS ONLY)

Haematological status
Descripción

Haematological status

Tipo de datos

integer

Alias
UMLS CUI [1]
C0279810
Organ status
Descripción

At diagnosis

Tipo de datos

integer

Alias
UMLS CUI [1]
C0478647
STATUS OF DISEASE AT START OF CONDITIONING FOR BMT
Descripción

STATUS OF DISEASE AT START OF CONDITIONING FOR BMT

Haematological status
Descripción

Haematological status

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0279810
UMLS CUI [1,2]
C0449438
Organ status
Descripción

At diagnosis

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0449438
UMLS CUI [1,2]
C0178784
Hb
Descripción

CLINICAL AND LABORATORY DATA

Tipo de datos

float

Unidades de medida
  • g/dl
Alias
UMLS CUI [1]
C0019046
g/dl
CLINICAL AND LABORATORY DATA
Descripción

CLINICAL AND LABORATORY DATA

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516606
UMLS CUI [1,2]
C1254595
BM aspirate: % plasmacytosis
Descripción

BM aspirate

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1,1]
C0857285
UMLS CUI [1,2]
C0085663
%
BM trephine % plasmacytosis
Descripción

BM trephine

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1,1]
C0398526
UMLS CUI [1,2]
C0085663
%
Monoclonal Ig in serum
Descripción

Monoclonal Ig in serum

Tipo de datos

float

Unidades de medida
  • g/L
Alias
UMLS CUI [1,1]
C1532873
UMLS CUI [1,2]
C3516447
g/L
Immunofixation of serum
Descripción

Immunofixation of serum

Tipo de datos

integer

Alias
UMLS CUI [1]
C1271678
Free Kappa light chains in serum
Descripción

Kappa light chains

Tipo de datos

integer

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0443743
Lambda light chains
Descripción

Lambda light chains

Tipo de datos

integer

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0021037
Immunofixation of urine
Descripción

Immunofixation of urine

Tipo de datos

integer

Alias
UMLS CUI [1]
C1271641
Monoclonal light chains in urine
Descripción

Monoclonal light chains in urine

Tipo de datos

integer

Unidades de medida
  • g/24h
Alias
UMLS CUI [1]
C0004965
g/24h
Serum Beta2 microglobulin
Descripción

Serum Beta2 microglobulin

Tipo de datos

float

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0859328
mg/L
Soft Tissues
Descripción

Soft Tissue

Tipo de datos

integer

Alias
UMLS CUI [1]
C0037578
Gastrointestinal Tract
Descripción

Gastrointestinal Tract

Tipo de datos

integer

Alias
UMLS CUI [1]
C0017189
Heart
Descripción

Heart

Tipo de datos

integer

Alias
UMLS CUI [1]
C0018787
Liver
Descripción

Liver

Tipo de datos

integer

Alias
UMLS CUI [1]
C0023884
Kidney
Descripción

Kidney

Tipo de datos

integer

Alias
UMLS CUI [1]
C0022646
Peripheral nerves
Descripción

Peripheral nerves

Tipo de datos

integer

Alias
UMLS CUI [1]
C1557517
Autonomic nerves
Descripción

Autonomic nerves

Tipo de datos

integer

Alias
UMLS CUI [1]
C0206250
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
Descripción

Liver span in ultrasound or CT scan

Tipo de datos

integer

Alias
UMLS CUI [1]
C1148377
NYHA class
Descripción

NYHA class

Tipo de datos

integer

Alias
UMLS CUI [1]
C1275491
Left Ventricular Ejection Fraction
Descripción

LVEF

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1]
C0428772
%
Interventricular septal wall thickness
Descripción

(mean # mm in echocardiogram)

Tipo de datos

float

Unidades de medida
  • mm
Alias
UMLS CUI [1]
C0801204
mm
Weight loss
Descripción

Weight loss

Tipo de datos

integer

Alias
UMLS CUI [1]
C1262477
Malabsorption
Descripción

Malabsorption

Tipo de datos

integer

Alias
UMLS CUI [1]
C0024523
GI bleeding
Descripción

GI Bleeding

Tipo de datos

integer

Alias
UMLS CUI [1]
C0017181
If other evidence of gastrointestinal involvement, please specify
Descripción

Other evidence of gastrointestinal involvement

Tipo de datos

integer

Alias
UMLS CUI [1]
C0521362
Neurological exam
Descripción

Neurological exam

Tipo de datos

text

Alias
UMLS CUI [1]
C0027853
Neurological exam: If abnormal: Specify abnormality
Descripción

Neurological exam

Tipo de datos

integer

Alias
UMLS CUI [1]
C0027853
PNP severity
Descripción

PNP severity

Tipo de datos

integer

Alias
UMLS CUI [1]
C0152025
Orthostatic hypotension
Descripción

Orthostatic hypotension

Tipo de datos

integer

Alias
UMLS CUI [1]
C0020651
Intractable diarrhoea
Descripción

Intractable diarrhoea

Tipo de datos

integer

Alias
UMLS CUI [1]
C1857276
Inflexible pulse rate
Descripción

Inflexible pulse rate

Tipo de datos

integer

Alias
UMLS CUI [1]
C0232117
Clinical evidence for involvement of other sites
Descripción

Other sites

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0012634
UMLS CUI [1,2]
C0450429
STATUS OF DISEASE AT 100 DAYS AFTER HSCT
Descripción

STATUS OF DISEASE AT 100 DAYS AFTER HSCT

BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS
Descripción

BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS

Tipo de datos

text

DATE RESPONSE ACHIEVED OR ASSESSED
Descripción

DATE RESPONSE ACHIEVED OR ASSESSED

Tipo de datos

date

CLINICAL AND LABORATORY DATA
Descripción

CLINICAL AND LABORATORY DATA

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516606
UMLS CUI [1,2]
C1254595
Serum creatinine
Descripción

CLINICAL AND LABORATORY DATA

Tipo de datos

float

Alias
UMLS CUI [1]
C0201976
Creatinine clearance (mL/min)
Descripción

Creatinine clearance (mL/min)

Tipo de datos

float

Alias
UMLS CUI [1]
C0373595
Total urinary protein excretion (mg/24 h)
Descripción

CLINICAL AND LABORATORY DATA

Tipo de datos

float

Alias
UMLS CUI [1]
C3897352
Total urinary albumin excretion (mg/24 h)
Descripción

CLINICAL AND LABORATORY DATA

Tipo de datos

float

Alias
UMLS CUI [1]
C0585937
Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
Descripción

Serum NT-pro-BNP (ng/L)

Tipo de datos

float

Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
Descripción

Serum c-Troponin T (μg/L)

Tipo de datos

float

BM aspirate: % plasmacytosis
Descripción

BM aspirate

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1,1]
C0857285
UMLS CUI [1,2]
C0085663
%
BM trephine % plasmacytosis
Descripción

BM trephine

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1,1]
C0398526
UMLS CUI [1,2]
C0085663
%
Monoclonal Ig in serum
Descripción

Monoclonal Ig in serum

Tipo de datos

float

Unidades de medida
  • g/L
Alias
UMLS CUI [1,1]
C1532873
UMLS CUI [1,2]
C3516447
g/L
Immunofixation of serum
Descripción

Immunofixation of serum

Tipo de datos

integer

Alias
UMLS CUI [1]
C1271678
Free Kappa light chains in serum
Descripción

Kappa light chains

Tipo de datos

integer

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0443743
Lambda light chains
Descripción

Lambda light chains

Tipo de datos

integer

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0021037
Immunofixation of urine
Descripción

Immunofixation of urine

Tipo de datos

integer

Alias
UMLS CUI [1]
C1271641
Monoclonal light chains in urine
Descripción

Monoclonal light chains in urine

Tipo de datos

integer

Unidades de medida
  • g/24h
Alias
UMLS CUI [1]
C0004965
g/24h
Serum Beta2 microglobulin
Descripción

Serum Beta2 microglobulin

Tipo de datos

float

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0859328
mg/L
ORGAN-SPECIFIC RESPONSES AT 100 DAYS AFTER HSCT
Descripción

ORGAN-SPECIFIC RESPONSES AT 100 DAYS AFTER HSCT

Kidney
Descripción

Renal response

Tipo de datos

integer

Liver Liver span in ultrasound or CT scan (cm craniocaudal diameter)
Descripción

Liver span in ultrasound or CT scan

Tipo de datos

float

Hepatic response
Descripción

Hepatic response

Tipo de datos

integer

Heart NYHA class
Descripción

NYHA class

Tipo de datos

integer

Left ventricular ejection fraction
Descripción

Left ventricular ejection fraction

Tipo de datos

float

Unidades de medida
  • %
%
Interventricular septal wall thickness (mean # mm in echocardiogram)
Descripción

Interventricular septal wall thickness

Tipo de datos

float

Cardiac response
Descripción

Cardiac response

Tipo de datos

text

Weight loss
Descripción

Weight loss

Tipo de datos

integer

Alias
UMLS CUI [1]
C1262477
Malabsorption
Descripción

Malabsorption

Tipo de datos

integer

Alias
UMLS CUI [1]
C0024523
GI bleeding
Descripción

GI Bleeding

Tipo de datos

integer

Alias
UMLS CUI [1]
C0017181
GI response
Descripción

GI response

Tipo de datos

integer

Neurological exam Peripheral neuropathy (Compare current situation to situation before HSCT)
Descripción

Neurological exam

Tipo de datos

integer

PNP severity Peripheral neuropathy (Compare current situation to situation before HSCT)
Descripción

PNP severity

Tipo de datos

integer

PN response Peripheral neuropathy (Compare current situation to situation before HSCT)
Descripción

PN response

Tipo de datos

integer

AN response Autonomic neuropathy
Descripción

AN response

Tipo de datos

integer

Clinical evidence for involvement of new sites Evidence of new organ involvement
Descripción

Clinical evidence for involvement of new sites

Tipo de datos

text

KARNOFSKY
Descripción

KARNOFSKY

Tipo de datos

text

FORMS TO BE FILLED IN
Descripción

FORMS TO BE FILLED IN

Type of Transplant
Descripción

Type of Transplant

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0559189
UMLS CUI [1,2]
C0040739
FOLLOW UP AL AMYLOIDOSIS
Descripción

FOLLOW UP AL AMYLOIDOSIS

Unique Identification Code (UIC) (if known)
Descripción

Unique Identification Code (UIC)

Tipo de datos

text

Alias
UMLS CUI [1]
C2348585
Hospital Unique Patient Number
Descripción

Hospital Unique Patient Number

Tipo de datos

text

Alias
UMLS CUI [1]
C2348585
Initials
Descripción

Initialen

Tipo de datos

text

Alias
UMLS CUI [1]
C2986440
Date of birth
Descripción

Date of birth

Tipo de datos

date

Alias
UMLS CUI [1]
C0421451
Date of HSCT
Descripción

Date of HSCT

Tipo de datos

date

Alias
UMLS CUI [1]
C2584899
PATIENT LAST SEEN
Descripción

PATIENT LAST SEEN

Date of Last Contact or Death
Descripción

Date last contact

Tipo de datos

date

Alias
UMLS CUI [1]
C0805839
Complete haematological remission obtained after the HSCT in the absence of additional disease treatment
Descripción

Complete haematological remission obtained after the HSCT in the absence of additional disease treatment

Tipo de datos

integer

GRAFT VERSUS HOST DISEASE (GvHD) SINCE LAST REPORT
Descripción

GRAFT VERSUS HOST DISEASE (GvHD) SINCE LAST REPORT

Maximum Grade of Acute GVHD
Descripción

Maximum Grade of Acute GVHD

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C0806909
UMLS CUI [1,3]
C0441800
UMLS CUI [1,4]
C1561607
If present type of GvHD
Descripción

If present type of GvHD

Tipo de datos

integer

Alias
UMLS CUI [1]
C0856825
Reason for aGvHD
Descripción

Reason for aGvHD

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0392360
UMLS CUI [1,2]
C0856825
Date onset of this episode (if new or recurrent)
Descripción

Date onset of this episode

Tipo de datos

date

Unidades de medida
  • yyyy/mm/dd
Alias
UMLS CUI [1]
C0574845
yyyy/mm/dd
aGvHD Stage
Descripción

aGvHD Stage

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C1306673
aGvHD Resolution
Descripción

aGvHD Resolution

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C1514893
Date of resolution
Descripción

aGvHD Date of resolution

Tipo de datos

date

Unidades de medida
  • yyyy/mm/dd
Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C1514893
UMLS CUI [1,3]
C0011008
yyyy/mm/dd
Presence of cGvHD
Descripción

Chronic Graft versus Host Disease

Tipo de datos

text

Alias
UMLS CUI [1]
C0867389
Presence of cGVHD if yes
Descripción

Presence of cGVHD

Tipo de datos

integer

Alias
UMLS CUI [1]
C0867389
cGvHD Date of onset
Descripción

cGvHD Date of onset

Tipo de datos

date

Unidades de medida
  • yyyy/mm/dd
Alias
UMLS CUI [1,1]
C0867389
UMLS CUI [1,2]
C0011008
yyyy/mm/dd
cGvHD grade
Descripción

cGvHD grade

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0867389
UMLS CUI [1,2]
C0441800
Organs affected
Descripción

Organs affected

Tipo de datos

integer

Alias
UMLS CUI [1]
C0449642
If resolved, specify the date of resolution:
Descripción

Date of Resolution

Tipo de datos

date

Alias
UMLS CUI [1,1]
C1514893
UMLS CUI [1,2]
C0011008
OTHER COMPLICATIONS SINCE LAST REPORT
Descripción

OTHER COMPLICATIONS SINCE LAST REPORT

Infection related complications
Descripción

Infection related complications

Tipo de datos

boolean

Alias
UMLS CUI [1,1]
C0009450
UMLS CUI [1,2]
C0009566
Bacteraemia / fungemia / viremia / parasites
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary Provide different dates for different episodes of the same complication if applicable.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0004610
UMLS CUI [2]
C0085082
UMLS CUI [3]
C0042749
UMLS CUI [4]
C0030498
Septic shock
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary. Date Provide different dates for different episodes of the same complication if applicable.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0036983
ARDS
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0035222
Multiorgan failure due to infection
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0026766
Pneumonia
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary. Date Provide different dates for different episodes of the same complication if applicable.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0032285
Hepatitis
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0019158
CNS infection
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0007684
Gut infection
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary

Tipo de datos

integer

Alias
UMLS CUI [1]
C0178238
Skin infection
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary. Date Provide different dates for different episodes of the same complication if applicable.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0037278
Date Provide different dates for different episodes of the same complication if applicable.
Descripción

Skin infection

Tipo de datos

text

Cystitis
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0010692
Retinitis
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary.

Tipo de datos

integer

Alias
UMLS CUI [1]
C0035333
Other
Descripción

Pathogen Use the list of pathogens listed after this table for guidance. Use “unknown” if necessary

Tipo de datos

integer

Alias
UMLS CUI [1]
C0205394
Non infection related complications
Descripción

Non infection related complications

Tipo de datos

boolean

Alias
UMLS CUI [1]
C0009566
CTC grade Cardiovascular
Descripción

CTC grade Cardiovascular

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0007226
UMLS CUI [1,2]
C1516728
Date Cardiovascular
Descripción

Date Cardiovascular

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0007222
UMLS CUI [1,2]
C2316983
Cardiovascular comments
Descripción

Cardiovascular comments

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0007222
CTC grade Dermatologic
Descripción

CTC grade Dermatologic

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C0205489
Date Dermatologic
Descripción

Date Dermatologic

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0205489
UMLS CUI [1,2]
C2316983
Comments
Descripción

Dermatologic

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0947611
UMLS CUI [1,2]
C0205489
CTC grade Gastrointestinal
Descripción

CTC grade Gastrointestinal

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C0521362
Date Gastrointestinal
Descripción

Date Gastrointestinal

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0521362
UMLS CUI [1,2]
C2316983
Gastrointestinal Comments
Descripción

Gastrointestinal Comments

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0521362
UMLS CUI [1,2]
C0947611
CTC grade Haemorrhage
Descripción

CTC grade Haemorrhage

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C0019080
Date Haemorrhage
Descripción

Date Haemorrhage

Tipo de datos

date

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C2316983
Haemorrhage Comments
Descripción

Haemorrhage Comments

Tipo de datos

text

Alias
UMLS CUI [1]
C1516728
CTC grade Hepatic
Descripción

CTC grade Hepatic

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C0205054
Date Hepatic
Descripción

Date Hepatic

Tipo de datos

date

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C2316983
Hepatic Comments
Descripción

Hepatic Comments

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C0947611
CTC grade Neurologic
Descripción

CTC grade Neurologic

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C0205494
Date Neurologic
Descripción

Date Neurologic

Tipo de datos

date

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C2316983
Neurologic Comments
Descripción

Neurologic Comments

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2316983
UMLS CUI [1,2]
C0947611
CTC grade Pulmonary
Descripción

CTC grade Pulmonary

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C0024109
Pulmonary Date
Descripción

Pulmonary Date

Tipo de datos

date

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C2316983
Pulmonary Comments
Descripción

Pulmonary Comments

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C0947611
CTC grade Renal
Descripción

CTC grade Renal

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C0022646
Renal Date
Descripción

Renal Date

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0022646
UMLS CUI [1,2]
C2316983
Renal Comments
Descripción

Renal Comments

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0022646
UMLS CUI [1,2]
C0947611
Other CTC grade
Descripción

Other CTC grade

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516728
UMLS CUI [1,2]
C0220886
Date of other Type
Descripción

Date of other Type

Tipo de datos

date

Alias
UMLS CUI [1,1]
C2316983
UMLS CUI [1,2]
C0220886
Comments of Other type
Descripción

Comments of Other type

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0220886
UMLS CUI [1,2]
C0947611
Graft loss
Descripción

Graft loss

Tipo de datos

text

Alias
UMLS CUI [1]
C0877042
Overall chimaerism
Descripción

Overall chimaerism

Tipo de datos

integer

Alias
UMLS CUI [1]
C0206612
GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM
Descripción

GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM

Date of Test
Descripción

Date of Test

Tipo de datos

date

Alias
UMLS CUI [1]
C0011008
Identification of donor or Cord Blood Unit given by the centre
Descripción

Identification

Tipo de datos

text

Alias
UMLS CUI [1]
C1718162
Number in the infusion order (if applicable)
Descripción

Number in the infusion order

Tipo de datos

text

Alias
UMLS CUI [1]
C0237753
Cell type on which test was performed BM
Descripción

(% Donor Cells):

Tipo de datos

integer

Unidades de medida
  • %
Alias
UMLS CUI [1,1]
C0449475
UMLS CUI [1,2]
C0022885
Laboratory tests used:
Descripción

Laboratory tests

Tipo de datos

integer

Alias
UMLS CUI [1]
C0022885
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
Descripción

SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED

Tipo de datos

integer

Alias
UMLS CUI [1]
C3266877
UMLS CUI [2]
C0024314
UMLS CUI [3]
C0027022
Date of diagnosis
Descripción

Date of diagnosis

Tipo de datos

date

Alias
UMLS CUI [1,1]
C2316983
UMLS CUI [1,2]
C1274082
Diagnosis Secondary Malignant Neoplasm
Descripción

Diagnosis

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0011900
UMLS CUI [1,2]
C2939419
If other diagnosis, please specify
Descripción

If other diagnosis, please specify

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0011900
UMLS CUI [1,2]
C2939419
UMLS CUI [1,3]
C0205394
ADDITIONAL THERAPIES SINCE LAST FOLLOW UP
Descripción

ADDITIONAL THERAPIES SINCE LAST FOLLOW UP

Treatment given since last report
Descripción

Additional treatment

Tipo de datos

text

Alias
UMLS CUI [1]
C1706712
Date started
Descripción

Date started

Tipo de datos

date

If yes: CELLULAR THERAPY One cell therapy regimen is defined as any number of infusions given within 10 weeks for the same indication. If more than one regimen of cell therapy has been given since last report, copy this section and complete it as many times as necessary.
Descripción

ADDITIONAL TREATMENT

Tipo de datos

integer

Disease status before this cellular therapy
Descripción

Disease status before this cellular therapy

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0012634
UMLS CUI [1,2]
C0012634
If yes: Type of cells
Descripción

Type of cells

Tipo de datos

integer

Alias
UMLS CUI [1]
C0302189
If DLI, specify the number of cells infused by type: Nucleated cells
Descripción

Nucleated cells

Tipo de datos

text

Alias
UMLS CUI [1]
C1180059
Number of cells infused by type
Descripción

Number of cells infused by type

Tipo de datos

integer

Alias
UMLS CUI [1]
C2145394
Total number of cells
Descripción

Total number of cells

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0007584
UMLS CUI [1,2]
C2145394
Chronological number of this cell therapy for this patient
Descripción

Chronological number

Tipo de datos

float

Alias
UMLS CUI [1]
C2348184
Indication (check all that apply)
Descripción

Indication

Tipo de datos

text

Alias
UMLS CUI [1,1]
C3146298
UMLS CUI [1,2]
C0302189
Number of infusions within 10 weeks (count only infusions that are part of same regimen and given for the same indication)
Descripción

Infusion count

Tipo de datos

float

Alias
UMLS CUI [1,1]
C0574032
UMLS CUI [1,2]
C0750480
Maximum Grade of Acute GVHD
Descripción

Maximum Grade of Acute GVHD

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0856825
UMLS CUI [1,2]
C0441800
Disease treatment (apart from donor cell infusion or other type of cell therapy)
Descripción

Disease treatment

Tipo de datos

integer

Alias
UMLS CUI [1]
C0087111
FIRST EVIDENCE OF DISEASE WORSENING SINCE LAST HSCT
Descripción

FIRST EVIDENCE OF DISEASE WORSENING SINCE LAST HSCT

EVIDENCE OF DISEASE ACTIVITY
Descripción

EVIDENCE OF DISEASE ACTIVITY

Tipo de datos

text

Alias
UMLS CUI [1]
C0544450
If yes, date first noted
Descripción

EVIDENCE OF DISEASE ACTIVITY

Tipo de datos

date

Alias
UMLS CUI [1,1]
C0544450
UMLS CUI [1,2]
C2316983
LAST DISEASE AND PATIENT STATUS
Descripción

LAST DISEASE AND PATIENT STATUS

HAEMATOLOGICAL DISEASE STATUS
Descripción

HAEMATOLOGICAL DISEASE STATUS

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0018939
UMLS CUI [1,2]
C0449438
Organ Response
Descripción

ORGAN RESPONSE

Tipo de datos

integer

Alias
UMLS CUI [1]
C1817419
CLINICAL AND LABORATORY DATA
Descripción

CLINICAL AND LABORATORY DATA

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1516606
UMLS CUI [1,2]
C1254595
BM aspirate: % plasmacytosis
Descripción

BM aspirate

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1,1]
C0857285
UMLS CUI [1,2]
C0085663
%
BM trephine % plasmacytosis
Descripción

BM trephine

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1,1]
C0398526
UMLS CUI [1,2]
C0085663
%
Monoclonal Ig in serum
Descripción

Monoclonal Ig in serum

Tipo de datos

float

Unidades de medida
  • g/L
Alias
UMLS CUI [1,1]
C1532873
UMLS CUI [1,2]
C3516447
g/L
Immunofixation of serum
Descripción

Immunofixation of serum

Tipo de datos

integer

Alias
UMLS CUI [1]
C1271678
Free Kappa light chains in serum
Descripción

Kappa light chains

Tipo de datos

integer

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0443743
Lambda light chains
Descripción

Lambda light chains

Tipo de datos

integer

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0021037
Immunofixation of urine
Descripción

Immunofixation of urine

Tipo de datos

integer

Alias
UMLS CUI [1]
C1271641
Monoclonal light chains in urine
Descripción

Monoclonal light chains in urine

Tipo de datos

integer

Unidades de medida
  • g/24h
Alias
UMLS CUI [1]
C0004965
g/24h
Serum Beta2 microglobulin
Descripción

Serum Beta2 microglobulin

Tipo de datos

float

Unidades de medida
  • mg/L
Alias
UMLS CUI [1]
C0859328
mg/L
Renal response
Descripción

ORGAN-SPECIFIC RESPONSES AT THIS FOLLOW UP

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0022646
UMLS CUI [1,2]
C1704632
Liver span (cm craniocaudal diameter)
Descripción

Liver span in ultrasound or CT scan

Tipo de datos

float

Hepatic response
Descripción

Hepatic response

Tipo de datos

text

Alias
UMLS CUI [1]
C1817762
NYHA class
Descripción

NYHA class

Tipo de datos

integer

Alias
UMLS CUI [1]
C1275491
Left Ventricular Ejection Fraction
Descripción

LVEF

Tipo de datos

float

Unidades de medida
  • %
Alias
UMLS CUI [1]
C0428772
%
Interventricular septal wall thickness (mean # mm in echocardiogram)
Descripción

Interventricular septal wall thickness

Tipo de datos

float

Alias
UMLS CUI [1]
C0225870
Cardiac response
Descripción

Cardiac response

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1522601
UMLS CUI [1,2]
C0871261
Weight loss
Descripción

Weight loss

Tipo de datos

integer

Alias
UMLS CUI [1]
C1262477
Malabsorption
Descripción

Malabsorption

Tipo de datos

integer

Alias
UMLS CUI [1]
C0024523
GI bleeding
Descripción

GI bleeding

Tipo de datos

integer

Alias
UMLS CUI [1]
C0017181
GI response
Descripción

GI response

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C1817419
UMLS CUI [1,2]
C0521362
Neurological exam
Descripción

Neurological exam

Tipo de datos

integer

Alias
UMLS CUI [1]
C0027853
PNP severity
Descripción

PNP severity

Tipo de datos

integer

Alias
UMLS CUI [1]
C0152025
PN response
Descripción

PN response

Tipo de datos

integer

Alias
UMLS CUI [1]
C0031117
Autonomic neuropathy
Descripción

Autonomic neuropathy

Tipo de datos

integer

Alias
UMLS CUI [1]
C0259749
Evidence of new organ involvement
Descripción

Clinical evidence for involvement of new sites

Tipo de datos

text

Alias
UMLS CUI [1]
C0457576
Has patient or partner become pregnant after this HSCT?
Descripción

Has patient or partner become pregnant after this HSCT?

Tipo de datos

integer

Survival Status
Descripción

Survival Status

Tipo de datos

integer

Alias
UMLS CUI [1]
C1148433
Type of score used PERFORMANCE SCORE (if alive)
Descripción

Type of score used

Tipo de datos

integer

Score
Descripción

Performance score

Tipo de datos

integer

Alias
UMLS CUI [1]
C1518965
CAUSE OF DEATH (check only one main cause)
Descripción

CAUSE OF DEATH

Tipo de datos

integer

Alias
UMLS CUI [1]
C0007465
cGvHD
Descripción

cGvHD

Tipo de datos

integer

Alias
UMLS CUI [1]
C0867389
Interstitial pneumonitis Cause of death
Descripción

Interstitial pneumonitis

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C0206061
Pulmonary toxicity Cause
Descripción

Pulmonary toxicity

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C0919924
Infection
Descripción

Infection

Tipo de datos

integer

Infection:
Descripción

Infection

Tipo de datos

integer

Alias
UMLS CUI [1]
C0009450
Rejection / poor graft function
Descripción

Rejection / poor graft function

Tipo de datos

integer

Alias
UMLS CUI [1]
C0018129
Veno-Occlusive disease (VOD)
Descripción

Veno-Occlusive disease (VOD)

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C0948441
Haemorrhage
Descripción

Haemorrhage

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C0019080
Cardiac toxicity
Descripción

Cardiac toxicity

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C0876994
Central nervous system toxicity
Descripción

Central nervous system toxicity

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C3160947
Gastro intestinal toxicity
Descripción

Gastro intestinal toxicity

Tipo de datos

integer

Alias
UMLS CUI [1,1]
C0007465
UMLS CUI [1,2]
C1142499
Skin toxicity
Descripción

Skin toxicity

Tipo de datos

integer

Alias
UMLS CUI [1]
C1167791
Renal failure
Descripción

Renal failure

Tipo de datos

integer

Alias
UMLS CUI [1]
C1533077
Multiple organ failure
Descripción

Multiple organ failure

Tipo de datos

integer

Alias
UMLS CUI [1]
C0026766
If other HSCT related cause, please specify
Descripción

Other

Tipo de datos

text

ADDITIONAL NOTES IF APPLICABLE
Descripción

ADDITIONAL NOTES IF APPLICABLE

Comments
Descripción

Comments

Tipo de datos

text

Alias
UMLS CUI [1]
C0947611
IDENTIFICATION & SIGNATURE
Descripción

IDENTIFICATION & SIGNATURE

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0205396
UMLS CUI [1,2]
C1519316
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Similar models

18pp EBMT Amyloidosis

1 formularios
  1. StudyEvent: ODM
    1. 18pp EBMT Amyloidosis
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
GENERAL INFORMATION TEAM
EBMT Centre Identification Code (CIC)
Item
EBMT Centre Identification Code (CIC)
integer
C2348585 (UMLS CUI [1,1])
C3826859 (UMLS CUI [1,2])
Hospital
Item
Name of the hospital
text
C0019994 (UMLS CUI [1])
Unit
Item
Unit
integer
C1519795 (UMLS CUI [1])
Contact person
Item
Name of contact person
text
C0337611 (UMLS CUI [1])
Telephone
Item
Telephone number
integer
C1515258 (UMLS CUI [1])
Fax
Item
Fax
integer
C1549619 (UMLS CUI [1])
E-Mail
Item
E-Mail
integer
C1705961 (UMLS CUI [1])
Date of this report
Item
Date of this report
date
C1302584 (UMLS CUI [1])
Item
Patient following national / international study / trial
integer
C1997894 (UMLS CUI [1])
Patient in Trial
Code List
Patient following national / international study / trial
CL Item
No (1)
CL Item
Yes (2)
CL Item
Not evaluated (3)
CL Item
Unknown (4)
Name of study / trial
Item
Name of study / trial
text
C0008976 (UMLS CUI [1])
Item Group
GENERAL INFORMATION PATIENT
Unique Identification Code (UIC)
Item
Unique Identification Code (UIC)
integer
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number or Code
Item
Hospital Unique Patient Number or Code
text
C1827636 (UMLS CUI [1])
Initials
Item
First name(s)_surname(s)
text
C2986440 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Sex
Code List
Sex
CL Item
Male (1)
CL Item
Female (2)
ABO Group
Item
ABO Group
integer
C0000778 (UMLS CUI [1])
Rh factor
Item
Rh factor Donor a
boolean
C0035403 (UMLS CUI [1,1])
C0013018 (UMLS CUI [1,2])
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
Myeloma/ Plasma cell disorder (Myeloma/ Plasma cell disorder)
C0026764 (UMLS CUI-1)
CL Item
Solid Tumour (Solid Tumour)
C0006826 (UMLS CUI-1)
CL Item
Myelodysplastic syndromes (Myelodysplastic syndromes)
C0280450 (UMLS CUI-1)
CL Item
MDS (MDS)
C3463824 (UMLS CUI-1)
CL Item
MD/ MPN (MD/ MPN)
C1292778 (UMLS CUI-1)
CL Item
Myeloproliferative neoplasm (Myeloproliferative neoplasm)
C1333046 (UMLS CUI-1)
CL Item
Bone marrow failure including Aplastic anaemia (Bone marrow failure including Aplastic anaemia)
C0002874 (UMLS CUI-1)
CL Item
Inherited disorders (Inherited disorders)
C0019247 (UMLS CUI-1)
CL Item
Primary immune deficiencies (Primary immune deficiencies)
C0398686 (UMLS CUI-1)
CL Item
Metabolic disorders (Metabolic disorders)
C0025517 (UMLS CUI-1)
CL Item
Histiocytic disorders (Histiocytic disorders)
C0398597 (UMLS CUI-1)
CL Item
Autoimmune disease (Autoimmune disease)
C0004364 (UMLS CUI-1)
CL Item
Juvenile Idiopathic Arthritis (Juvenile Idiopathic Arthritis)
C1444841 (UMLS CUI-1)
CL Item
Multiple Sclerosis (Multiple Sclerosis)
C0026769 (UMLS CUI-1)
CL Item
Systemic Lupus (Systemic Lupus)
C0024141 (UMLS CUI-1)
CL Item
Systemic Sclerosis (Systemic Sclerosis)
C0036421 (UMLS CUI-1)
CL Item
Other diagnosis (Other diagnosis)
C0205394 (UMLS CUI-1)
CL Item
Hodgkin´s Disease (Hodgkin´s Disease)
C0019829 (UMLS CUI-1)
CL Item
Haemoglobinopathies (Haemoglobinopathies)
C0019045 (UMLS CUI-1)
Item Group
AL AMYLOIDOSIS INITIAL DIAGNOSIS
Item
Has the information requested in this section been submitted with a previous HSCT registration for this patient?
integer
C2348568 (UMLS CUI [1])
SubmittedPreviously
Code List
Has the information requested in this section been submitted with a previous HSCT registration for this patient?
CL Item
Yes: go to page 3, Pre-HSCT Treatment (1)
CL Item
No: proceed with this section (2)
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
Item
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
boolean
C1959632 (UMLS CUI [1])
Item
In case of EVIDENCE OF UNDERLYING PLASMA CELL DISORDER, please specify:
integer
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
Code List
In case of EVIDENCE OF UNDERLYING PLASMA CELL DISORDER, please specify:
CL Item
Monoclonal Gammopathy (Monoclonal Gammopathy)
C1136085 (UMLS CUI-1)
CL Item
Multiple Myeloma (Multiple Myeloma)
C0026764 (UMLS CUI-1)
CL Item
Other B-cell malignancy (Other B-cell malignancy)
C1868683 (UMLS CUI-1)
If Other B-cell malignancy, specify
Item
If Other B-cell malignancy, specify
text
Item
Select one as applicable
integer
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
Code List
Select one as applicable
CL Item
IgG (1)
C0202087 (UMLS CUI-1)
CL Item
IgA (2)
C0202083 (UMLS CUI-1)
CL Item
IgD (3)
C0577612 (UMLS CUI-1)
CL Item
IgE (4)
C0020846 (UMLS CUI-1)
CL Item
IgM (5)
C0202084 (UMLS CUI-1)
CL Item
Absent (6)
C0332197 (UMLS CUI-1)
CL Item
Not evaluated (7)
C3846720 (UMLS CUI-1)
Item
Select one as applicable
integer
EVIDENCE OF UNDERLYING PLASMA CELL DISORDER
Code List
Select one as applicable
CL Item
Kappa (1)
CL Item
Lambda (2)
CL Item
Absent (3)
CL Item
Not evaluated (4)
Item
If Multiple myeloma: Stage at diagnosis (Salmon and Durie) A
integer
C0278722 (UMLS CUI [1])
Stage at diagnosis (Salmon and Durie) A
Code List
If Multiple myeloma: Stage at diagnosis (Salmon and Durie) A
CL Item
I (I)
CL Item
II (II)
CL Item
III (III)
If Multiple myeloma: Stage at diagnosis (Salmon and Durie) B
Item
If Multiple myeloma: Stage at diagnosis (Salmon and Durie) B
boolean
C0278722 (UMLS CUI [1,1])
C0026764 (UMLS CUI [1,2])
Item
DIAGNOSIS OF AMYLOIDOSIS
integer
C0740340 (UMLS CUI [1,1])
C1550352 (UMLS CUI [1,2])
Methods Hereditary Amyloidosis
Code List
DIAGNOSIS OF AMYLOIDOSIS
CL Item
Excluded (1)
CL Item
Not evaluated (2)
Item
DIAGNOSIS OF AMYLOIDOSIS via Immunohistochemistry
integer
C0021044 (UMLS CUI [1,1])
C0740340 (UMLS CUI [1,2])
Methods Immunohistochemistry
Code List
DIAGNOSIS OF AMYLOIDOSIS via Immunohistochemistry
CL Item
Done (Done)
CL Item
Not evaluated (Not evaluated)
Item
CLINICAL AND LABORATORY DATA
integer
C1516606 (UMLS CUI [1,1])
C1254595 (UMLS CUI [1,2])
Hb (g/dL)
Code List
CLINICAL AND LABORATORY DATA
CL Item
Serum creatinine (1)
C0201976 (UMLS CUI-1)
CL Item
Hb (g/dL) (2)
C0019046 (UMLS CUI-1)
CL Item
Total urinary protein excretion (mg/24 h) (3)
C0033687 (UMLS CUI-1)
CL Item
Total urinary albumin excretion (mg/24 h) (4)
C2362049 (UMLS CUI-1)
CL Item
Serum calcium (mmol/L) (5)
C0036785 (UMLS CUI-1)
CL Item
Serum albumin (g/L) (6)
C0036773 (UMLS CUI-1)
CL Item
Serum alkaline phosphatase (IU/L) (7)
C0428334 (UMLS CUI-1)
CL Item
Serum bilirubin (8)
C1278039 (UMLS CUI-1)
CL Item
NT-proBNP (ng/L) (9)
C0754710 (UMLS CUI-1)
CL Item
Serum c-Troponin T (μg/L) (10)
C0077404 (UMLS CUI-1)
BM aspirate
Item
BM aspirate: % plasmacytosis
float
C0857285 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
BM trephine
Item
BM trephine % plasmacytosis
float
C0398526 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
C1532873 (UMLS CUI [1,1])
C3516447 (UMLS CUI [1,2])
Item
Immunofixation of serum
integer
C1271678 (UMLS CUI [1])
Immunofixation of serum
Code List
Immunofixation of serum
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Free Kappa light chains in serum
integer
C0443743 (UMLS CUI [1])
Kappa light chains
Code List
Free Kappa light chains in serum
CL Item
Not evaluated (1)
Item
Lambda light chains
integer
C0021037 (UMLS CUI [1])
Lambda light chains
Code List
Lambda light chains
CL Item
Not evaluated (1)
Item
Immunofixation of urine
integer
C1271641 (UMLS CUI [1])
Immunofixation of urine
Code List
Immunofixation of urine
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
integer
C0004965 (UMLS CUI [1])
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
C0859328 (UMLS CUI [1])
Item
Bone structure (X-ray)
integer
C0262950 (UMLS CUI [1])
Bone structure (X-ray)
Code List
Bone structure (X-ray)
CL Item
Normal  (1)
C0205307 (UMLS CUI-1)
CL Item
Lytic lesion  (2)
C0221204 (UMLS CUI-1)
CL Item
Not evaluated  (3)
C3846720 (UMLS CUI-1)
CL Item
Unknown (4)
C0439673 (UMLS CUI-1)
Item
Macroglossia
integer
C0024421 (UMLS CUI [1])
Macroglossy
Code List
Macroglossia
CL Item
Absent  (1)
CL Item
Present  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Periorbital bleeding
integer
C3203729 (UMLS CUI [1])
Periorbital bleeding
Code List
Periorbital bleeding
CL Item
Absent  (1)
CL Item
Present  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Shoulder pad sign
integer
C0231656 (UMLS CUI [1])
Shoulder pad sign
Code List
Shoulder pad sign
CL Item
Absent  (1)
CL Item
Present  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item Group
ORGAN INVOLVEMENT AT DIAGNOSIS
Item
Soft Tissues
integer
C0037578 (UMLS CUI [1])
Soft Tissues
Code List
Soft Tissues
CL Item
Dominant organ(s) involved (Dominant organ(s) involved)
C1527180 (UMLS CUI-1)
CL Item
Additional organ involvement (Additional organ involvement)
C0457576 (UMLS CUI-1)
CL Item
Biopsy (Biopsy)
C0005558 (UMLS CUI-1)
CL Item
No involvement (No involvement)
C1517677 (UMLS CUI-1)
Item
Gastrointestinal Tract
integer
C0017189 (UMLS CUI [1])
Gastrointestinal Tract
Code List
Gastrointestinal Tract
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Heart
integer
C0018787 (UMLS CUI [1])
Heart
Code List
Heart
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Liver
integer
C0023884 (UMLS CUI [1])
Liver
Code List
Liver
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Kidney
integer
C0022646 (UMLS CUI [1])
Kidney
Code List
Kidney
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Peripheral nerves
integer
C1557517 (UMLS CUI [1])
Peripheral nerves
Code List
Peripheral nerves
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Autonomic nerves
integer
C0206250 (UMLS CUI [1])
Autonomic nerves
Code List
Autonomic nerves
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
if other, please specify
integer
C0457577 (UMLS CUI [1])
ORGAN INVOLVEMENT AT DIAGNOSIS
Code List
if other, please specify
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
integer
C1148377 (UMLS CUI [1])
Liver span in ultrasound or CT scan
Code List
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
CL Item
Not evaluated (1)
Item
NYHA class
integer
C1275491 (UMLS CUI [1])
NYHA class
Code List
NYHA class
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
CL Item
not done (99)
LVEF
Item
Left Ventricular Ejection Fraction
float
C0428772 (UMLS CUI [1])
Interventricular septal wall thickness
Item
Interventricular septal wall thickness
float
C0801204 (UMLS CUI [1])
Item
Weight loss
integer
C1262477 (UMLS CUI [1])
Weight loss
Code List
Weight loss
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Malabsorption
integer
C0024523 (UMLS CUI [1])
Malabsorption
Code List
Malabsorption
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI bleeding
integer
C0017181 (UMLS CUI [1])
GI Bleeding
Code List
GI bleeding
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Other evidence of gastrointestinal involvement
Item
If other evidence of gastrointestinal involvement, please specify
integer
C0521362 (UMLS CUI [1])
Item
Neurological exam
text
C0027853 (UMLS CUI [1])
Neurological exam
Code List
Neurological exam
CL Item
Normal  (Normal )
CL Item
Abnormal  ( Abnormal )
CL Item
Not evaluated or failed  ( Not evaluated or failed )
CL Item
Unknown ( Unknown)
Neurological exam
Item
Neurological exam: If abnormal: Specify abnormality
integer
C0027853 (UMLS CUI [1])
Item
PNP severity
integer
C0152025 (UMLS CUI [1])
PNP severity
Code List
PNP severity
CL Item
grade I  (1)
CL Item
grade II  (2)
CL Item
grade III  (3)
CL Item
grade IV (4)
Item
Orthostatic hypotension
integer
C0020651 (UMLS CUI [1])
Orthostatic hypotension
Code List
Orthostatic hypotension
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Intractable diarrhoea
integer
C1857276 (UMLS CUI [1])
Intractable diarrhoea
Code List
Intractable diarrhoea
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Inflexible pulse rate
integer
C0232117 (UMLS CUI [1])
Inflexible pulse rate
Code List
Inflexible pulse rate
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Other sites
Item
Clinical evidence for involvement of other sites
text
C0012634 (UMLS CUI [1,1])
C0450429 (UMLS CUI [1,2])
Item Group
PRE-HSCT TREATMENT
WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?
Item
WAS THE PATIENT TREATED BEFORE THE HSCT PROCEDURE?
boolean
C0420262 (UMLS CUI [1])
Chemotherapy
Item
Chemotherapy
boolean
C0392920 (UMLS CUI [1])
Item
Modality Chemotherapy
integer
Chemotherapy
Code List
Modality Chemotherapy
CL Item
Chemotherapy regimen (Chemotherapy regimen)
CL Item
Number of cycles (Number of cycles)
Modality
Item
If Other Modality, please specify
integer
C0695347 (UMLS CUI [1])
Item Group
HSCT
DATE OF HSCT
Item
DATE OF HSCT
date
C2584899 (UMLS CUI [1])
HSCT TYPE
Item
HSCT TYPE Allogeneic:
boolean
C1515895 (UMLS CUI [1])
Autologous: Date of 1st collection or pheresis
Item
Autologous: Date of 1st collection or pheresis
date
C2584899 (UMLS CUI [1])
Item Group
STATUS OF DISEASE AT COLLECTION (AUTOGRAFTS ONLY)
Item
Haematological status
integer
C0279810 (UMLS CUI [1])
Haematological status
Code List
Haematological status
CL Item
At diagnosis  (At diagnosis )
CL Item
CR1  ( CR1 )
C0677874 (UMLS CUI-1)
CL Item
CR2  ( CR2 )
C0677874 (UMLS CUI-1)
CL Item
>CR2  ( >CR2 VNUMSTM)
C0677874 (UMLS CUI-1)
CL Item
PR1  ( PR1 )
C1521726 (UMLS CUI-1)
CL Item
PR2  (PR2 )
C1521726 (UMLS CUI-1)
CL Item
>PR2  ( >PR2 )
C1521726 (UMLS CUI-1)
CL Item
MR (MR)
CL Item
No change  ( No change )
C0442739 (UMLS CUI-1)
CL Item
Progression  ( Progression )
C0242656 (UMLS CUI-1)
CL Item
Unknown ( Unknown)
C0439673 (UMLS CUI-1)
Item
Organ status
integer
C0478647 (UMLS CUI [1])
Organ status
Code List
Organ status
CL Item
Response  (2)
C0521982 (UMLS CUI-1)
CL Item
No change  (3)
C0442739 (UMLS CUI-1)
CL Item
Progression  (4)
C0242656 (UMLS CUI-1)
CL Item
Unknown (5)
C0439673 (UMLS CUI-1)
Item Group
STATUS OF DISEASE AT START OF CONDITIONING FOR BMT
Item
Haematological status
integer
C0279810 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
Haematological status
Code List
Haematological status
CL Item
At diagnosis  (At diagnosis )
CL Item
CR1  (CR1 )
C0449438 (UMLS CUI-1)
CL Item
CR2  ( CR2 )
C0449438 (UMLS CUI-1)
CL Item
>CR2  ( >CR2 )
C0449438 (UMLS CUI-1)
CL Item
PR1  ( PR1 )
C1521726 (UMLS CUI-1)
CL Item
PR2  ( PR2 )
C1521726 (UMLS CUI-1)
CL Item
>PR2  ( >PR2 )
C1521726 (UMLS CUI-1)
CL Item
MR ( MR)
CL Item
No change  ( No change )
C0443172 (UMLS CUI-1)
CL Item
Progression  (Progression )
C0242656 (UMLS CUI-1)
CL Item
Unknown (Unknown)
C0439673 (UMLS CUI-1)
Item
Organ status
integer
C0449438 (UMLS CUI [1,1])
C0178784 (UMLS CUI [1,2])
Organ status
Code List
Organ status
CL Item
Response  (2)
C0521982 (UMLS CUI-1)
CL Item
No change  (3)
C0442739 (UMLS CUI-1)
CL Item
Progression  (4)
C0242656 (UMLS CUI-1)
CL Item
Unknown (5)
C0439673 (UMLS CUI-1)
Hb
Item
Hb
float
C0019046 (UMLS CUI [1])
Item
CLINICAL AND LABORATORY DATA
integer
C1516606 (UMLS CUI [1,1])
C1254595 (UMLS CUI [1,2])
Hb (g/dL)
Code List
CLINICAL AND LABORATORY DATA
CL Item
Serum creatinine (1)
C0201976 (UMLS CUI-1)
CL Item
Hb (g/dL) (2)
C0019046 (UMLS CUI-1)
CL Item
Total urinary protein excretion (mg/24 h) (3)
C0033687 (UMLS CUI-1)
CL Item
Total urinary albumin excretion (mg/24 h) (4)
C2362049 (UMLS CUI-1)
CL Item
Serum calcium (mmol/L) (5)
C0036785 (UMLS CUI-1)
CL Item
Serum albumin (g/L) (6)
C0036773 (UMLS CUI-1)
CL Item
Serum alkaline phosphatase (IU/L) (7)
C0428334 (UMLS CUI-1)
CL Item
Serum bilirubin (8)
C1278039 (UMLS CUI-1)
CL Item
NT-proBNP (ng/L) (9)
C0754710 (UMLS CUI-1)
CL Item
Serum c-Troponin T (μg/L) (10)
C0077404 (UMLS CUI-1)
BM aspirate
Item
BM aspirate: % plasmacytosis
float
C0857285 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
BM trephine
Item
BM trephine % plasmacytosis
float
C0398526 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
C1532873 (UMLS CUI [1,1])
C3516447 (UMLS CUI [1,2])
Item
Immunofixation of serum
integer
C1271678 (UMLS CUI [1])
Immunofixation of serum
Code List
Immunofixation of serum
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Free Kappa light chains in serum
integer
C0443743 (UMLS CUI [1])
Kappa light chains
Code List
Free Kappa light chains in serum
CL Item
Not evaluated (1)
Item
Lambda light chains
integer
C0021037 (UMLS CUI [1])
Lambda light chains
Code List
Lambda light chains
CL Item
Not evaluated (1)
Item
Immunofixation of urine
integer
C1271641 (UMLS CUI [1])
Immunofixation of urine
Code List
Immunofixation of urine
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
integer
C0004965 (UMLS CUI [1])
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
C0859328 (UMLS CUI [1])
Item
Soft Tissues
integer
C0037578 (UMLS CUI [1])
Soft Tissues
Code List
Soft Tissues
CL Item
Dominant organ(s) involved (Dominant organ(s) involved)
C1527180 (UMLS CUI-1)
CL Item
Additional organ involvement (Additional organ involvement)
C0457576 (UMLS CUI-1)
CL Item
Biopsy (Biopsy)
C0005558 (UMLS CUI-1)
CL Item
No involvement (No involvement)
C1517677 (UMLS CUI-1)
Item
Gastrointestinal Tract
integer
C0017189 (UMLS CUI [1])
Gastrointestinal Tract
Code List
Gastrointestinal Tract
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Heart
integer
C0018787 (UMLS CUI [1])
Heart
Code List
Heart
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Liver
integer
C0023884 (UMLS CUI [1])
Liver
Code List
Liver
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Kidney
integer
C0022646 (UMLS CUI [1])
Kidney
Code List
Kidney
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Peripheral nerves
integer
C1557517 (UMLS CUI [1])
Peripheral nerves
Code List
Peripheral nerves
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Autonomic nerves
integer
C0206250 (UMLS CUI [1])
Autonomic nerves
Code List
Autonomic nerves
CL Item
Dominant organ(s) involved (1)
CL Item
Additional organ involvement (2)
CL Item
Biopsy (3)
CL Item
No involvement (4)
Item
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
integer
C1148377 (UMLS CUI [1])
Liver span in ultrasound or CT scan
Code List
Liver span in ultrasound or CT scan (cm craniocaudal diameter)
CL Item
Not evaluated (1)
Item
NYHA class
integer
C1275491 (UMLS CUI [1])
NYHA class
Code List
NYHA class
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
CL Item
not done (99)
LVEF
Item
Left Ventricular Ejection Fraction
float
C0428772 (UMLS CUI [1])
Interventricular septal wall thickness
Item
Interventricular septal wall thickness
float
C0801204 (UMLS CUI [1])
Item
Weight loss
integer
C1262477 (UMLS CUI [1])
Weight loss
Code List
Weight loss
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Malabsorption
integer
C0024523 (UMLS CUI [1])
Malabsorption
Code List
Malabsorption
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI bleeding
integer
C0017181 (UMLS CUI [1])
GI Bleeding
Code List
GI bleeding
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Other evidence of gastrointestinal involvement
Item
If other evidence of gastrointestinal involvement, please specify
integer
C0521362 (UMLS CUI [1])
Item
Neurological exam
text
C0027853 (UMLS CUI [1])
Neurological exam
Code List
Neurological exam
CL Item
Normal  (Normal )
CL Item
Abnormal  ( Abnormal )
CL Item
Not evaluated or failed  ( Not evaluated or failed )
CL Item
Unknown ( Unknown)
Neurological exam
Item
Neurological exam: If abnormal: Specify abnormality
integer
C0027853 (UMLS CUI [1])
Item
PNP severity
integer
C0152025 (UMLS CUI [1])
PNP severity
Code List
PNP severity
CL Item
grade I  (1)
CL Item
grade II  (2)
CL Item
grade III  (3)
CL Item
grade IV (4)
Item
Orthostatic hypotension
integer
C0020651 (UMLS CUI [1])
Orthostatic hypotension
Code List
Orthostatic hypotension
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Intractable diarrhoea
integer
C1857276 (UMLS CUI [1])
Intractable diarrhoea
Code List
Intractable diarrhoea
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Inflexible pulse rate
integer
C0232117 (UMLS CUI [1])
Inflexible pulse rate
Code List
Inflexible pulse rate
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Other sites
Item
Clinical evidence for involvement of other sites
text
C0012634 (UMLS CUI [1,1])
C0450429 (UMLS CUI [1,2])
Item Group
STATUS OF DISEASE AT 100 DAYS AFTER HSCT
Item
BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS
text
BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS
Code List
BEST HAEMATOLOGICAL RESPONSE TO HSCT AT 100 DAYS
CL Item
CR1  (CR1 )
CL Item
CR2  ( CR2 )
CL Item
>CR2 ( >CR2)
CL Item
PR1  (PR1 )
CL Item
PR2  (PR2 )
CL Item
>PR2  ( >PR2 )
CL Item
MR ( MR)
CL Item
No change  (No change )
CL Item
Progression  ( Progression )
CL Item
Not evaluable  (Not evaluable )
CL Item
Unknown ( Unknown)
DATE RESPONSE ACHIEVED OR ASSESSED
Item
DATE RESPONSE ACHIEVED OR ASSESSED
date
Item
CLINICAL AND LABORATORY DATA
integer
C1516606 (UMLS CUI [1,1])
C1254595 (UMLS CUI [1,2])
Hb (g/dL)
Code List
CLINICAL AND LABORATORY DATA
CL Item
Serum creatinine (1)
C0201976 (UMLS CUI-1)
CL Item
Hb (g/dL) (2)
C0019046 (UMLS CUI-1)
CL Item
Total urinary protein excretion (mg/24 h) (3)
C0033687 (UMLS CUI-1)
CL Item
Total urinary albumin excretion (mg/24 h) (4)
C2362049 (UMLS CUI-1)
CL Item
Serum calcium (mmol/L) (5)
C0036785 (UMLS CUI-1)
CL Item
Serum albumin (g/L) (6)
C0036773 (UMLS CUI-1)
CL Item
Serum alkaline phosphatase (IU/L) (7)
C0428334 (UMLS CUI-1)
CL Item
Serum bilirubin (8)
C1278039 (UMLS CUI-1)
CL Item
NT-proBNP (ng/L) (9)
C0754710 (UMLS CUI-1)
CL Item
Serum c-Troponin T (μg/L) (10)
C0077404 (UMLS CUI-1)
Serum creatinine
Item
Serum creatinine
float
C0201976 (UMLS CUI [1])
Creatinine clearance (mL/min)
Item
Creatinine clearance (mL/min)
float
C0373595 (UMLS CUI [1])
Total urinary protein excretion (mg/24 h)
Item
Total urinary protein excretion (mg/24 h)
float
C3897352 (UMLS CUI [1])
Total urinary albumin excretion (mg/24 h)
Item
Total urinary albumin excretion (mg/24 h)
float
C0585937 (UMLS CUI [1])
Serum NT-pro-BNP (ng/L)
Item
Serum NT-pro-BNP (ng/L) CLINICAL AND LABORATORY DATA
float
Serum c-Troponin T (μg/L)
Item
Serum c-Troponin T (μg/L) CLINICAL AND LABORATORY DATA
float
BM aspirate
Item
BM aspirate: % plasmacytosis
float
C0857285 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
BM trephine
Item
BM trephine % plasmacytosis
float
C0398526 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
C1532873 (UMLS CUI [1,1])
C3516447 (UMLS CUI [1,2])
Item
Immunofixation of serum
integer
C1271678 (UMLS CUI [1])
Immunofixation of serum
Code List
Immunofixation of serum
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Free Kappa light chains in serum
integer
C0443743 (UMLS CUI [1])
Kappa light chains
Code List
Free Kappa light chains in serum
CL Item
Not evaluated (1)
Item
Lambda light chains
integer
C0021037 (UMLS CUI [1])
Lambda light chains
Code List
Lambda light chains
CL Item
Not evaluated (1)
Item
Immunofixation of urine
integer
C1271641 (UMLS CUI [1])
Immunofixation of urine
Code List
Immunofixation of urine
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
integer
C0004965 (UMLS CUI [1])
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
C0859328 (UMLS CUI [1])
Item Group
ORGAN-SPECIFIC RESPONSES AT 100 DAYS AFTER HSCT
Item
Kidney
integer
Renal response
Code List
Kidney
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Liver span in ultrasound or CT scan
Item
Liver Liver span in ultrasound or CT scan (cm craniocaudal diameter)
float
Item
Hepatic response
integer
Hepatic response
Code List
Hepatic response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Item
Heart NYHA class
integer
NYHA class
Code List
Heart NYHA class
CL Item
I (I)
CL Item
II (II)
CL Item
III (III)
CL Item
IV (IV)
CL Item
Unknown (Unknown)
Left ventricular ejection fraction
Item
Left ventricular ejection fraction
float
Interventricular septal wall thickness
Item
Interventricular septal wall thickness (mean # mm in echocardiogram)
float
Item
Cardiac response
text
Cardiac response
Code List
Cardiac response
CL Item
Response  (Response )
CL Item
No response/stable disease  ( No response/stable disease )
CL Item
Progressive disease ( Progressive disease)
CL Item
Not evaluable  ( Not evaluable )
CL Item
Not evaluated/not applicable  ( Not evaluated/not applicable )
CL Item
Unknown ( Unknown)
Item
Weight loss
integer
C1262477 (UMLS CUI [1])
Weight loss
Code List
Weight loss
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Malabsorption
integer
C0024523 (UMLS CUI [1])
Malabsorption
Code List
Malabsorption
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI bleeding
integer
C0017181 (UMLS CUI [1])
GI Bleeding
Code List
GI bleeding
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI response
integer
GI response
Code List
GI response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Item
Neurological exam Peripheral neuropathy (Compare current situation to situation before HSCT)
integer
Neurological exam
Code List
Neurological exam Peripheral neuropathy (Compare current situation to situation before HSCT)
CL Item
Improved  (1)
CL Item
Worsened  (2)
CL Item
Unchanged  (3)
CL Item
Unknown (4)
Item
PNP severity Peripheral neuropathy (Compare current situation to situation before HSCT)
integer
PNP severity
Code List
PNP severity Peripheral neuropathy (Compare current situation to situation before HSCT)
CL Item
grade I  (1)
CL Item
grade II  (2)
CL Item
grade III  (3)
CL Item
grade IV (4)
Item
PN response Peripheral neuropathy (Compare current situation to situation before HSCT)
integer
PN response
Code List
PN response Peripheral neuropathy (Compare current situation to situation before HSCT)
CL Item
Response  (Response )
CL Item
Unknown (Unknown)
CL Item
No response/stable disease  (No response/stable disease )
CL Item
Progressive disease (Progressive disease)
CL Item
Not evaluable  (Not evaluable )
CL Item
Not evaluated/not applicable  (Not evaluated/not applicable )
Item
AN response Autonomic neuropathy
integer
AN response
Code List
AN response Autonomic neuropathy
CL Item
Response  (Response )
CL Item
No response/stable disease  (No response/stable disease )
CL Item
Progressive disease (Progressive disease)
CL Item
Not evaluable  (Not evaluable )
CL Item
Not evaluated/not applicable  (Not evaluated/not applicable )
CL Item
Unknown (Unknown)
Clinical evidence for involvement of new sites
Item
Clinical evidence for involvement of new sites Evidence of new organ involvement
text
KARNOFSKY
Item
KARNOFSKY
text
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) (AUTOgraft (proceed to Autograft form))
CL Item
ALLOgraft or Syngeneic graft (proceed to Allograft form) (ALLOgraft or Syngeneic graft (proceed to Allograft form))
CL Item
Other (contact the EBMT Central Registry for instructions) (Other (contact the EBMT Central Registry for instructions))
Item Group
FOLLOW UP AL AMYLOIDOSIS
Unique Identification Code (UIC)
Item
Unique Identification Code (UIC) (if known)
text
C2348585 (UMLS CUI [1])
Hospital Unique Patient Number
Item
Hospital Unique Patient Number
text
C2348585 (UMLS CUI [1])
Initialen
Item
Initials
text
C2986440 (UMLS CUI [1])
Date of birth
Item
Date of birth
date
C0421451 (UMLS CUI [1])
Date of HSCT
Item
Date of HSCT
date
C2584899 (UMLS CUI [1])
Item Group
PATIENT LAST SEEN
Date last contact
Item
Date of Last Contact or Death
date
C0805839 (UMLS CUI [1])
Item
Complete haematological remission obtained after the HSCT in the absence of additional disease treatment
integer
Complete haematological remission obtained after the HSCT in the absence of additional disease treatment
Code List
Complete haematological remission obtained after the HSCT in the absence of additional disease treatment
CL Item
Previously reported (1)
CL Item
Yes, date (2)
CL Item
No (3)
CL Item
Unknown (4)
Item Group
GRAFT VERSUS HOST DISEASE (GvHD) SINCE LAST REPORT
Item
Maximum Grade of Acute GVHD
text
C0856825 (UMLS CUI [1,1])
C0806909 (UMLS CUI [1,2])
C0441800 (UMLS CUI [1,3])
C1561607 (UMLS CUI [1,4])
AcuteGraftVersusHostDiseaseMaximumOverallGrade
Code List
Maximum Grade of Acute GVHD
CL Item
Agvhd Grade 0 (0)
CL Item
Agvhd Grade I (I)
CL Item
Agvhd Grade Ii (II)
CL Item
Agvhd Grade Iii (III)
CL Item
Agvhd Grade Iv (IV)
CL Item
Agvhd Present, Grade Unknown (Present, grade unknown)
Item
If present type of GvHD
integer
C0856825 (UMLS CUI [1])
Maximum grade
Code List
If present type of GvHD
CL Item
New onset  (1)
CL Item
Recurrent  (2)
CL Item
Persistent (3)
Item
Reason for aGvHD
integer
C0392360 (UMLS CUI [1,1])
C0856825 (UMLS CUI [1,2])
Maximum grade
Code List
Reason for aGvHD
CL Item
Unexplained (Unexplained)
C0439673 (UMLS CUI-1)
CL Item
Tapering (Tapering)
C0441640 (UMLS CUI-1)
CL Item
DLI (DLI)
C1512034 (UMLS CUI-1)
Date onset of this episode
Item
Date onset of this episode (if new or recurrent)
date
C0574845 (UMLS CUI [1])
Item
aGvHD Stage
integer
C0856825 (UMLS CUI [1,1])
C1306673 (UMLS CUI [1,2])
aGvHD Stage Skin
Code List
aGvHD Stage
CL Item
Stage skin (1)
C1610605 (UMLS CUI-1)
CL Item
Stage liver (2)
C1610054 (UMLS CUI-1)
CL Item
Stage gut (3)
C0856825 (UMLS CUI-1)
C0017178 (UMLS CUI-2)
Item
aGvHD Resolution
integer
C0856825 (UMLS CUI [1,1])
C1514893 (UMLS CUI [1,2])
aGvHD Resolution
Code List
aGvHD Resolution
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])
Item
Presence of cGvHD
text
C0867389 (UMLS CUI [1])
Chronic Graft versus Host Disease
Code List
Presence of cGvHD
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Present continously since last reported episode (Present continously since last reported episode)
CL Item
Resolved (Resolved)
Item
Presence of cGVHD if yes
integer
C0867389 (UMLS CUI [1])
Presence of cGVHD
Code List
Presence of cGVHD if yes
CL Item
First episode (1)
CL Item
Recurrence (2)
cGvHD Date of onset
Item
cGvHD Date of onset
date
C0867389 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item
cGvHD grade
integer
C0867389 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
cGvHD grade
Code List
cGvHD grade
CL Item
limited (1)
CL Item
Extensive (2)
Item
Organs affected
integer
C0449642 (UMLS CUI [1])
Organs affected
Code List
Organs affected
CL Item
Skin (1)
CL Item
Gut (2)
CL Item
Liver (3)
CL Item
Mouth (4)
CL Item
Eyes (5)
CL Item
Lung (6)
CL Item
Other, specify (7)
CL Item
Unknown (8)
Date of Resolution
Item
If resolved, specify the date of resolution:
date
C1514893 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
OTHER COMPLICATIONS SINCE LAST REPORT
Infection related complications
Item
Infection related complications
boolean
C0009450 (UMLS CUI [1,1])
C0009566 (UMLS CUI [1,2])
Item
Bacteraemia / fungemia / viremia / parasites
integer
C0004610 (UMLS CUI [1])
C0085082 (UMLS CUI [2])
C0042749 (UMLS CUI [3])
C0030498 (UMLS CUI [4])
Bacteraemia / fungemia / viremia / parasites
Code List
Bacteraemia / fungemia / viremia / parasites
CL Item
Pathogen (1)
CL Item
Date (2)
Item
integer
C0036983 (UMLS CUI [1])
Septic shock
Code List
Septic shock
CL Item
Pathogen (1)
CL Item
Date (2)
Item
ARDS
integer
C0035222 (UMLS CUI [1])
ARDS
Code List
ARDS
CL Item
Pathogen (1)
CL Item
Date (2)
Item
Multiorgan failure due to infection
integer
C0026766 (UMLS CUI [1])
Multiorgan failure due to infection
Code List
Multiorgan failure due to infection
CL Item
Pathogen (1)
CL Item
Date (2)
Item
Pneumonia
integer
C0032285 (UMLS CUI [1])
Pneumonia
Code List
Pneumonia
CL Item
Pathogen (1)
CL Item
Date (2)
Item
Hepatitis
integer
C0019158 (UMLS CUI [1])
Hepatitis
Code List
Hepatitis
CL Item
Pathogen (1)
CL Item
Date (2)
Item
CNS infection
integer
C0007684 (UMLS CUI [1])
CNS infection
Code List
CNS infection
CL Item
Pathogen (1)
Item
Gut infection
integer
C0178238 (UMLS CUI [1])
Gut infection
Code List
Gut infection
CL Item
Pathogen (1)
CL Item
Date (2)
Item
Skin infection
integer
C0037278 (UMLS CUI [1])
Skin infection
Code List
Skin infection
CL Item
Pathogen (1)
CL Item
Date (2)
Skin infection
Item
Date Provide different dates for different episodes of the same complication if applicable.
text
Item
Cystitis
integer
C0010692 (UMLS CUI [1])
Cystitis
Code List
Cystitis
CL Item
Pathogen (1)
CL Item
Date (2)
Item
Retinitis
integer
C0035333 (UMLS CUI [1])
Retinitis
Code List
Retinitis
CL Item
Pathogen (1)
CL Item
Date (2)
Item
Other
integer
C0205394 (UMLS CUI [1])
Other
Code List
Other
CL Item
Pathogen (1)
CL Item
Date (2)
Non infection related complications
Item
Non infection related complications
boolean
C0009566 (UMLS CUI [1])
Item
CTC grade Cardiovascular
integer
C0007226 (UMLS CUI [1,1])
C1516728 (UMLS CUI [1,2])
CTC grade Cardiovascular
Code List
CTC grade Cardiovascular
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Cardiovascular
Item
Date Cardiovascular
date
C0007222 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
Cardiovascular comments
Item
Cardiovascular comments
integer
C0947611 (UMLS CUI [1,1])
C0007222 (UMLS CUI [1,2])
Item
CTC grade Dermatologic
integer
C1516728 (UMLS CUI [1,1])
C0205489 (UMLS CUI [1,2])
CTC grade Dermatologic
Code List
CTC grade Dermatologic
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Dermatologic
Item
Date Dermatologic
date
C0205489 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
Dermatologic
Item
Comments
text
C0947611 (UMLS CUI [1,1])
C0205489 (UMLS CUI [1,2])
Item
CTC grade Gastrointestinal
integer
C1516728 (UMLS CUI [1,1])
C0521362 (UMLS CUI [1,2])
CTC grade Gastrointestinal
Code List
CTC grade Gastrointestinal
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Gastrointestinal
Item
Date Gastrointestinal
date
C0521362 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
Gastrointestinal Comments
Item
Gastrointestinal Comments
text
C0521362 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
Item
CTC grade Haemorrhage
integer
C1516728 (UMLS CUI [1,1])
C0019080 (UMLS CUI [1,2])
CTC grade Haemorrhage
Code List
CTC grade Haemorrhage
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Haemorrhage
Item
Date Haemorrhage
date
C1516728 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
Haemorrhage Comments
Item
Haemorrhage Comments
text
C1516728 (UMLS CUI [1])
Item
CTC grade Hepatic
integer
C1516728 (UMLS CUI [1,1])
C0205054 (UMLS CUI [1,2])
CTC grade Hepatic
Code List
CTC grade Hepatic
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Hepatic
Item
Date Hepatic
date
C1516728 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
Hepatic Comments
Item
Hepatic Comments
text
C1516728 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
Item
CTC grade Neurologic
integer
C1516728 (UMLS CUI [1,1])
C0205494 (UMLS CUI [1,2])
CTC grade Neurologic
Code List
CTC grade Neurologic
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date Neurologic
Item
Date Neurologic
date
C1516728 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
Neurologic Comments
Item
Neurologic Comments
text
C2316983 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
Item
CTC grade Pulmonary
integer
C1516728 (UMLS CUI [1,1])
C0024109 (UMLS CUI [1,2])
CTC grade Pulmonary
Code List
CTC grade Pulmonary
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Pulmonary Date
Item
Pulmonary Date
date
C1516728 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
Pulmonary Comments
Item
Pulmonary Comments
text
C1516728 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
Item
CTC grade Renal
integer
C1516728 (UMLS CUI [1,1])
C0022646 (UMLS CUI [1,2])
CTC grade Renal
Code List
CTC grade Renal
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Renal Date
Item
Renal Date
date
C0022646 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
Renal Comments
Item
Renal Comments
text
C0022646 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
Item
Other CTC grade
integer
C1516728 (UMLS CUI [1,1])
C0220886 (UMLS CUI [1,2])
Other CTC grade
Code List
Other CTC grade
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
Date of other Type
Item
Date of other Type
date
C2316983 (UMLS CUI [1,1])
C0220886 (UMLS CUI [1,2])
Comments of Other type
Item
Comments of Other type
text
C0220886 (UMLS CUI [1,1])
C0947611 (UMLS CUI [1,2])
Item
Graft loss
text
C0877042 (UMLS CUI [1])
Graft loss
Code List
Graft loss
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Not evaluated (Not evaluated)
Item
Overall chimaerism
integer
C0206612 (UMLS CUI [1])
Overall chimaerism
Code List
Overall chimaerism
CL Item
Full (donor >95 %)  (1)
CL Item
Mixed (partial) (2)
CL Item
Autologous reconstitution (recipient >95 %)  (3)
CL Item
Aplasia (4)
CL Item
Not evaluated (5)
Item Group
GRAFT ASSESSMENT AND HAEMOPOIETIC CHIMAERISM
Date of Test
Item
Date of Test
date
C0011008 (UMLS CUI [1])
Identification
Item
Identification of donor or Cord Blood Unit given by the centre
text
C1718162 (UMLS CUI [1])
Number in the infusion order
Item
Number in the infusion order (if applicable)
text
C0237753 (UMLS CUI [1])
Item
Cell type on which test was performed BM
integer
C0449475 (UMLS CUI [1,1])
C0022885 (UMLS CUI [1,2])
Cell type on which test was performed
Code List
Cell type on which test was performed BM
CL Item
Bone marrow (1)
C0005953 (UMLS CUI-1)
CL Item
PB mononuclear cells (PBMC) (2)
C1321301 (UMLS CUI-1)
CL Item
T-cell (3)
C0039194 (UMLS CUI-1)
CL Item
B-cells (4)
C0004561 (UMLS CUI-1)
CL Item
Red blood cells (5)
C0014772 (UMLS CUI-1)
CL Item
Monocytes (6)
C0026473 (UMLS CUI-1)
CL Item
PMNs (neutrophils) (7)
C0200633 (UMLS CUI-1)
CL Item
Lymphocytes (8)
C0024264 (UMLS CUI-1)
CL Item
Myeloid cells (9)
C0887899 (UMLS CUI-1)
CL Item
Other (10)
C0205394 (UMLS CUI-1)
Item
Laboratory tests used:
integer
C0022885 (UMLS CUI [1])
Laboratory tests
Code List
Laboratory tests used:
CL Item
FISH (FISH)
C0162789 (UMLS CUI-1)
CL Item
Molecular (Molecular)
C0026376 (UMLS CUI-1)
CL Item
Cytogenetic (Cytogenetic)
C0010802 (UMLS CUI-1)
CL Item
ABO group (ABO group)
C0000778 (UMLS CUI-1)
CL Item
Other (Other)
C0205394 (UMLS CUI-1)
CL Item
unknown (unknown)
C0439673 (UMLS CUI-1)
Item
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
integer
C3266877 (UMLS CUI [1])
C0024314 (UMLS CUI [2])
C0027022 (UMLS CUI [3])
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
Code List
SECONDARY MALIGNANCY, LYMPHOPROLIFERATIVE OR MYELOPROLIFRATIVE DISORDER DIAGNOSED
CL Item
Previously reported (1)
C0205309 (UMLS CUI-1)
CL Item
Yes (2)
C1705108 (UMLS CUI-1)
CL Item
No at date of this follow-up (3)
C1298908 (UMLS CUI-1)
Date of diagnosis
Item
Date of diagnosis
date
C2316983 (UMLS CUI [1,1])
C1274082 (UMLS CUI [1,2])
Item
Diagnosis Secondary Malignant Neoplasm
integer
C0011900 (UMLS CUI [1,1])
C2939419 (UMLS CUI [1,2])
Diagnosis
Code List
Diagnosis Secondary Malignant Neoplasm
CL Item
AML  (1)
C0023467 (UMLS CUI-1)
CL Item
MDS  (2)
C3463824 (UMLS CUI-1)
CL Item
Lymphoproliferative disorder  (3)
C0024314 (UMLS CUI-1)
CL Item
Other (4)
C0205394 (UMLS CUI-1)
If other diagnosis, please specify
Item
If other diagnosis, please specify
text
C0011900 (UMLS CUI [1,1])
C2939419 (UMLS CUI [1,2])
C0205394 (UMLS CUI [1,3])
Item Group
ADDITIONAL THERAPIES SINCE LAST FOLLOW UP
Item
Treatment given since last report
text
C1706712 (UMLS CUI [1])
Additional treatment
Code List
Treatment given since last report
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Unknown (Unknown)
Date started
Item
Date started
date
Item
If yes: CELLULAR THERAPY One cell therapy regimen is defined as any number of infusions given within 10 weeks for the same indication. If more than one regimen of cell therapy has been given since last report, copy this section and complete it as many times as necessary.
integer
ADDITIONAL TREATMENT
Code List
If yes: CELLULAR THERAPY One cell therapy regimen is defined as any number of infusions given within 10 weeks for the same indication. If more than one regimen of cell therapy has been given since last report, copy this section and complete it as many times as necessary.
CL Item
No (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
Disease status before this cellular therapy
integer
C0012634 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
Disease status before this cellular therapy
Code List
Disease status before this cellular therapy
CL Item
CR  (1)
CL Item
Not in CR  (2)
CL Item
Not evaluated (3)
Item
If yes: Type of cells
integer
C0302189 (UMLS CUI [1])
Type of cells
Code List
If yes: Type of cells
CL Item
Donor lymphocyte infusion (DLI) (1)
CL Item
Mesenchymal cells (2)
CL Item
Other (3)
CL Item
Unknown (4)
Item
If DLI, specify the number of cells infused by type: Nucleated cells
text
C1180059 (UMLS CUI [1])
Nucleated cells
Code List
If DLI, specify the number of cells infused by type: Nucleated cells
CL Item
Evaluated (Evaluated)
CL Item
Not evaluated (Not evaluated)
CL Item
unknown (unknown)
Item
Number of cells infused by type
integer
C2145394 (UMLS CUI [1])
Number of cells infused by type
Code List
Number of cells infused by type
CL Item
Nucleated cells (1)
CL Item
CD 34+ (2)
CL Item
CD 3+ (3)
Item
Total number of cells
text
C0007584 (UMLS CUI [1,1])
C2145394 (UMLS CUI [1,2])
All cells
Code List
Total number of cells
CL Item
Evaluated (Evaluated)
CL Item
Not Evaluated (Not Evaluated)
CL Item
Unknown (Unknown)
Chronological number
Item
Chronological number of this cell therapy for this patient
float
C2348184 (UMLS CUI [1])
Item
Indication (check all that apply)
text
C3146298 (UMLS CUI [1,1])
C0302189 (UMLS CUI [1,2])
Indication
Code List
Indication (check all that apply)
CL Item
Planned/ protocol (Planned/ protocol)
CL Item
Treatment for disease (Treatment for disease)
CL Item
Prophylactic (Prophylactic)
CL Item
Mixed chimaerism (Mixed chimaerism)
CL Item
Treatment of GvHD (Treatment of GvHD)
CL Item
Treatment viral infection (Treatment viral infection)
CL Item
Loss/decreased chimaerism (Loss/decreased chimaerism)
CL Item
Treatment PTLD, EBV, lymphoma (Treatment PTLD, EBV, lymphoma)
CL Item
Other (Other)
Infusion count
Item
Number of infusions within 10 weeks (count only infusions that are part of same regimen and given for the same indication)
float
C0574032 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
Item
Maximum Grade of Acute GVHD
text
C0856825 (UMLS CUI [1,1])
C0441800 (UMLS CUI [1,2])
AcuteGraftVersusHostDiseaseMaximumOverallGrade
Code List
Maximum Grade of Acute GVHD
CL Item
Agvhd Grade 0 (0)
CL Item
Agvhd Grade I (I)
CL Item
Agvhd Grade Ii (II)
CL Item
Agvhd Grade Iii (III)
CL Item
Agvhd Grade Iv (IV)
CL Item
Agvhd Present, Grade Unknown (Present, grade unknown)
Item
Disease treatment (apart from donor cell infusion or other type of cell therapy)
integer
C0087111 (UMLS CUI [1])
Disease treatment
Code List
Disease treatment (apart from donor cell infusion or other type of cell therapy)
CL Item
No (1)
CL Item
Yes: Planned (planned before HSCT took place) (2)
CL Item
Yes: Not planned (for relapse/progression or persistent disease) (3)
Item Group
FIRST EVIDENCE OF DISEASE WORSENING SINCE LAST HSCT
Item
EVIDENCE OF DISEASE ACTIVITY
text
C0544450 (UMLS CUI [1])
EVIDENCE OF DISEASE ACTIVITY
Code List
EVIDENCE OF DISEASE ACTIVITY
CL Item
Previously reported (Previously reported)
CL Item
No (No)
CL Item
Yes (Yes)
CL Item
Continuous worsening since HSCT (Continuous worsening since HSCT)
CL Item
Unknown (Unknown)
EVIDENCE OF DISEASE ACTIVITY
Item
If yes, date first noted
date
C0544450 (UMLS CUI [1,1])
C2316983 (UMLS CUI [1,2])
Item Group
LAST DISEASE AND PATIENT STATUS
Item
HAEMATOLOGICAL DISEASE STATUS
integer
C0018939 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
HAEMATOLOGICAL DISEASE STATUS
Code List
HAEMATOLOGICAL DISEASE STATUS
CL Item
Complete remission (Complete remission)
CL Item
Partial remission (Partial remission)
CL Item
Stable disease (Stable disease)
CL Item
Progression (Progression)
CL Item
Not evaluable (Not evaluable)
CL Item
Unknown (Unknown)
Item
Organ Response
integer
C1817419 (UMLS CUI [1])
ORGAN RESPONSE
Code List
Organ Response
CL Item
Response (1)
CL Item
Non Response (2)
CL Item
Progression (3)
CL Item
Not evaluable (4)
CL Item
Unknown (5)
Item
CLINICAL AND LABORATORY DATA
integer
C1516606 (UMLS CUI [1,1])
C1254595 (UMLS CUI [1,2])
Hb (g/dL)
Code List
CLINICAL AND LABORATORY DATA
CL Item
Serum creatinine (1)
C0201976 (UMLS CUI-1)
CL Item
Hb (g/dL) (2)
C0019046 (UMLS CUI-1)
CL Item
Total urinary protein excretion (mg/24 h) (3)
C0033687 (UMLS CUI-1)
CL Item
Total urinary albumin excretion (mg/24 h) (4)
C2362049 (UMLS CUI-1)
CL Item
Serum calcium (mmol/L) (5)
C0036785 (UMLS CUI-1)
CL Item
Serum albumin (g/L) (6)
C0036773 (UMLS CUI-1)
CL Item
Serum alkaline phosphatase (IU/L) (7)
C0428334 (UMLS CUI-1)
CL Item
Serum bilirubin (8)
C1278039 (UMLS CUI-1)
CL Item
NT-proBNP (ng/L) (9)
C0754710 (UMLS CUI-1)
CL Item
Serum c-Troponin T (μg/L) (10)
C0077404 (UMLS CUI-1)
BM aspirate
Item
BM aspirate: % plasmacytosis
float
C0857285 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
BM trephine
Item
BM trephine % plasmacytosis
float
C0398526 (UMLS CUI [1,1])
C0085663 (UMLS CUI [1,2])
Monoclonal Ig in serum
Item
Monoclonal Ig in serum
float
C1532873 (UMLS CUI [1,1])
C3516447 (UMLS CUI [1,2])
Item
Immunofixation of serum
integer
C1271678 (UMLS CUI [1])
Immunofixation of serum
Code List
Immunofixation of serum
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Free Kappa light chains in serum
integer
C0443743 (UMLS CUI [1])
Kappa light chains
Code List
Free Kappa light chains in serum
CL Item
Not evaluated (1)
Item
Lambda light chains
integer
C0021037 (UMLS CUI [1])
Lambda light chains
Code List
Lambda light chains
CL Item
Not evaluated (1)
Item
Immunofixation of urine
integer
C1271641 (UMLS CUI [1])
Immunofixation of urine
Code List
Immunofixation of urine
CL Item
Negative  (1)
CL Item
Positive  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Monoclonal light chains in urine
Item
Monoclonal light chains in urine
integer
C0004965 (UMLS CUI [1])
Serum Beta2 microglobulin
Item
Serum Beta2 microglobulin
float
C0859328 (UMLS CUI [1])
Item
Renal response
integer
C0022646 (UMLS CUI [1,1])
C1704632 (UMLS CUI [1,2])
Renal response
Code List
Renal response
CL Item
Response (1)
CL Item
No response/stable disease (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable (4)
CL Item
Not evaluated/not applicable (5)
CL Item
Unknown (6)
Liver span in ultrasound or CT scan
Item
Liver span (cm craniocaudal diameter)
float
Item
Hepatic response
text
C1817762 (UMLS CUI [1])
Hepatic response
Code List
Hepatic response
CL Item
Response (Response)
CL Item
No response/stable disease (No response/stable disease)
CL Item
Progressive disease (Progressive disease)
CL Item
Not evaluable (Not evaluable)
CL Item
Not evaluated/not applicable (Not evaluated/not applicable)
CL Item
Unknown (Unknown)
Item
NYHA class
integer
C1275491 (UMLS CUI [1])
NYHA class
Code List
NYHA class
CL Item
I (1)
CL Item
II (2)
CL Item
III (3)
CL Item
IV (4)
CL Item
unknown (5)
LVEF
Item
Left Ventricular Ejection Fraction
float
C0428772 (UMLS CUI [1])
Interventricular septal wall thickness
Item
Interventricular septal wall thickness (mean # mm in echocardiogram)
float
C0225870 (UMLS CUI [1])
Item
Cardiac response
integer
C1522601 (UMLS CUI [1,1])
C0871261 (UMLS CUI [1,2])
Cardiac response
Code List
Cardiac response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Item
Weight loss
integer
C1262477 (UMLS CUI [1])
Weight loss
Code List
Weight loss
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
Malabsorption
integer
C0024523 (UMLS CUI [1])
Malabsorption
Code List
Malabsorption
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI bleeding
integer
C0017181 (UMLS CUI [1])
GI bleeding
Code List
GI bleeding
CL Item
No  (1)
CL Item
Yes  (2)
CL Item
Not evaluated  (3)
CL Item
Unknown (4)
Item
GI response
integer
C1817419 (UMLS CUI [1,1])
C0521362 (UMLS CUI [1,2])
GI response
Code List
GI response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Item
Neurological exam
integer
C0027853 (UMLS CUI [1])
Neurological exam
Code List
Neurological exam
CL Item
Improved  (1)
CL Item
Worsened  (2)
CL Item
Unchanged  (3)
CL Item
Unknown (4)
Item
PNP severity
integer
C0152025 (UMLS CUI [1])
PNP severity
Code List
PNP severity
CL Item
grade I  (1)
CL Item
grade II  (2)
CL Item
grade III  (3)
CL Item
grade IV (4)
Item
PN response
integer
C0031117 (UMLS CUI [1])
PN response
Code List
PN response
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Item
Autonomic neuropathy
integer
C0259749 (UMLS CUI [1])
AN response
Code List
Autonomic neuropathy
CL Item
Response  (1)
CL Item
No response/stable disease  (2)
CL Item
Progressive disease (3)
CL Item
Not evaluable  (4)
CL Item
Not evaluated/not applicable  (5)
CL Item
Unknown (6)
Evidence of new organ involvement
Item
Evidence of new organ involvement
text
C0457576 (UMLS CUI [1])
Item
Has patient or partner become pregnant after this HSCT?
integer
Has patient or partner become pregnant after this HSCT?
Code List
Has patient or partner become pregnant after this HSCT?
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Unknown (3)
Item
Survival Status
integer
C1148433 (UMLS CUI [1])
Survival Status
Code List
Survival Status
CL Item
alive (0)
CL Item
dead (1)
Item
Type of score used PERFORMANCE SCORE (if alive)
integer
Type of score used
Code List
Type of score used PERFORMANCE SCORE (if alive)
CL Item
Karnofsky (1)
CL Item
Lansky (2)
Item
Score
integer
C1518965 (UMLS CUI [1])
Performance score
Code List
Score
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)
Item
CAUSE OF DEATH (check only one main cause)
integer
C0007465 (UMLS CUI [1])
CAUSE OF DEATH
Code List
CAUSE OF DEATH (check only one main cause)
CL Item
Due to amyloidosis (progression of disease) (1)
C0002726 (UMLS CUI-1)
C0007465 (UMLS CUI-2)
CL Item
Secondary malignancy (including lymphoproliferative disease) (2)
C0007465 (UMLS CUI-1)
C3266877 (UMLS CUI-2)
CL Item
HSCT related cause (3)
C0007465 (UMLS CUI-1)
C0472699 (UMLS CUI-2)
CL Item
unknown (4)
C0439673 (UMLS CUI-1)
C0007465 (UMLS CUI-2)
CL Item
other (5)
C0007465 (UMLS CUI-1)
C0439673 (UMLS CUI-2)
Item
cGvHD
integer
C0867389 (UMLS CUI [1])
cGvHD cause
Code List
cGvHD
CL Item
Yes  (1)
CL Item
No  (2)
CL Item
Unknown (3)
Item
Interstitial pneumonitis Cause of death
integer
C0007465 (UMLS CUI [1,1])
C0206061 (UMLS CUI [1,2])
Interstitial pneumonitis
Code List
Interstitial pneumonitis Cause of death
CL Item
No  (1)
CL Item
Yes (2)
CL Item
Unknown (3)
Item
Pulmonary toxicity Cause
integer
C0007465 (UMLS CUI [1,1])
C0919924 (UMLS CUI [1,2])
Pulmonary toxicity
Code List
Pulmonary toxicity Cause
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Infection
integer
Infection
Code List
Infection
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Infection:
integer
C0009450 (UMLS CUI [1])
Infection
Code List
Infection:
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])
Rejection / poor graft function
Code List
Rejection / poor graft function
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])
Veno-Occlusive disease (VOD)
Code List
Veno-Occlusive disease (VOD)
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Haemorrhage
integer
C0007465 (UMLS CUI [1,1])
C0019080 (UMLS CUI [1,2])
Haemorrhage
Code List
Haemorrhage
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Cardiac toxicity
integer
C0007465 (UMLS CUI [1,1])
C0876994 (UMLS CUI [1,2])
Cardiac toxicity
Code List
Cardiac toxicity
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Central nervous system toxicity
integer
C0007465 (UMLS CUI [1,1])
C3160947 (UMLS CUI [1,2])
Central nervous system toxicity
Code List
Central nervous system toxicity
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Gastro intestinal toxicity
integer
C0007465 (UMLS CUI [1,1])
C1142499 (UMLS CUI [1,2])
Gastro intestinal toxicity
Code List
Gastro intestinal toxicity
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Skin toxicity
integer
C1167791 (UMLS CUI [1])
Skin toxicity
Code List
Skin toxicity
CL Item
Yes  (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Renal failure
integer
C1533077 (UMLS CUI [1])
Renal failure
Code List
Renal failure
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Item
Multiple organ failure
integer
C0026766 (UMLS CUI [1])
Multiple organ failure
Code List
Multiple organ failure
CL Item
Yes (1)
CL Item
No (2)
CL Item
Unknown (3)
Other
Item
If other HSCT related cause, please specify
text
Item Group
ADDITIONAL NOTES IF APPLICABLE
Comments
Item
Comments
text
C0947611 (UMLS CUI [1])
IDENTIFICATION & SIGNATURE
Item
IDENTIFICATION & SIGNATURE
text
C0205396 (UMLS CUI [1,1])
C1519316 (UMLS CUI [1,2])
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