German

Autologe SZT

25 forms  
SZT Konditionierung
Description

SZT Konditionierung

Alias
UMLS CUI-1
C0376450
Klinik nummer
Description

Hospital number

Data type

integer

Alias
UMLS CUI [1]
C0806432
Patienten-Nr
Description

Patient number

Data type

integer

Alias
UMLS CUI [1]
C2348585
Patienten-Initialen:
Description

Patient initials

Data type

text

Alias
UMLS CUI [1]
C2986440
Größe
Description

Patient height

Data type

integer

Measurement units
  • cm
Alias
UMLS CUI [1]
C0489786
cm
Gewicht
Description

Patient weight

Data type

integer

Measurement units
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Körperoberfläche
Description

Body surface

Data type

float

Measurement units
  • m2
Alias
UMLS CUI [1]
C0005902
m2
Konditionierung Busulfan
Description

Busulfan oder Busulfex

Data type

boolean

Alias
UMLS CUI [1,1]
C0376450
UMLS CUI [1,2]
C0006463
Konditionierung Busulfex
Description

Busulfan oder Busulfex

Data type

boolean

Alias
UMLS CUI [1,1]
C0376450
UMLS CUI [1,2]
C0939273
Konditionierung Cyclophosphamid
Description

Conditioning agent Cyclophosphamide

Data type

boolean

Alias
UMLS CUI [1,1]
C0376450
UMLS CUI [1,2]
C0010583
Art der Verabreichung
Description

Drug Administration Routes

Data type

integer

Alias
UMLS CUI [1]
C0013153
Busulfan Behandlungstage -7 bis -4
Description

Treatment day

Data type

boolean

Alias
UMLS CUI [1,1]
C0006463
UMLS CUI [1,2]
C0439228
UMLS CUI [1,3]
C0750480
Busulfex Behandlungstage -7 bis -4
Description

Treatment day

Data type

boolean

Alias
UMLS CUI [1,1]
C0939273
UMLS CUI [1,2]
C0439228
UMLS CUI [1,3]
C0750480
Cyclophosphamid Behandlungstag -3 bis -2
Description

Treatment day

Data type

boolean

Alias
UMLS CUI [1,1]
C0010583
UMLS CUI [1,2]
C2348070
Busulfan Tagesdosis 4 x 1 mg/kg
Description

Busulfan daily dose

Data type

boolean

Alias
UMLS CUI [1,1]
C0006463
UMLS CUI [1,2]
C2348070
Busulfex Tagesdosis 4 x 0,8 mg/kg
Description

Busulfex daily dose

Data type

boolean

Alias
UMLS CUI [1,1]
C0939273
UMLS CUI [1,2]
C2348070
Cyclophosphamid Tagesdosis 60 mg/kg
Description

Cyclophosphamide daily dose

Data type

boolean

Alias
UMLS CUI [1,1]
C0010583
UMLS CUI [1,2]
C2348070
Busulfan Gesamtdosis
Description

Busulfan Cumulative dose

Data type

integer

Measurement units
  • mg
Alias
UMLS CUI [1,1]
C2986497
UMLS CUI [1,2]
C0006463
mg
Busulfex Gesamtdosis
Description

Busulfex Cumulative dose

Data type

integer

Measurement units
  • mg
Alias
UMLS CUI [1,1]
C2986497
UMLS CUI [1,2]
C0939273
mg
Cyclophosphamid Gesamtdosis
Description

Cyclophosphamide cumulative dose

Data type

integer

Measurement units
  • mg
Alias
UMLS CUI [1,1]
C2986497
UMLS CUI [1,2]
C0010583
mg
Andere Konditionierung Substanz
Description

Other Conditioning agent

Data type

text

Alias
UMLS CUI [1,1]
C0376450
UMLS CUI [1,2]
C0205394
UMLS CUI [1,3]
C0013227
Art der Verabreichung
Description

Drug Administration Routes

Data type

text

Alias
UMLS CUI [1]
C0013153
Behandlungstag
Description

Treatment day

Data type

text

Alias
UMLS CUI [1,1]
C0439228
UMLS CUI [1,2]
C0750480
Tagesdosis
Description

Daily dose

Data type

text

Alias
UMLS CUI [1]
C2348070
Gesamtdosis
Description

Cumulative dose

Data type

text

Alias
UMLS CUI [1]
C2986497
Transplantat (PBSZ)
Description

Transplantat (PBSZ)

Alias
UMLS CUI-1
C1142466
nukleäre Zellen (TNC)
Description

nucleated cells

Data type

integer

Measurement units
  • *10^8 /kg
Alias
UMLS CUI [1,1]
C1180059
UMLS CUI [1,2]
C0007584
*10^8 /kg
CD34+ Zellen
Description

CD34+ Cells

Data type

integer

Measurement units
  • *10^6/kg
Alias
UMLS CUI [1]
C1277788
*10^6/kg
CD3 (T-Zellen)
Description

CD3 (T-Cells)

Data type

integer

Measurement units
  • *10^5 /kg
Alias
UMLS CUI [1]
C2025558
*10^5 /kg
Zeitpunkt der Apheresegewinnung
Description

Apheresis

Data type

integer

Alias
UMLS CUI [1,1]
C0005791
UMLS CUI [1,2]
C0808070
Anderer Zeitpunkt der Apheresegewinnung
Description

Specify other

Data type

text

Alias
UMLS CUI [1,1]
C1521902
UMLS CUI [1,2]
C0205394
Engraftment
Description

Engraftment

Data type

boolean

Alias
UMLS CUI [1]
C0301944
Neutrophile Engraftment Take Datum
Description

3x >0,5 GPt/l bzw . ≥ 500 /μl

Data type

date

Alias
UMLS CUI [1,1]
C1882078
UMLS CUI [1,2]
C0011008
Andauernd
Description

Sustained

Data type

boolean

Alias
UMLS CUI [1]
C3827885
Thrombozyten Engraftment Take Datum
Description

3x >20 GPt/l bzw . ≥ 20.000 /μl

Data type

date

Alias
UMLS CUI [1,1]
C1882407
UMLS CUI [1,2]
C0011008
Andauernd
Description

Sustained

Data type

boolean

Alias
UMLS CUI [1]
C3827885
Thrombozyten Engraftment Take Datum
Description

3x >50 GPt/l bzw . ≥ 50.000 /μl

Data type

date

Alias
UMLS CUI [1,1]
C1882407
UMLS CUI [1,2]
C0011008
Andauernd
Description

Sustained

Data type

boolean

Alias
UMLS CUI [1]
C3827885
Anzahl Erythrozythentransfusionen
Description

Number red blood cell transfusions

Data type

integer

Alias
UMLS CUI [1,1]
C0086252
UMLS CUI [1,2]
C0750480
Andauernd
Description

sustained

Data type

boolean

Alias
UMLS CUI [1]
C0443318
Thrombozyten Transfusion
Description

Platelet transfusion

Data type

integer

Alias
UMLS CUI [1]
C0086818
Anzahl Einzelspender Transfusionen
Description

Count of Platelet transfusions

Data type

integer

Alias
UMLS CUI [1,1]
C0086818
UMLS CUI [1,2]
C0750480
UMLS CUI [1,3]
C1277092
andauernd
Description

Sustained

Data type

boolean

Alias
UMLS CUI [1]
C0443318
Anzahl gepoolter Thrombozyten Transfusionen
Description

Count of pooled platelet transfusions

Data type

integer

Alias
UMLS CUI [1,1]
C0086818
UMLS CUI [1,2]
C1277095
UMLS CUI [1,3]
C0750480
andauernd
Description

Sustained

Data type

boolean

Alias
UMLS CUI [1]
C0443318
Anzahl Granulozytentransfusionen
Description

Count of granulocyte transfusions

Data type

integer

Alias
UMLS CUI [1,1]
C0085430
UMLS CUI [1,2]
C0018183
UMLS CUI [1,3]
C0750480
SZT-spezifische Nebenwirkungen
Description

SCT specific adverse events

Data type

integer

Alias
UMLS CUI [1,1]
C0371849
UMLS CUI [1,2]
C0877248
SZT-spezifische Nebenwirkungen, sonstige
Description

SCT specific adverse event , specify other

Data type

text

Alias
UMLS CUI [1,1]
C0371849
UMLS CUI [1,2]
C0877248
UMLS CUI [1,3]
C3845569
Materialversand an Studienzentrale
Description

Materialversand an Studienzentrale

Alias
UMLS CUI-1
C1524049
UMLS CUI-2
C0520510
mind. 10 ml heparinisiertes KM
Description

Bone marrow heparinized

Data type

boolean

Alias
UMLS CUI [1,1]
C0019134
UMLS CUI [1,2]
C0005953
Datum
Description

Shipping date

Data type

date

Alias
UMLS CUI [1,1]
C1524049
UMLS CUI [1,2]
C0011008
mind. 40 ml heparinisiertes pB
Description

heparinized pB

Data type

boolean

Alias
UMLS CUI [1,1]
C0019134
UMLS CUI [1,2]
C0229664
Datum
Description

Shipping date

Data type

date

Alias
UMLS CUI [1,1]
C1524049
UMLS CUI [1,2]
C0011008
5 ungefärbte KM-Ausstriche
Description

bone marrow smears

Data type

boolean

Alias
UMLS CUI [1,1]
C0205451
UMLS CUI [1,2]
C1883469
UMLS CUI [1,3]
C2097112
Datum
Description

Shipping date

Data type

date

Alias
UMLS CUI [1,1]
C1524049
UMLS CUI [1,2]
C0011008
5 ungefärbte pB-Ausstriche
Description

peripheral blood smears

Data type

boolean

Alias
UMLS CUI [1,1]
C0205451
UMLS CUI [1,2]
C1883469
UMLS CUI [1,3]
C2238079
Datum
Description

Shipping date

Data type

date

Alias
UMLS CUI [1,1]
C1524049
UMLS CUI [1,2]
C0011008
KM-Morphologie
Description

KM-Morphologie

Alias
UMLS CUI-1
C2704380
KM-Morphologie durchgeführt?
Description

Bone marrow examination done?

Data type

boolean

Alias
UMLS CUI [1,1]
C0005957
UMLS CUI [1,2]
C0884358
Datum
Description

Date

Data type

date

Alias
UMLS CUI [1]
C0011008
Grund für Nichtdurchführung
Description

Not done reason

Data type

text

Alias
UMLS CUI [1]
C2826287
Blastenanteil im KM
Description

Blasts in Bone marrow

Data type

integer

Measurement units
  • %
Alias
UMLS CUI [1]
C1982687
%
Labor
Description

Laboratory Name

Data type

text

Alias
UMLS CUI [1]
C1882331
Beurteilung des Therapieerfolges
Description

Beurteilung des Therapieerfolges

Alias
UMLS CUI-1
C0085565
Status nach SZT (nach Regeneration)
Description

Status post SCT

Data type

integer

Alias
UMLS CUI [1,1]
C0371849
UMLS CUI [1,2]
C0085415
SZT-assoziierter Todesfall: wievielter Tag nach SZT
Description

SCT associated death day number post-treatment

Data type

integer

Alias
UMLS CUI [1,1]
C0371849
UMLS CUI [1,2]
C0206277
UMLS CUI [1,3]
C2709088
Datum
Description

Date of completion

Data type

date

Alias
UMLS CUI [1,1]
C0011008
UMLS CUI [1,2]
C0850287
Name des Studienarztes
Description

Investigator name

Data type

text

Alias
UMLS CUI [1]
C2826892
Unterschrift
Description

Investigator Signature

Data type

text

Alias
UMLS CUI [1]
C2346576
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Similar models

Autologe SZT

25 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
SZT Konditionierung
C0376450 (UMLS CUI-1)
Hospital number
Item
Klinik nummer
integer
C0806432 (UMLS CUI [1])
Patient number
Item
Patienten-Nr
integer
C2348585 (UMLS CUI [1])
Patient initials
Item
Patienten-Initialen:
text
C2986440 (UMLS CUI [1])
Patient height
Item
Größe
integer
C0489786 (UMLS CUI [1])
Patient weight
Item
Gewicht
integer
C0005910 (UMLS CUI [1])
Body surface
Item
Körperoberfläche
float
C0005902 (UMLS CUI [1])
Conditioning agent Busulfan
Item
Konditionierung Busulfan
boolean
C0376450 (UMLS CUI [1,1])
C0006463 (UMLS CUI [1,2])
Conditioning agent Busulfex
Item
Konditionierung Busulfex
boolean
C0376450 (UMLS CUI [1,1])
C0939273 (UMLS CUI [1,2])
Conditioning agent Cyclophosphamide
Item
Konditionierung Cyclophosphamid
boolean
C0376450 (UMLS CUI [1,1])
C0010583 (UMLS CUI [1,2])
Item
Art der Verabreichung
integer
C0013153 (UMLS CUI [1])
Drug Administration Routes
Code List
Art der Verabreichung
CL Item
p.o. (Busulfan) (1)
CL Item
i.v. (Busulfex+Cyclophosphamid) (2)
Treatment day
Item
Busulfan Behandlungstage -7 bis -4
boolean
C0006463 (UMLS CUI [1,1])
C0439228 (UMLS CUI [1,2])
C0750480 (UMLS CUI [1,3])
Treatment day
Item
Busulfex Behandlungstage -7 bis -4
boolean
C0939273 (UMLS CUI [1,1])
C0439228 (UMLS CUI [1,2])
C0750480 (UMLS CUI [1,3])
Treatment day
Item
Cyclophosphamid Behandlungstag -3 bis -2
boolean
C0010583 (UMLS CUI [1,1])
C2348070 (UMLS CUI [1,2])
Busulfan daily dose
Item
Busulfan Tagesdosis 4 x 1 mg/kg
boolean
C0006463 (UMLS CUI [1,1])
C2348070 (UMLS CUI [1,2])
Busulfex daily dose
Item
Busulfex Tagesdosis 4 x 0,8 mg/kg
boolean
C0939273 (UMLS CUI [1,1])
C2348070 (UMLS CUI [1,2])
Cyclophosphamide daily dose
Item
Cyclophosphamid Tagesdosis 60 mg/kg
boolean
C0010583 (UMLS CUI [1,1])
C2348070 (UMLS CUI [1,2])
Busulfan Cumulative dose
Item
Busulfan Gesamtdosis
integer
C2986497 (UMLS CUI [1,1])
C0006463 (UMLS CUI [1,2])
Busulfex Cumulative dose
Item
Busulfex Gesamtdosis
integer
C2986497 (UMLS CUI [1,1])
C0939273 (UMLS CUI [1,2])
Cyclophosphamide cumulative dose
Item
Cyclophosphamid Gesamtdosis
integer
C2986497 (UMLS CUI [1,1])
C0010583 (UMLS CUI [1,2])
Other Conditioning agent
Item
Andere Konditionierung Substanz
text
C0376450 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
C0013227 (UMLS CUI [1,3])
Item
Art der Verabreichung
text
C0013153 (UMLS CUI [1])
Drug Administration Routes
Code List
Art der Verabreichung
Treatment day
Item
Behandlungstag
text
C0439228 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
Daily dose
Item
Tagesdosis
text
C2348070 (UMLS CUI [1])
Cumulative dose
Item
Gesamtdosis
text
C2986497 (UMLS CUI [1])
Item Group
Transplantat (PBSZ)
C1142466 (UMLS CUI-1)
nucleated cells
Item
nukleäre Zellen (TNC)
integer
C1180059 (UMLS CUI [1,1])
C0007584 (UMLS CUI [1,2])
CD34+ Cells
Item
CD34+ Zellen
integer
C1277788 (UMLS CUI [1])
CD3 (T-Cells)
Item
CD3 (T-Zellen)
integer
C2025558 (UMLS CUI [1])
Item
Zeitpunkt der Apheresegewinnung
integer
C0005791 (UMLS CUI [1,1])
C0808070 (UMLS CUI [1,2])
Apheresis
Code List
Zeitpunkt der Apheresegewinnung
CL Item
nach MAC/Ara-C (1)
CL Item
frühe Regeneration (2)
CL Item
steady state (3)
CL Item
anderer (4)
Specify other
Item
Anderer Zeitpunkt der Apheresegewinnung
text
C1521902 (UMLS CUI [1,1])
C0205394 (UMLS CUI [1,2])
Engraftment
Item
Engraftment
boolean
C0301944 (UMLS CUI [1])
Neutrophils graft acceptance date
Item
Neutrophile Engraftment Take Datum
date
C1882078 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Sustained
Item
Andauernd
boolean
C3827885 (UMLS CUI [1])
Platelets graft acceptance date
Item
Thrombozyten Engraftment Take Datum
date
C1882407 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Sustained
Item
Andauernd
boolean
C3827885 (UMLS CUI [1])
Platelets graft acceptance date
Item
Thrombozyten Engraftment Take Datum
date
C1882407 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Sustained
Item
Andauernd
boolean
C3827885 (UMLS CUI [1])
Number red blood cell transfusions
Item
Anzahl Erythrozythentransfusionen
integer
C0086252 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
sustained
Item
Andauernd
boolean
C0443318 (UMLS CUI [1])
Item
Thrombozyten Transfusion
integer
C0086818 (UMLS CUI [1])
Platelet transfusion
Code List
Thrombozyten Transfusion
CL Item
Einzelspender (1)
CL Item
gepoolt (2)
Count of Platelet transfusions
Item
Anzahl Einzelspender Transfusionen
integer
C0086818 (UMLS CUI [1,1])
C0750480 (UMLS CUI [1,2])
C1277092 (UMLS CUI [1,3])
Sustained
Item
andauernd
boolean
C0443318 (UMLS CUI [1])
Count of pooled platelet transfusions
Item
Anzahl gepoolter Thrombozyten Transfusionen
integer
C0086818 (UMLS CUI [1,1])
C1277095 (UMLS CUI [1,2])
C0750480 (UMLS CUI [1,3])
Sustained
Item
andauernd
boolean
C0443318 (UMLS CUI [1])
Count of granulocyte transfusions
Item
Anzahl Granulozytentransfusionen
integer
C0085430 (UMLS CUI [1,1])
C0018183 (UMLS CUI [1,2])
C0750480 (UMLS CUI [1,3])
Item
SZT-spezifische Nebenwirkungen
integer
C0371849 (UMLS CUI [1,1])
C0877248 (UMLS CUI [1,2])
SCT specific adverse events
Code List
SZT-spezifische Nebenwirkungen
CL Item
Markversagen / Abstoßung (1)
CL Item
VOD (2)
CL Item
sonstige (3)
SCT specific adverse event , specify other
Item
SZT-spezifische Nebenwirkungen, sonstige
text
C0371849 (UMLS CUI [1,1])
C0877248 (UMLS CUI [1,2])
C3845569 (UMLS CUI [1,3])
Item Group
Materialversand an Studienzentrale
C1524049 (UMLS CUI-1)
C0520510 (UMLS CUI-2)
Bone marrow heparinized
Item
mind. 10 ml heparinisiertes KM
boolean
C0019134 (UMLS CUI [1,1])
C0005953 (UMLS CUI [1,2])
Shipping date
Item
Datum
date
C1524049 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
heparinized pB
Item
mind. 40 ml heparinisiertes pB
boolean
C0019134 (UMLS CUI [1,1])
C0229664 (UMLS CUI [1,2])
Shipping date
Item
Datum
date
C1524049 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
bone marrow smears
Item
5 ungefärbte KM-Ausstriche
boolean
C0205451 (UMLS CUI [1,1])
C1883469 (UMLS CUI [1,2])
C2097112 (UMLS CUI [1,3])
Shipping date
Item
Datum
date
C1524049 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
peripheral blood smears
Item
5 ungefärbte pB-Ausstriche
boolean
C0205451 (UMLS CUI [1,1])
C1883469 (UMLS CUI [1,2])
C2238079 (UMLS CUI [1,3])
Shipping date
Item
Datum
date
C1524049 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Item Group
KM-Morphologie
C2704380 (UMLS CUI-1)
Bone marrow examination done?
Item
KM-Morphologie durchgeführt?
boolean
C0005957 (UMLS CUI [1,1])
C0884358 (UMLS CUI [1,2])
Date
Item
Datum
date
C0011008 (UMLS CUI [1])
Not done reason
Item
Grund für Nichtdurchführung
text
C2826287 (UMLS CUI [1])
Blasts in Bone marrow
Item
Blastenanteil im KM
integer
C1982687 (UMLS CUI [1])
Laboratory Name
Item
Labor
text
C1882331 (UMLS CUI [1])
Item Group
Beurteilung des Therapieerfolges
C0085565 (UMLS CUI-1)
Item
Status nach SZT (nach Regeneration)
integer
C0371849 (UMLS CUI [1,1])
C0085415 (UMLS CUI [1,2])
Status post SCT
Code List
Status nach SZT (nach Regeneration)
CL Item
komplette Remission (1)
CL Item
SZT-assoziierter Todesfall (2)
CL Item
Transplantatversagen (3)
CL Item
Rezidiv (4)
SCT associated death day number post-treatment
Item
SZT-assoziierter Todesfall: wievielter Tag nach SZT
integer
C0371849 (UMLS CUI [1,1])
C0206277 (UMLS CUI [1,2])
C2709088 (UMLS CUI [1,3])
Date of completion
Item
Datum
date
C0011008 (UMLS CUI [1,1])
C0850287 (UMLS CUI [1,2])
Investigator name
Item
Name des Studienarztes
text
C2826892 (UMLS CUI [1])
Investigator Signature
Item
Unterschrift
text
C2346576 (UMLS CUI [1])
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