- 17/9/21 - 1 formulario, 69 itemgroups, 315 items, 1 idioma

Itemgroups: CIBMTR Use Only, Center Identification, Recipient Identification: Part 1 of 2, Study ID Number, Recipient Identification: Part 2 of 2, Recipient Race, Disease Classification, Hematopoietic Stem Cell Transplant (HSCT) : Part 1 of 4, Cell Source, Hematopoietic Stem Cell Transplant (HSCT) : Part 2 of 4, Donor Information, Hematopoietic Stem Cell Transplant (HSCT) : Part 3 of 4, Ex Vivo Graft Manipulation Type, Hematopoietic Stem Cell Transplant (HSCT) : Part 4 of 4, Preparative Regimen - Part 1 / 7, Preparative Regimen - Part 2 / 7, Preparative Regimen - Part 3 / 7 (Anthracyclines), Preparative Regimen - Part 4 / 7 (Monoclonal Antibodies), Preparative Regimen - Part 5 / 7 (Radiolabeled MAb), Preparative Regimen - Part 6 / 7 (Intent of Preparative Regimen), Preparative Regimen - Part 7 / 7 (Reason for NST / RIC), Comorbid Conditions, Type of Comorbid Condition, GVHD Prophylaxis, Post-HSCT Disease Therapy Planned as of Day 0, Type of Additional Post-HSCT Therapy, Other Toxicity Modifying Regimen, Pre-Transplant Essential Data Disease Classification Sheet, Acute Myelogenous Leukemia (AML) or Acute Nonlymphocytic Leukemia (ANLL): Part 1 of 2, Type of Therapy Related AML, Acute Myelogenous Leukemia (AML) or Acute Nonlymphocytic Leukemia (ANLL): Part 2 of 2, Acute Lymphoblastic Leukemia (ALL), Other Acute Leukemia, Chronic Myelogenous Leukemia (CML): Part 1 of 2, CML Prior HSCT Treatment, Chronic Myelogenous Leukemia (CML): Part 2 of 2, Myelodysplastic or Myeloproliferative Disease Classification, Myelodysplastic or Myeloproliferative Diseases: Part 1 of 2, Type of Therapy Related MDS / MPS, Myelodysplastic or Myeloproliferative Diseases: Part 2 of 2, Other Leukemias, Hodgkin Lymphoma, Non-Hodgkin's Lymphoma, Plasma Cell Disorders, Breast Cancer, Other Disease, Other Malignancies, Anemia/Hemoglobinopathy, Platelet Disorders, Histiocytic Disorders, Inherited Disorders of Metabolism/Osteopetrosis, Immune Deficiencies, Autoimmune Disorders, Systemic Sclerosis Involvement, Systemic Sclerosis Laboratory Procedures, Systemic Lupus Erythematosus (SLE) Involvement, Systemic Lupus Erythematosus (SLE) Laboratory Procedures, Sjogren Syndrome Involvement, Polymyositis / Dermatomyositis Involvement, Polymyositis / Dermatomyositis Laboratory Procedure, Antiphospholipid Syndrome Involvement, Antiphospholipid Syndrome Laboratory Procedures, Wegener Granulomatosis Involvement, Wegener Granulomatosis Laboratory Procedures, Polyarteritis Nodosa Involvement, Polyarteritis Nodosa Laboratory Procedures, Rheumatoid Arthritis Involvement, Psoriatic Arthritis / Psoriasis Involvement, Multiple Sclerosis (MS) Involvement

• Treatment Form
• Clinical Trial

- 17/9/21 - 1 formulario, 69 itemgroups, 315 items, 1 idioma

Itemgroups: CIBMTR Use Only, Center Identification, Recipient Identification: Part 1 of 2, Study ID Number, Recipient Identification: Part 2 of 2, Recipient Race, Disease Classification, Hematopoietic Stem Cell Transplant (HSCT) : Part 1 of 4, Cell Source, Hematopoietic Stem Cell Transplant (HSCT) : Part 2 of 4, Donor Information, Hematopoietic Stem Cell Transplant (HSCT) : Part 3 of 4, Ex Vivo Graft Manipulation Type, Hematopoietic Stem Cell Transplant (HSCT) : Part 4 of 4, Preparative Regimen - Part 1 / 7, Preparative Regimen - Part 2 / 7, Preparative Regimen - Part 3 / 7 (Anthracyclines), Preparative Regimen - Part 4 / 7 (Monoclonal Antibodies), Preparative Regimen - Part 5 / 7 (Radiolabeled MAb), Preparative Regimen - Part 6 / 7 (Intent of Preparative Regimen), Preparative Regimen - Part 7 / 7 (Reason for NST / RIC), Comorbid Conditions, Type of Comorbid Condition, GVHD Prophylaxis, Post-HSCT Disease Therapy Planned as of Day 0, Type of Additional Post-HSCT Therapy, Other Toxicity Modifying Regimen, Pre-Transplant Essential Data Disease Classification Sheet, Acute Myelogenous Leukemia (AML) or Acute Nonlymphocytic Leukemia (ANLL): Part 1 of 2, Type of Therapy Related AML, Acute Myelogenous Leukemia (AML) or Acute Nonlymphocytic Leukemia (ANLL): Part 2 of 2, Acute Lymphoblastic Leukemia (ALL), Other Acute Leukemia, Chronic Myelogenous Leukemia (CML): Part 1 of 2, CML Prior HSCT Treatment, Chronic Myelogenous Leukemia (CML): Part 2 of 2, Myelodysplastic or Myeloproliferative Disease Classification, Myelodysplastic or Myeloproliferative Diseases: Part 1 of 2, Type of Therapy Related MDS / MPS, Myelodysplastic or Myeloproliferative Diseases: Part 2 of 2, Other Leukemias, Hodgkin Lymphoma, Non-Hodgkin's Lymphoma, Plasma Cell Disorders, Breast Cancer, Other Disease, Other Malignancies, Anemia/Hemoglobinopathy, Platelet Disorders, Histiocytic Disorders, Inherited Disorders of Metabolism/Osteopetrosis, Immune Deficiencies, Autoimmune Disorders, Systemic Sclerosis Involvement, Systemic Sclerosis Laboratory Procedures, Systemic Lupus Erythematosus (SLE) Involvement, Systemic Lupus Erythematosus (SLE) Laboratory Procedures, Sjogren Syndrome Involvement, Polymyositis / Dermatomyositis Involvement, Polymyositis / Dermatomyositis Laboratory Procedure, Antiphospholipid Syndrome Involvement, Antiphospholipid Syndrome Laboratory Procedures, Wegener Granulomatosis Involvement, Wegener Granulomatosis Laboratory Procedures, Polyarteritis Nodosa Involvement, Polyarteritis Nodosa Laboratory Procedures, Rheumatoid Arthritis Involvement, Psoriatic Arthritis / Psoriasis Involvement, Multiple Sclerosis (MS) Involvement

• Clinical Trial
• Treatment Form

- 17/9/21 - 1 formulario, 71 itemgroups, 316 items, 1 idioma

Itemgroups: CIBMTR Use Only, Center Identification, Recipient Identification: Part 1 of 2, Study ID Number, Recipient Identification: Part 2 of 2, Recipient Race, Disease Classification, Hematopoietic Stem Cell Transplant (HSCT) : Part 1 of 4, Cell Source, Autologous HSCT, Hematopoietic Stem Cell Transplant (HSCT) : Part 2 of 4, Donor Information, Hematopoietic Stem Cell Transplant (HSCT) : Part 3 of 4, Ex Vivo Graft Manipulation Type, Hematopoietic Stem Cell Transplant (HSCT) : Part 4 of 4, Preparative Regimen - Part 1 / 7, Preparative Regimen - Part 2 / 7, Preparative Regimen - Part 3 / 7 (Anthracyclines), Preparative Regimen - Part 4 / 7 (Monoclonal Antibodies), Preparative Regimen - Part 5 / 7 (Radiolabeled MAb), Preparative Regimen - Part 6 / 7 (Intent of Preparative Regimen), Preparative Regimen - Part 7 / 7 (Reason for NST / RIC), Comorbid Conditions, Type of Comorbid Condition, GVHD Prophylaxis, Post-HSCT Disease Therapy Planned as of Day 0, Type of Additional Post-HSCT Therapy, Other Toxicity Modifying Regimen, Pre-Transplant Essential Data Disease Classification Sheet, Acute Myelogenous Leukemia (AML) or Acute Nonlymphocytic Leukemia (ANLL): Part 1 of 2, Type of Therapy Related AML, Acute Myelogenous Leukemia (AML) or Acute Nonlymphocytic Leukemia (ANLL): Part 2 of 2, Acute Lymphoblastic Leukemia (ALL), Other Acute Leukemia, Chronic Myelogenous Leukemia (CML): Part 1 of 2, CML Prior HSCT Treatment, Chronic Myelogenous Leukemia (CML): Part 2 of 2, Myelodysplastic or Myeloproliferative Disease Classification at Diagnosis, Myelodysplastic or Myeloproliferative Disease Status at Transplantation, Myelodysplastic or Myeloproliferative Diseases: Part 1 of 2, Type of Therapy Related MDS / MPS, Myelodysplastic or Myeloproliferative Diseases: Part 2 of 2, Other Leukemias, Hodgkin Lymphoma, Non-Hodgkin's Lymphoma, Plasma Cell Disorders, Breast Cancer, Other Disease, Other Malignancies, Anemia/Hemoglobinopathy, Platelet Disorders, Histiocytic Disorders, Inherited Disorders of Metabolism/Osteopetrosis, Immune Deficiencies, Autoimmune Disorders, Systemic Sclerosis Involvement, Systemic Sclerosis Laboratory Procedures, Systemic Lupus Erythematosus (SLE) Involvement, Systemic Lupus Erythematosus (SLE) Laboratory Procedures, Sjogren Syndrome Involvement, Polymyositis / Dermatomyositis Involvement, Polymyositis / Dermatomyositis Laboratory Procedure, Antiphospholipid Syndrome Involvement, Antiphospholipid Syndrome Laboratory Procedures, Wegener Granulomatosis Involvement, Wegener Granulomatosis Laboratory Procedures, Polyarteritis Nodosa Involvement, Polyarteritis Nodosa Laboratory Procedures, Rheumatoid Arthritis Involvement, Psoriatic Arthritis / Psoriasis Involvement, Multiple Sclerosis (MS) Involvement

• Treatment Form
• Clinical Trial