08142023 - Tab B - Current SCTOD Information Collections to HRSA - 081420235006

08142023 - Tab B - Current SCTOD Information Collections to HRSA - 081420235006.xlsx

Stem Cell Therapeutic Outcomes Database

08142023 - Tab B - Current SCTOD Information Collections to HRSA - 081420235006

OMB: 0915-0310

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0915-0310 can be found here:

2024-07-25 - No material or nonsubstantive change to a currently approved collection

Document [xlsx]

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Overview

Header Definitions
Change Summary
Pre-Transplant Information Coll
Transplant Procedure&Produc
Post-Transplant Periodic Inform
pull down menus

Sheet 1: Header Definitions


Information Collection Domains	Indicates the category of information collection by time period that corresponds to the burden table. For each of the following Domains, there is a corresponding Tab. 1- Pre-Transplant Information Collection 2- Transplant Procedure and Product Information 3- Post-Transplant Periodic Information Collection Below are the defintions for each column heading.

Column Header Title	Column Header Title Definitions
Information Collection Domain Sub-Type	Identifies a grouping of information collection within an Information Collection Domain. These information collection domain sub types roughly correspond to section/domain headers currently found on CIBMTR data collection instruments.
Information Collection Domain Additional Sub Domain	Additional Sub Domain set recipeint, donor, infusion type or product criteria that must be met for an information collection element to be required
Response required if Additional Sub Domain applies	Response options are "yes" or "no". If the criteria noted in Additional sub domain applies, the information collection data element will be applicable and information collection data element responses supplied. Always "yes" when an additional sub domain is present.
Information Collection may be requested at multiple times	Response options are "yes" or "no". Some information may be collected at "multiple" time points or in multiple iterations. A multiple request may occur with a new or duplicate event, new infusion, changes in treatment or outcomes follow up. For example: product analyses at multple timepoints, chimerism analyses on multple dates, subsequent neoplasms, co-morbidities, covid infection, Disease Status, Post Transplant Therapy, GVHD, labs and pathology (collected at diagnosis, between diagnosis and infusion, at infusion and during followup)
Current Information Collection Data Element (if applicable)	Depicts the information collection data element currently being requested.
Current Information Collection Data Element Response Option(s)	Depicts the information collection data element response options currently being requested.
Information Collection update:	Notes the type of update. If Blank, there was no change.
	options:
	Addition of Information Requested
	Deletion of Information Requested
	Deletion of Information: Merged to Check all that Apply
	Change/Clarification of Information Requested
	Change/Clarification of Response Options
	Change/Clarification of Information Requested and Response Options
	Data will be captured on Lab Module
Proposed Information Collection Data Element (if applicable)	Depicts the changes to the information collection data element requested in red line format. Rows containing changes are highlighted in Yellow
Proposed Information Collection Data Element Response Option(s)	Depicts the changes to the information collection data element response options in red line format. Rows containing changes are highlighted in yellow.
Rationale for Information Collection Update	The following options identify the change summary:
	options:
	Reduce burden: expanded response options to include responses previously reported manually or created a "check all that apply"
	Be consistent with current clinical landscape, improve transplant outcome data
	Capture data accurately
	Examples added or typographical errors corrected for clarification
	Covid-19 Impact
	Capture additional relevent disease information

Sheet 2: Change Summary

Item ID	Time Point	Information Collection Domain Sub-Type	Information Collection Domain Additional Sub Domain	Response required if Additional Sub Domain applies	Information Collection may be requested multiple times	Current Information Collection Data Element (if applicable)	Current Information Collection Data Element Response Option(s)	Information Collection update:	Proposed Information Collection Data Element (if applicable)	Proposed Information Collection Data Element Response Option(s)	Rationale for Information Collection Update
PRE588	Pre-Transplant	Pre-Transplant Essential Data	Clinical Trial Participants	yes	no	Study Sponsor	BMT CTN, RCI-BMT, PIDTC, USIDNET, COG, PedAL, Other sponsor	Change/Clarification of Response Options	Study Sponsor	BMT CTN, RCI-BMT CIBMTR CRO Services, PIDTC, USIDNET, COG, PedAL, Other sponsor	Capture data accurately
PRE590	Pre-Transplant	Pre-Transplant Essential Data	Clinical Trial Participants	yes	no	Study ID Number	A Representative list of current response options is shown here. This list will change on a frequent basis to accommodate updates – changes in the response options do not affect burden of completing this question. BMT CTN 0301 - Aplastic Anemia,BMT CTN 0601 - Sickle Cell Anemia,BMT CTN 0701 - Follicular Lymphoma,BMT CTN 0702 - Myeloma,BMT CTN 0801 - Chronic GVHD Treatment,BMT CTN 0803 - Auto HCT in HIV + Patients,RCI BMT 09 - MRD,RCI BMT 09 - Plex,BMT CTN 0901 - Myeloablative vs. RIC,BMT CTN 0902 - Peri-TX Stress Mgmt,BMT CTN 0903 - Allo HCT in HIV + Patients,RCI BMT 10 - CBA,RCI BMT 10-CMSMDS-1,RCI BMT 11 - Treo,BMT CTN 1101 - Haplo vs. Double UCB with RIC,BMT CTN 1102 - MDS in older patients,RCI BMT 12 - Moxe,BMT CTN 1202 - Biomarker,BMT CTN 1203 - GVHD Prophylaxis,BMT CTN 1204 - HLH,BMT CTN 1205 - Easy-to-read Consent Form (ETRIC),RCI BMT 13 - TLEC,BMT CTN 1301 - CNI-Free,BMT CTN 1302 - Allo MM,BMT CTN 1401 - Myeloma Vaccine,RCI BMT 145-ADS-202,RCI BMT 15 - MMUD,BMT CTN 1501 - Standard Risk GVHD,BMT CTN 1502 - CHAMP Aplastic Anemia,BMT CTN 1503 - STRIDE2,BMT CTN 1506 - AML Maintenance Therapy,BMT CTN 1507 - Haplo Sickle Cell,RCI BMT 16-CMS-MF,RCI BMT 16 - NTCD,RCI BMT 17- CD33,RCI BMT 17-CMS-MM,RCI BMT 17-CMS-SCD,RCI BMT 17 - CSIDE,BMT CTN 1703 - PROGRESS III,BMT CTN 1704 - CHARM,BMT CTN 1803 - Haplo NK Cell,BMT CTN 1903 - HIV T Cell,BMT CTN 1904 - Treo BM Failure Syndromes,BMT CTN 1905 - BEAT-MS (ITN077AI),PIDTC 6901 - Disorders of the immune system (SCID),PIDTC 6903 - Disorders of the immune system (CGD),PIDTC 6904 - Disorders of the immune system (WAS),RCI BMT ACCESS,RCI BMT KIR - DS,RCI BMT SQOL	Change/Clarification of Response Options	Study ID Number	A Representative list of current response options is shown here. This list will change on a frequent basis to accommodate updates – changes in the response options do not affect burden of completing this question.BMT CTN 0301 - Aplastic Anemia,BMT CTN 0601 - Sickle Cell Anemia,BMT CTN 0701 - Follicular Lymphoma,BMT CTN 0702 - Myeloma,BMT CTN 0801 - Chronic GVHD Treatment,BMT CTN 0803 - Auto HCT in HIV + Patients,RCI BMT 09 - MRD,RCI BMT 09 - Plex,BMT CTN 0901 - Myeloablative vs. RIC,BMT CTN 0902 - Peri-TX Stress Mgmt,BMT CTN 0903 - Allo HCT in HIV + Patients,RCI BMT 10 - CBA,RCI BMT 10-CMSMDS-1,RCI BMT 11 - Treo,BMT CTN 1101 - Haplo vs. Double UCB with RIC,BMT CTN 1102 - MDS in older patients,RCI BMT 12 - Moxe,BMT CTN 1202 - Biomarker,BMT CTN 1203 - GVHD Prophylaxis,BMT CTN 1204 - HLH,BMT CTN 1205 - Easy-to-read Consent Form (ETRIC),RCI BMT 13 - TLEC,BMT CTN 1301 - CNI-Free,BMT CTN 1302 - Allo MM,BMT CTN 1401 - Myeloma Vaccine,RCI BMT 145-ADS-202,RCI BMT 15 - MMUD,BMT CTN 1501 - Standard Risk GVHD,BMT CTN 1502 - CHAMP Aplastic Anemia,BMT CTN 1503 - STRIDE2,BMT CTN 1506 - AML Maintenance Therapy,BMT CTN 1507 - Haplo Sickle Cell,RCI BMT 16-CMS-MF,RCI BMT 16 - NTCD,RCI BMT 17- CD33,RCI BMT 17-CMS-MM,RCI BMT 17-CMS-SCD,RCI BMT 17 - CSIDE,BMT CTN 1703 - PROGRESS III,BMT CTN 1704 - CHARM,BMT CTN 1803 - Haplo NK Cell,BMT CTN 1903 - HIV T Cell,BMT CTN 1904 - Treo BM Failure Syndromes,BMT CTN 1905 - BEAT-MS (ITN077AI),PIDTC 6901 - Disorders of the immune system (SCID),PIDTC 6903 - Disorders of the immune system (CGD),PIDTC 6904 - Disorders of the immune system (WAS),RCI BMT ACCESS,RCI BMT KIR - DS,RCI BMT SQOL, COG APAL2020SC (PedAL), COG ASCT2031, COG AALL1732, COG AAML1831	Capture data accurately
PRE657	Pre-Transplant	Pre-Transplant Essential Data	Autologous Transplant	yes	yes	Name of product (gene therapy recipients)	Other name	Change/Clarification of Response Options	Name of product (gene therapy recipients)	Betibeglogene autotemcel (Zyntelgo®), Elivaldogene autotemcel (Skysona®), Exagamglogene autotemcel, Other name	Capture data accurately
PRE694	Pre-Transplant	Pre-Transplant Essential Data		no	no	Glomerular filtration rate (GFR):	__ __ __ mL/min/1.732	Change/Clarification of Response Options	Glomerular filtration rate (GFR):	__ __ __ mL/min/1.73m2	Capture data accurately

Sheet 3: Pre-Transplant Information Coll

				Information Collection Domain: Pre-Transplant Information Collection
Item ID	Time Point	Information Collection Domain Sub-Type	Information Collection Domain Additional Sub Domain	Response required if Additional Sub Domain applies	Information Collection may be requested multiple times	Current Information Collection Data Element (if applicable)	Current Information Collection Data Element Response Option(s)	Information Collection update:	Proposed Information Collection Data Element (if applicable)	Proposed Information Collection Data Element Response Option(s)	Rationale for Information Collection Update
PRE588	Pre-Transplant	Pre-Transplant Essential Data	Clinical Trial Participants	yes	no	Study Sponsor	BMT CTN, RCI-BMT, PIDTC, USIDNET, COG, PedAL, Other sponsor	Change/Clarification of Response Options	Study Sponsor	BMT CTN, RCI-BMT CIBMTR CRO Services, PIDTC, USIDNET, COG, PedAL, Other sponsor	Capture data accurately
PRE590	Pre-Transplant	Pre-Transplant Essential Data	Clinical Trial Participants	yes	no	Study ID Number	A Representative list of current response options is shown here. This list will change on a frequent basis to accommodate updates – changes in the response options do not affect burden of completing this question. BMT CTN 0301 - Aplastic Anemia,BMT CTN 0601 - Sickle Cell Anemia,BMT CTN 0701 - Follicular Lymphoma,BMT CTN 0702 - Myeloma,BMT CTN 0801 - Chronic GVHD Treatment,BMT CTN 0803 - Auto HCT in HIV + Patients,RCI BMT 09 - MRD,RCI BMT 09 - Plex,BMT CTN 0901 - Myeloablative vs. RIC,BMT CTN 0902 - Peri-TX Stress Mgmt,BMT CTN 0903 - Allo HCT in HIV + Patients,RCI BMT 10 - CBA,RCI BMT 10-CMSMDS-1,RCI BMT 11 - Treo,BMT CTN 1101 - Haplo vs. Double UCB with RIC,BMT CTN 1102 - MDS in older patients,RCI BMT 12 - Moxe,BMT CTN 1202 - Biomarker,BMT CTN 1203 - GVHD Prophylaxis,BMT CTN 1204 - HLH,BMT CTN 1205 - Easy-to-read Consent Form (ETRIC),RCI BMT 13 - TLEC,BMT CTN 1301 - CNI-Free,BMT CTN 1302 - Allo MM,BMT CTN 1401 - Myeloma Vaccine,RCI BMT 145-ADS-202,RCI BMT 15 - MMUD,BMT CTN 1501 - Standard Risk GVHD,BMT CTN 1502 - CHAMP Aplastic Anemia,BMT CTN 1503 - STRIDE2,BMT CTN 1506 - AML Maintenance Therapy,BMT CTN 1507 - Haplo Sickle Cell,RCI BMT 16-CMS-MF,RCI BMT 16 - NTCD,RCI BMT 17- CD33,RCI BMT 17-CMS-MM,RCI BMT 17-CMS-SCD,RCI BMT 17 - CSIDE,BMT CTN 1703 - PROGRESS III,BMT CTN 1704 - CHARM,BMT CTN 1803 - Haplo NK Cell,BMT CTN 1903 - HIV T Cell,BMT CTN 1904 - Treo BM Failure Syndromes,BMT CTN 1905 - BEAT-MS (ITN077AI),PIDTC 6901 - Disorders of the immune system (SCID),PIDTC 6903 - Disorders of the immune system (CGD),PIDTC 6904 - Disorders of the immune system (WAS),RCI BMT ACCESS,RCI BMT KIR - DS,RCI BMT SQOL	Change/Clarification of Response Options	Study ID Number	A Representative list of current response options is shown here. This list will change on a frequent basis to accommodate updates – changes in the response options do not affect burden of completing this question.BMT CTN 0301 - Aplastic Anemia,BMT CTN 0601 - Sickle Cell Anemia,BMT CTN 0701 - Follicular Lymphoma,BMT CTN 0702 - Myeloma,BMT CTN 0801 - Chronic GVHD Treatment,BMT CTN 0803 - Auto HCT in HIV + Patients,RCI BMT 09 - MRD,RCI BMT 09 - Plex,BMT CTN 0901 - Myeloablative vs. RIC,BMT CTN 0902 - Peri-TX Stress Mgmt,BMT CTN 0903 - Allo HCT in HIV + Patients,RCI BMT 10 - CBA,RCI BMT 10-CMSMDS-1,RCI BMT 11 - Treo,BMT CTN 1101 - Haplo vs. Double UCB with RIC,BMT CTN 1102 - MDS in older patients,RCI BMT 12 - Moxe,BMT CTN 1202 - Biomarker,BMT CTN 1203 - GVHD Prophylaxis,BMT CTN 1204 - HLH,BMT CTN 1205 - Easy-to-read Consent Form (ETRIC),RCI BMT 13 - TLEC,BMT CTN 1301 - CNI-Free,BMT CTN 1302 - Allo MM,BMT CTN 1401 - Myeloma Vaccine,RCI BMT 145-ADS-202,RCI BMT 15 - MMUD,BMT CTN 1501 - Standard Risk GVHD,BMT CTN 1502 - CHAMP Aplastic Anemia,BMT CTN 1503 - STRIDE2,BMT CTN 1506 - AML Maintenance Therapy,BMT CTN 1507 - Haplo Sickle Cell,RCI BMT 16-CMS-MF,RCI BMT 16 - NTCD,RCI BMT 17- CD33,RCI BMT 17-CMS-MM,RCI BMT 17-CMS-SCD,RCI BMT 17 - CSIDE,BMT CTN 1703 - PROGRESS III,BMT CTN 1704 - CHARM,BMT CTN 1803 - Haplo NK Cell,BMT CTN 1903 - HIV T Cell,BMT CTN 1904 - Treo BM Failure Syndromes,BMT CTN 1905 - BEAT-MS (ITN077AI),PIDTC 6901 - Disorders of the immune system (SCID),PIDTC 6903 - Disorders of the immune system (CGD),PIDTC 6904 - Disorders of the immune system (WAS),RCI BMT ACCESS,RCI BMT KIR - DS,RCI BMT SQOL, COG APAL2020SC (PedAL), COG ASCT2031, COG AALL1732, COG AAML1831	Capture data accurately
PRE657	Pre-Transplant	Pre-Transplant Essential Data	Autologous Transplant	yes	yes	Name of product (gene therapy recipients)	Other name	Change/Clarification of Response Options	Name of product (gene therapy recipients)	Betibeglogene autotemcel (Zyntelgo®), Elivaldogene autotemcel (Skysona®), Exagamglogene autotemcel, Other name	Capture data accurately
PRE694	Pre-Transplant	Pre-Transplant Essential Data		no	no	Glomerular filtration rate (GFR):	__ __ __ mL/min/1.732	Change/Clarification of Response Options	Glomerular filtration rate (GFR):	__ __ __ mL/min/1.73m2	Capture data accurately
PRE001	Pre-Transplant	Additional Drugs Given In the Peri-Transplant Period		no	no	ALG, ALS, ATG, ATS, Alemtuzumab, Defibrotide, KGF, Ursodiol, None	(check all that apply)		ALG, ALS, ATG, ATS, Alemtuzumab, Defibrotide, KGF, Ursodiol, None	(check all that apply)
PRE002	Pre-Transplant	Additional Drugs Given In the Peri-Transplant Period		no	no	Total prescribed dose:	__ __ __ __ __ mg/kg		Total prescribed dose:	__ __ __ __ __ mg/kg
PRE003	Pre-Transplant	Additional Drugs Given In the Peri-Transplant Period		no	no	Specify source	ATGAM (horse),ATG - Fresenius (rabbit),Other,Thymoglobulin (rabbit)		Specify source	ATGAM (horse),ATG - Fresenius (rabbit),Other,Thymoglobulin (rabbit)
PRE004	Pre-Transplant	Additional Drugs Given In the Peri-Transplant Period		no	no	Specify other source:	open text		Specify other source:	open text
PRE005	Pre-Transplant	Additional Drugs Given In the Peri-Transplant Period		no	no	Total prescribed dose:	__ __ __ __ . _ mg/m2 __ __ __ __ __ . __mg/kg __ __ __ __ __ . __mg/kg		Total prescribed dose:	__ __ __ __ . _ mg/m2 __ __ __ __ __ . __mg/kg __ __ __ __ __ . __mg/kg
PRE006	Pre-Transplant	Covid-19 Impact		no	no				Was the HCT impacted for a reason related to the COVID-19 (SARS-CoV-2) pandemic?	no,yes
PRE007	Pre-Transplant	Covid-19 Impact		no	no				Is the HCT date different than the originally intended HCT date?	no,yes
PRE008	Pre-Transplant	Covid-19 Impact		no	no				Original Date of HCT	YYYY/MM/DD
PRE009	Pre-Transplant	Covid-19 Impact		no	no				Date estimated	checked
PRE010	Pre-Transplant	Covid-19 Impact		no	no				Is the donor different than the originally intended donor?	no,yes
PRE011	Pre-Transplant	Covid-19 Impact		no	no				Specify the originally intended donor	unrelated donor, syngeneic (monozygotic twin) , HLA-idential sibling (may include non-monozygotic twin) , HLA-matched other relative (does NOT include a haplo-identical donor), HLA-mismatched relative
PRE012	Pre-Transplant	Covid-19 Impact		no	no				Is the product type (bone marrow, PBSC, cord blood unit) different than the originally intended product type?	no,yes
PRE013	Pre-Transplant	Covid-19 Impact		no	no				Specify the originally intended product type	bone marrow,Other product,PBSC, cord blood unit
PRE014	Pre-Transplant	Covid-19 Impact		no	no				Specify other product type	open text
PRE015	Pre-Transplant	Covid-19 Impact		no	no				Was the current product thawed from a cryopreserved state prior to infusion?	no,yes
PRE016	Pre-Transplant	Covid-19 Impact		no	no				Did the preparative regimen change from the original plan?	no, yes
PRE017	Pre-Transplant	Covid-19 Impact		no	no				Did the GVHD prophylaxis change from the original plan?	no,yes
PRE018	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Specify method(s) that was used to assess measurable residual disease status (check all that apply)	FISH, Karyotyping, Flow Cytometry, PCR, NGS, Not assessed		Specify method(s) that was used to assess measurable residual disease status (check all that apply)	FISH, Karyotyping, Flow Cytometry, PCR, NGS, Not assessed
PRE019	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Was measurable residual disease detected by FISH?	no,yes		Was measurable residual disease detected by FISH?	no,yes
PRE020	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Was measurable residual disease detected by karyotyping assay?	no,yes		Was measurable residual disease detected by karyotyping assay?	no,yes
PRE021	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Which leukemia phenotype was used for detection (check all the apply)	original leukemia immunophenotype, aberrant phenotype		Which leukemia phenotype was used for detection (check all the apply)	original leukemia immunophenotype, aberrant phenotype
PRE022	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	What is the lower limit of detection (for the original leukemia immunophenotype)	open text		What is the lower limit of detection (for the original leukemia immunophenotype)	open text
PRE023	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	What is the lower limit of detection (for the aberrant phenotype)	open text		What is the lower limit of detection (for the aberrant phenotype)	open text
PRE024	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Was measurable residual disease detected by flow cytometry?	no,yes		Was measurable residual disease detected by flow cytometry?	no,yes
PRE025	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Was measurable residual disease detected by PCR?	no,yes		Was measurable residual disease detected by PCR?	no,yes
PRE026	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Was measurable residual disease detected by NGS?	no,yes		Was measurable residual disease detected by NGS?	no,yes
PRE027	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Specify method(s) that was used to assess measurable residual disease status (check all that apply)	FISH, Karyotyping, Flow Cytometry, PCR, NGS, Not assessed		Specify method(s) that was used to assess measurable residual disease status (check all that apply)	FISH, Karyotyping, Flow Cytometry, PCR, NGS, Not assessed
PRE028	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Was measurable residual disease detected by FISH?	no,yes		Was measurable residual disease detected by FISH?	no,yes
PRE029	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Was measurable residual disease detected by karyotyping assay?	no,yes		Was measurable residual disease detected by karyotyping assay?	no,yes
PRE030	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Which leukemia phenotype was used for detection (check all the apply)	original leukemia immunophenotype, aberrant phenotype		Which leukemia phenotype was used for detection (check all the apply)	original leukemia immunophenotype, aberrant phenotype
PRE031	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	What is the lower limit of detection (for the original leukemia immunophenotype)	open text		What is the lower limit of detection (for the original leukemia immunophenotype)	open text
PRE032	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	What is the lower limit of detection (for the aberrant phenotype)	open text		What is the lower limit of detection (for the aberrant phenotype)	open text
PRE033	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Was measurable residual disease detected by flow cytometry?	no,yes		Was measurable residual disease detected by flow cytometry?	no,yes
PRE034	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Was measurable residual disease detected by PCR?	no,yes		Was measurable residual disease detected by PCR?	no,yes
PRE035	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Was measurable residual disease detected by NGS?	no,yes		Was measurable residual disease detected by NGS?	no,yes
PRE036	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify the liver size:	: ___ ___ centimeters		Specify the liver size:	: ___ ___ centimeters
PRE037	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	JAK2 Exon 12	Negative,Not done,Positive		JAK2 Exon 12	Negative,Not done,Positive
PRE038	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(5q) / 5q-,del(7q) / 7q-,del(13q) / 13q-,dup(1),i17q,inv(3),-5,-7,-Y,Other abnormality,t(1;any),t(11q23;any),t(12p11.2;any),t(3q21;any),t(6;9),+8,+9		Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(5q) / 5q-,del(7q) / 7q-,del(13q) / 13q-,dup(1),i17q,inv(3),-5,-7,-Y,Other abnormality,t(1;any),t(11q23;any),t(12p11.2;any),t(3q21;any),t(6;9),+8,+9
PRE039	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. FISH report)	No,Yes
PRE040	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Assignment of DLBCL (germinal center B-cell type vs. activated B-cell type) subtype was based on	Gene expression profile,Immunohistochemistry (e.g. Han’s algorithm),Unknown		Assignment of DLBCL (germinal center B-cell type vs. activated B-cell type) subtype was based on	Gene expression profile,Immunohistochemistry (e.g. Han’s algorithm),Unknown
PRE041	Pre-Transplant	Disease Classification		no	yes	Date of diagnosis of primary disease for HCT / cellular therapy:	YYYY/MM/DD		Date of diagnosis of primary disease for HCT / cellular therapy:	YYYY/MM/DD
PRE042	Pre-Transplant	Disease Classification		no	no	What was the primary disease for which the HCT / cellular therapy was performed?	Autoimmune diseases,Acute lymphoblastic leukemia (ALL),Acute myeloid leukemia (AML or ANLL),Chronic myeloid leukemia (CML),Hemoglobinopathies,Histiocytic disorders,Hodgkin lymphoma,Inherited Bone Marrow Failure Syndromes(If the recipient developed MDS or AML, indicate MDS or AML as the primary disease.)– ,Disorders of the immune system,Inherited disorders of metabolism,Inherited abnormalities of platelets,Myelodysplastic syndrome (MDS) (If recipient has transformed to AML, indicate AML as the primary disease.),Myeloproliferative neoplasms (MPN)(If recipient has transformed to AML, indicate AML as the primary disease.),Non-Hodgkin lymphoma,Acute leukemia of ambiguous lineage and other myeloid neoplasms,Other disease,Other leukemia (includes CLL),Multiple myeloma / plasma cell disorder (PCD),Paroxysmal nocturnal hemoglobinuria (PNH),Recessive dystrophic epidermolysis bullosa,Aplastic Anemia(If the recipient developed MDS or AML, indicate MDS or AML as the primary disease.) ,Solid tumors,Tolerance induction associated with solid organ transplant		What was the primary disease for which the HCT / cellular therapy was performed?	Autoimmune diseases,Acute lymphoblastic leukemia (ALL),Acute myeloid leukemia (AML or ANLL),Chronic myeloid leukemia (CML),Hemoglobinopathies,Histiocytic disorders,Hodgkin lymphoma,Inherited Bone Marrow Failure Syndromes(If the recipient developed MDS or AML, indicate MDS or AML as the primary disease.)– ,Disorders of the immune system,Inherited disorders of metabolism,Inherited abnormalities of platelets,Myelodysplastic syndrome (MDS) (If recipient has transformed to AML, indicate AML as the primary disease.),Myeloproliferative neoplasms (MPN)(If recipient has transformed to AML, indicate AML as the primary disease.),Non-Hodgkin lymphoma,Acute leukemia of ambiguous lineage and other myeloid neoplasms,Other disease,Other leukemia (includes CLL),Multiple myeloma / plasma cell disorder (PCD),Paroxysmal nocturnal hemoglobinuria (PNH),Recessive dystrophic epidermolysis bullosa,Aplastic Anemia(If the recipient developed MDS or AML, indicate MDS or AML as the primary disease.) ,Solid tumors,Tolerance induction associated with solid organ transplant
PRE043	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Specify the AML classification	AML with recurrent genetic abnormalities: AML with t(9;11) (p22.3;q23.3); MLLT3-KMT2A (5), AML with t(6;9) (p23;q34.1); DEK-NUP214 (6), AML with inv(3) (q21.3;q26.2) or t(3;3) (q21.3;q26.2); GATA2, MECOM (7), AML (megakaryoblastic) with t(1;22) (p13.3;q13.3); RBM15-MKL1 (8), AML with t(8;21); (q22; q22.1); RUNX1-RUNX1T1 (281), AML with inv(16) (p13.1;1q22) or t(16;16)(p13.1; q22); CBFB-MYH11 (282), APL with PML-RARA (283), AML with BCR-ABL1 (provisional entity) (3), AML with mutated NPM1 (4), AML with biallelic mutations of CEBPA (297), AML with mutated RUNX1 (provisional entity) (298), AML with 11q23 (MLL) abnormalities (i.e., t(4;11), t(6;11), t(9;11), t(11;19)) (284), AML with myelodysplasia – related changes (285), Therapy related AML (t-AML) (9), AML, not otherwise specified: AML, not otherwise specified (280), AML, minimally differentiated (286), AML without maturation (287) , AML with maturation (288) , Acute myelomonocytic leukemia (289), Acute monoblastic / acute monocytic leukemia (290), Acute erythroid leukemia (erythroid / myeloid and pure erythroleukemia) (291), Acute megakaryoblastic leukemia (292), Acute basophilic leukemia (293), Acute panmyelosis with myelofibrosis (294), Myeloid sarcoma (295), Myeloid leukemia associated with Down syndrome (299),		Specify the AML classification	AML with recurrent genetic abnormalities: AML with t(9;11) (p22.3;q23.3); MLLT3-KMT2A (5), AML with t(6;9) (p23;q34.1); DEK-NUP214 (6), AML with inv(3) (q21.3;q26.2) or t(3;3) (q21.3;q26.2); GATA2, MECOM (7), AML (megakaryoblastic) with t(1;22) (p13.3;q13.3); RBM15-MKL1 (8), AML with t(8;21); (q22; q22.1); RUNX1-RUNX1T1 (281), AML with inv(16) (p13.1;1q22) or t(16;16)(p13.1; q22); CBFB-MYH11 (282), APL with PML-RARA (283), AML with BCR-ABL1 (provisional entity) (3), AML with mutated NPM1 (4), AML with biallelic mutations of CEBPA (297), AML with mutated RUNX1 (provisional entity) (298), AML with 11q23 (MLL) abnormalities (i.e., t(4;11), t(6;11), t(9;11), t(11;19)) (284), AML with myelodysplasia – related changes (285), Therapy related AML (t-AML) (9), AML, not otherwise specified: AML, not otherwise specified (280), AML, minimally differentiated (286), AML without maturation (287) , AML with maturation (288) , Acute myelomonocytic leukemia (289), Acute monoblastic / acute monocytic leukemia (290), Acute erythroid leukemia (erythroid / myeloid and pure erythroleukemia) (291), Acute megakaryoblastic leukemia (292), Acute basophilic leukemia (293), Acute panmyelosis with myelofibrosis (294), Myeloid sarcoma (295), Myeloid leukemia associated with Down syndrome (299),
PRE044	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Did AML transform from MDS or MPN?	no,yes-Also complete MDS or MPN Disease Classification questions		Did AML transform from MDS or MPN?	no,yes-Also complete MDS or MPN Disease Classification questions
PRE045	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Is the disease (AML) therapy related?	no,Unknown,yes		Is the disease (AML) therapy related?	no,Unknown,yes
PRE046	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Did the recipient have a predisposing condition?	no,Unknown,yes		Did the recipient have a predisposing condition?	no,Unknown,yes
PRE047	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Specify condition	Bloom syndrome,Dyskeratosis congenita,Down Syndrome,Fanconi anemia,Other condition		Specify condition	Bloom syndrome,Dyskeratosis congenita,Down Syndrome,Fanconi anemia,Other condition
PRE048	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Specify other condition:	open text		Specify other condition:	open text
PRE049	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were cytogenetics tested (karyotyping or FISH)? (at diagnosis)	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)? (at diagnosis or relapse)	no,Unknown,yes
PRE050	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE051	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE052	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE053	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE054	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8
PRE055	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE056	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were cytogenetics tested via karyotyping?	No,Yes		Were cytogenetics tested via karyotyping?	No,Yes
PRE057	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE058	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE059	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE060	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8
PRE061	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE062	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE063	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were tests for molecular markers performed? (at diagnosis or relapse)	no,Unknown,yes		Were tests for molecular markers performed? (at diagnosis or relapse)	no,Unknown,yes
PRE064	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	CEBPA	Negative,Not Done,Positive		CEBPA	Negative,Not Done,Positive
PRE065	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify CEBPA mutation	Biallelic (homozygous),Monoallelic (heterozygous),Unknown		Specify CEBPA mutation	Biallelic (double mutant),Monoallelic (single mutant),Unknown
PRE066	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	FLT3 - TKD (point mutations in D835 or deletions of codon I836)	Negative,Not done,Positive		FLT3 - TKD (point mutations in D835 or deletions of codon I836)	Negative,Not done,Positive
PRE067	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	FLT3 – ITD mutation	Negative,Not Done,Positive		FLT3 – ITD mutation	Negative,Not Done,Positive
PRE068	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	FLT3 - ITD allelic ratio	Known,Unknown		FLT3 - ITD allelic ratio	Known,Unknown
PRE069	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify FLT3 - ITD allelic ratio:	__ __ . __ __		Specify FLT3 - ITD allelic ratio:	__ __ . __ __
PRE070	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	IDH1	Negative,Not Done,Positive		IDH1	Negative,Not Done,Positive
PRE071	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	IDH2	Negative,Not Done,Positive		IDH2	Negative,Not Done,Positive
PRE072	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	KIT	Negative,Not Done,Positive		KIT	Negative,Not Done,Positive
PRE073	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	NPM1	Negative,Not Done,Positive		NPM1	Negative,Not Done,Positive
PRE074	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Other molecular marker	Negative,Not Done,Positive		Other molecular marker	Negative,Not Done,Positive
PRE075	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify other molecular marker:	open text		Specify other molecular marker:	open text
PRE076	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were cytogenetics tested (karyotyping or FISH)? (between diagnosis and last evaluation)	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)? (between diagnosis or relapse and last evaluation)	no,Unknown,yes
PRE077	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE078	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE079	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE080	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE081	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8
PRE082	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE083	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were cytogenetics tested via karyotyping?	No,Yes		Were cytogenetics tested via karyotyping?	No,Yes
PRE084	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE085	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE086	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE087	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8
PRE088	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE089	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE090	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were tests for molecular markers performed? (e.g. PCR, NGS) (between diagnosis and last evaluation)	no,Unknown,yes		Were tests for molecular markers performed? (e.g. PCR, NGS) (between diagnosis or relapse and last evaluation)	no,Unknown,yes
PRE091	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	CEBPA	Negative,Not Done,Positive		CEBPA	Negative,Not Done,Positive
PRE092	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify CEBPA mutation	Biallelic (homozygous),Monoallelic (heterozygous),Unknown		Specify CEBPA mutation	Biallelic (double mutant),Monoallelic (single mutant),Unknown
PRE093	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	FLT3 - TKD (point mutations in D835 or deletions of codon I836)	Negative,Not done,Positive		FLT3 - TKD (point mutations in D835 or deletions of codon I836)	Negative,Not done,Positive
PRE094	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	FLT3 – ITD mutation	Negative,Not Done,Positive		FLT3 – ITD mutation	Negative,Not Done,Positive
PRE095	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	FLT3 - ITD allelic ratio	Known,Unknown		FLT3 - ITD allelic ratio	Known,Unknown
PRE096	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify FLT3 - ITD allelic ratio:	__ __ . __ __		Specify FLT3 - ITD allelic ratio:	__ __ . __ __
PRE097	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	IDH1	Negative,Not Done,Positive		IDH1	Negative,Not Done,Positive
PRE098	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	IDH2	Negative,Not Done,Positive		IDH2	Negative,Not Done,Positive
PRE099	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	KIT	Negative,Not Done,Positive		KIT	Negative,Not Done,Positive
PRE100	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	NPM1	Negative,Not Done,Positive		NPM1	Negative,Not Done,Positive
PRE101	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Other molecular marker	Negative,Not Done,Positive		Other molecular marker	Negative,Not Done,Positive
PRE102	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify other molecular marker:	open text		Specify other molecular marker:	open text
PRE103	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were cytogenetics tested (karyotyping or FISH)? (at last evaluation)	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)? (at last evaluation)	no,Unknown,yes
PRE104	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE105	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE106	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE107	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE108	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8
PRE109	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE110	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were cytogenetics tested via karyotyping?	No,Yes		Were cytogenetics tested via karyotyping?	No,Yes
PRE111	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE112	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE113	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE114	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,del(11q) / 11q-,del(16q) / 16q-,del(17q) / 17q-,del(20q) / 20q-,del(21q) / 21q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,inv(16),inv(3),-17,-18,-5,-7,-X,-Y,Other abnormality,t(15;17) and variants,t(16;16),t(3;3),t(6;9),t(8;21),t(9;11),t(9;22),+11,+13,+14,+21,+22,+4,+8
PRE115	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE116	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE117	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Were tests for molecular markers performed?(e.g. PCR, NGS) (at last evaluation)	no,Unknown,yes		Were tests for molecular markers performed?(e.g. PCR, NGS) (at last evaluation)	no,Unknown,yes
PRE118	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	CEBPA	Negative,Not Done,Positive		CEBPA	Negative,Not Done,Positive
PRE119	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify CEBPA mutation	Biallelic (homozygous),Monoallelic (heterozygous),Unknown		Specify CEBPA mutation	Biallelic (double mutant),Monoallelic (single mutant),Unknown
PRE120	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	FLT3 - TKD (point mutations in D835 or deletions of codon I836)	Negative,Not done,Positive		FLT3 - TKD (point mutations in D835 or deletions of codon I836)	Negative,Not done,Positive
PRE121	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	FLT3 – ITD mutation	Negative,Not Done,Positive		FLT3 – ITD mutation	Negative,Not Done,Positive
PRE122	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	FLT3 - ITD allelic ratio	Known,Unknown		FLT3 - ITD allelic ratio	Known,Unknown
PRE123	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify FLT3 - ITD allelic ratio:	__ __ . __ __		Specify FLT3 - ITD allelic ratio:	__ __ . __ __
PRE124	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	IDH1	Negative,Not Done,Positive		IDH1	Negative,Not Done,Positive
PRE125	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	IDH2	Negative,Not Done,Positive		IDH2	Negative,Not Done,Positive
PRE126	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	KIT	Negative,Not Done,Positive		KIT	Negative,Not Done,Positive
PRE127	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	NPM1	Negative,Not Done,Positive		NPM1	Negative,Not Done,Positive
PRE128	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Other molecular marker	Negative,Not Done,Positive		Other molecular marker	Negative,Not Done,Positive
PRE129	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	yes	Specify other molecular marker:	open text		Specify other molecular marker:	open text
PRE130	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Did the recipient have central nervous system leukemia at any time prior to the start of the preparative regimen / infusion?	no,Unknown,yes		Did the recipient have central nervous system leukemia at any time prior to the start of the preparative regimen / infusion?	no,Unknown,yes
PRE131	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	What was the disease status?	1st complete remission,1st relapse,2nd complete remission,2nd relapse,≥ 3rd complete remission, ≥3rd relapse,No treatment,Primary induction failure		What was the disease status?	1st complete remission,1st relapse,2nd complete remission,2nd relapse,≥ 3rd complete remission, ≥3rd relapse,No treatment,Primary induction failure
PRE132	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	How many cycles of induction therapy were required to achieve 1st complete remission? (includes CRi)	1,2, ≥ 3		How many cycles of induction therapy were required to achieve 1st complete remission? (includes CRi)	1,2, ≥ 3
PRE133	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Date of most recent relapse:	YYYY/MM/DD		Date of most recent relapse:	YYYY/MM/DD
PRE134	Pre-Transplant	Disease Classification	Acute Myelogenous Leukemia (AML)	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE135	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Specify ALL classification	B-lymphoblastic leukemia / lymphoma: B-lymphoblastic leukemia / lymphoma, NOS (B-cell ALL, NOS) (191), B-lymphoblastic leukemia / lymphoma with t(9;22)(q34.1;q11.2); BCR-ABL1 (192), B-lymphoblastic leukemia / lymphoma with t(v;11q23.3); KMT2A rearranged (193), B-lymphoblastic leukemia / lymphoma with t(1;19)(q23;p13.3); TCF3-PBX1 (194), B-lymphoblastic leukemia / lymphoma with t(12;21) (p13.2;q22.1); ETV6-RUNX1 (195), B-lymphoblastic leukemia / lymphoma with t(5;14) (q31.1;q32.3); IL3-IGH (81), B-lymphoblastic leukemia / lymphoma with Hyperdiploidy (51-65 chromosomes) (82), B-lymphoblastic leukemia / lymphoma with Hypodiploidy (<46 chromosomes) (83), B-lymphoblastic leukemia / lymphoma, BCR-ABL1-like (provisional entity) (94), B-lymphoblastic leukemia / lymphoma, with iAMP21 (95), T-cell lymphoblastic leukemia / lymphoma: T-cell lymphoblastic leukemia / lymphoma (Precursor T-cell ALL) (196), Early T-cell precursor lymphoblastic leukemia (96),NK cell lymphoblastic leukemia / lymphoma: Natural killer (NK)- cell lymphoblastic leukemia / lymphoma (97)		Specify ALL classification	B-lymphoblastic leukemia / lymphoma: B-lymphoblastic leukemia / lymphoma, NOS (B-cell ALL, NOS) (191), B-lymphoblastic leukemia / lymphoma with t(9;22)(q34.1;q11.2); BCR-ABL1 (192), B-lymphoblastic leukemia / lymphoma with t(v;11q23.3); KMT2A rearranged (193), B-lymphoblastic leukemia / lymphoma with t(1;19)(q23;p13.3); TCF3-PBX1 (194), B-lymphoblastic leukemia / lymphoma with t(12;21) (p13.2;q22.1); ETV6-RUNX1 (195), B-lymphoblastic leukemia / lymphoma with t(5;14) (q31.1;q32.3); IL3-IGH (81), B-lymphoblastic leukemia / lymphoma with Hyperdiploidy (51-65 chromosomes) (82), B-lymphoblastic leukemia / lymphoma with Hypodiploidy (<46 chromosomes) (83), B-lymphoblastic leukemia / lymphoma, BCR-ABL1-like (provisional entity) (94), B-lymphoblastic leukemia / lymphoma, with iAMP21 (95), T-cell lymphoblastic leukemia / lymphoma: T-cell lymphoblastic leukemia / lymphoma (Precursor T-cell ALL) (196), Early T-cell precursor lymphoblastic leukemia (96),NK cell lymphoblastic leukemia / lymphoma: Natural killer (NK)- cell lymphoblastic leukemia / lymphoma (97)
PRE136	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Did the recipient have a predisposing condition?	no,Unknown,yes		Did the recipient have a predisposing condition?	no,Unknown,yes
PRE137	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Specify condition	Aplastic anemia,Bloom syndrome,Down Syndrome,Fanconi anemia,Other condition		Specify condition	Aplastic anemia,Bloom syndrome,Down Syndrome,Fanconi anemia,Other condition
PRE138	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Specify other condition:	open text		Specify other condition:	open text
PRE139	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Were tyrosine kinase inhibitors given for therapy at any time prior to the start of the preparative regimen / infusion? (e.g. imatinib mesylate, dasatinib, etc.)	no,yes		Were tyrosine kinase inhibitors given for therapy at any time prior to the start of the preparative regimen / infusion? (e.g. imatinib mesylate, dasatinib, etc.)	no,yes
PRE140	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were cytogenetics tested (karyotyping or FISH)? (at diagnosis)	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)? (at diagnosis or relapse)	no,Unknown,yes
PRE141	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE142	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE143	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE144	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE145	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8
PRE146	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE147	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were cytogenetics tested via karyotyping?	No,Yes		Were cytogenetics tested via karyotyping?	No,Yes
PRE148	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE149	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE150	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE151	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8
PRE152	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE153	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE154	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were tests for molecular markers performed? (at diagnosis)	no,Unknown,yes		Were tests for molecular markers performed? (at diagnosis or relapse)	no,Unknown,yes
PRE155	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	BCR / ABL	Negative,Not Done,Positive		BCR / ABL	Negative,Not Done,Positive
PRE156	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	TEL-AML / AML1	Negative,Not Done,Positive		TEL-AML / AML1	Negative,Not Done,Positive
PRE157	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Other molecular marker	Negative,Not Done,Positive		Other molecular marker	Negative,Not Done,Positive
PRE158	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify other molecular marker:	open text		Specify other molecular marker:	open text
PRE159	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were cytogenetics tested (karyotyping or FISH)? (between diagnosis and last evaluation)	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)? (between diagnosis or at relapse and last evaluation)	no,Unknown,yes
PRE160	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE161	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE162	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE163	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE164	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8
PRE165	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE166	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were cytogenetics tested via karyotyping?	No,Yes		Were cytogenetics tested via karyotyping?	No,Yes
PRE167	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE168	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE169	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE170	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8
PRE171	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE172	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE173	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were tests for molecular markers performed? (e.g. PCR, NGS) (between diagnosis and last evaluation)	no,Unknown,yes		Were tests for molecular markers performed? (e.g. PCR, NGS) (between diagnosis or relapse and last evaluation)	no,Unknown,yes
PRE174	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	BCR / ABL	Negative,Not Done,Positive		BCR / ABL	Negative,Not Done,Positive
PRE175	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	TEL-AML / AML1	Negative,Not Done,Positive		TEL-AML / AML1	Negative,Not Done,Positive
PRE176	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Other molecular marker	Negative,Not Done,Positive		Other molecular marker	Negative,Not Done,Positive
PRE177	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify other molecular marker:	open text		Specify other molecular marker:	open text
PRE178	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were cytogenetics tested (karyotyping or FISH)? (at last evaluation)	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)? (at last evaluation)	no,Unknown,yes
PRE179	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE180	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE181	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE182	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE183	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8
PRE184	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE185	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were cytogenetics tested via karyotyping? (at last evaluation)	No,Yes		Were cytogenetics tested via karyotyping? (at last evaluation)	No,Yes
PRE186	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE187	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE188	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE189	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8		Specify abnormalities (check all that apply)	(11q23) any abnormality,12p any abnormality,9p any abnormality,add(14q),del(12p) / 12p-,del(6q) / 6q-,del(9p) / 9p-,Hyperdiploid (> 50),Hypodiploid (< 46),iAMP21,-7,Other abnormality,t(1;19),t(10;14),t(11;14),t(12;21),t(2;8),t(4;11),t(5;14),t(8;14),t(8;22),t(9;22),+17,+21,+4,+8
PRE190	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE191	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE192	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Were tests for molecular markers performed? (e.g. PCR, NGS) (at last evaluation)	no,Unknown,yes		Were tests for molecular markers performed? (e.g. PCR, NGS) (at last evaluation)	no,Unknown,yes
PRE193	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	BCR / ABL	Negative,Not Done,Positive		BCR / ABL	Negative,Not Done,Positive
PRE194	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	TEL-AML / AML1	Negative,Not Done,Positive		TEL-AML / AML1	Negative,Not Done,Positive
PRE195	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Other molecular marker	Negative,Not Done,Positive		Other molecular marker	Negative,Not Done,Positive
PRE196	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	yes	Specify other molecular marker:	open text		Specify other molecular marker:	open text
PRE197	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Did the recipient have central nervous system leukemia at any time prior to the start of the preparative regimen / infusion?	no,Unknown,yes		Did the recipient have central nervous system leukemia at any time prior to the start of the preparative regimen / infusion?	no,Unknown,yes
PRE198	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	What was the disease status?	1st complete remission (include CRi),1st relapse,2nd complete remission,2nd relapse, ≥ 3rd complete remission, ≥3rd relapse,No treatment,Primary induction failure		What was the disease status?	1st complete remission (include CRi),1st relapse,2nd complete remission,2nd relapse, ≥ 3rd complete remission, ≥3rd relapse,No treatment,Primary induction failure
PRE199	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	How many cycles of induction therapy were required to achieve 1st complete remission?	1,2, ≥ 3		How many cycles of induction therapy were required to achieve 1st complete remission?	1,2, ≥ 3
PRE200	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Date of most recent relapse:	YYYY/MM/DD		Date of most recent relapse:	YYYY/MM/DD
PRE201	Pre-Transplant	Disease Classification	Acute Lymphoblastic Leukemia (ALL)	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE202	Pre-Transplant	Disease Classification	Acute Leukemias of Ambiguous Lineage and Other Myeloid Neoplasms	yes	no	Specify acute leukemias of ambiguous lineage and other myeloid neoplasm classification	Acute undifferentiated leukemia,Blastic plasmacytoid dendritic cell neoplasm ,Mixed phenotype acute leukemia, B/myeloid, NOS,Mixed phenotype acute leukemia (MPAL) with t(9;22)(q34.1;q11.2); BCR-ABL1,Mixed phenotype acute leukemia with t(v; 11q23.3); KMT2A rearranged,Mixed phenotype acute leukemia, T/myeloid, NOS,Other acute leukemia of ambiguous lineage or myeloid neoplasm		Specify acute leukemias of ambiguous lineage and other myeloid neoplasm classification	Acute undifferentiated leukemia,Blastic plasmacytoid dendritic cell neoplasm ,Mixed phenotype acute leukemia, B/myeloid, NOS,Mixed phenotype acute leukemia (MPAL) with t(9;22)(q34.1;q11.2); BCR-ABL1,Mixed phenotype acute leukemia with t(v; 11q23.3); KMT2A rearranged,Mixed phenotype acute leukemia, T/myeloid, NOS,Other acute leukemia of ambiguous lineage or myeloid neoplasm
PRE203	Pre-Transplant	Disease Classification	Acute Leukemias of Ambiguous Lineage and Other Myeloid Neoplasms	yes	no	Specify other acute leukemia of ambiguous lineage or myeloid neoplasm:	open text		Specify other acute leukemia of ambiguous lineage or myeloid neoplasm:	open text
PRE204	Pre-Transplant	Disease Classification	Acute Leukemias of Ambiguous Lineage and Other Myeloid Neoplasms	yes	no	What was the disease status? (based on hematological test results)	1st complete remission (no previous marrow or extramedullary relapse),1st relapse,2nd complete remission,2nd relapse, ≥ 3rd complete remission, ≥ 3rd relapse,No treatment,Primary induction failure		What was the disease status? (based on hematological test results)	1st complete remission (no previous marrow or extramedullary relapse),1st relapse,2nd complete remission,2nd relapse, ≥ 3rd complete remission, ≥ 3rd relapse,No treatment,Primary induction failure
PRE205	Pre-Transplant	Disease Classification	Acute Leukemias of Ambiguous Lineage and Other Myeloid Neoplasms	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE206	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	Was therapy given prior to this HCT?	no,yes		Was therapy given prior to this HCT?	no,yes
PRE207	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	Combination chemotherapy	no,yes		Combination chemotherapy	no,yes
PRE208	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	Hydroxyurea (Droxia, Hydrea)	no,yes		Hydroxyurea (Droxia, Hydrea)	no,yes
PRE209	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	Tyrosine kinase inhibitor (e.g.imatinib mesylate, dasatinib, nilotinib)	no,yes		Tyrosine kinase inhibitor (e.g.imatinib mesylate, dasatinib, nilotinib)	no,yes
PRE210	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	Interferon-α (Intron, Roferon) (includes PEG)	no,yes		Interferon-α (Intron, Roferon) (includes PEG)	no,yes
PRE211	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	Other therapy	no,yes		Other therapy	no,yes
PRE212	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	Specify other therapy:	open text		Specify other therapy:	open text
PRE213	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	What was the disease status?	Accelerated phase,Blast phase,Complete hematologic response (CHR) preceded by accelerated phase and/or blast phase,Complete hematologic response (CHR) preceded only by chronic phase,Chronic phase		What was the disease status?	Accelerated phase,Blast phase,Complete hematologic response (CHR) preceded by accelerated phase and/or blast phase,Complete hematologic response (CHR) preceded only by chronic phase,Chronic phase
PRE214	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	Specify level of response	Complete cytogenetic response (CCyR),Complete molecular remission (CMR),Minimal cytogenetic response,Minor cytogenetic response,Major molecular remission (MMR),No cytogenetic response (No CyR),Partial cytogenetic response (PCyR)		Specify level of response	Complete cytogenetic response (CCyR),Complete molecular remission (CMR),Minimal cytogenetic response,Minor cytogenetic response,Major molecular remission (MMR),No cytogenetic response (No CyR),Partial cytogenetic response (PCyR)
PRE215	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	Number	1st,2nd,3rd or higher		Number	1st,2nd,3rd or higher
PRE216	Pre-Transplant	Disease Classification	Chronic Myelogenous Leukemia (CML)	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE217	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	What was the MDS subtype at diagnosis? - If transformed to AML, indicate AML as primary disease; also complete AML Disease Classification questions	Atypical chronic myeloid leukemia (aCML), BCR-ABL1-,Chronic myelomonocytic leukemia (CMMoL),Juvenile myelomonocytic leukemia (JMML/JCML),Myelodysplastic syndrome with isolated del(5q),Myelodysplastic syndrome with multilineage dysplasia (MDS-MLD),MDS / MPN with ring sideroblasts and thrombocytosis (MDS / MPN-RS-T),Myelodysplastic syndrome / myeloproliferative neoplasm, unclassifiable, syndrome with single lineage dysplasia (MDS-SLD),Myelodysplastic syndrome (MDS), unclassifiable,Refractory cytopenia of childhood. Myelodysplatic Syndrome with excess blasts (MDS-EB): MDS with excess blasts-1 (MDS-EB-1),MDS with excess blasts-2 (MDS-EB-2). Myelodysplatic Syndrome with ring sideroblasts: MDS-RS with multilineage dysplasia (MDS-RS-MLD),MDS-RS with single lineage dysplasia (MDS-RS-SLD),Myelodysplastic		What was the MDS subtype at diagnosis? - If transformed to AML, indicate AML as primary disease; also complete AML Disease Classification questions	Atypical chronic myeloid leukemia (aCML), BCR-ABL1-,Chronic myelomonocytic leukemia (CMMoL),Juvenile myelomonocytic leukemia (JMML/JCML),Myelodysplastic syndrome with isolated del(5q),Myelodysplastic syndrome with multilineage dysplasia (MDS-MLD),MDS / MPN with ring sideroblasts and thrombocytosis (MDS / MPN-RS-T),Myelodysplastic syndrome / myeloproliferative neoplasm, unclassifiable, syndrome with single lineage dysplasia (MDS-SLD),Myelodysplastic syndrome (MDS), unclassifiable,Refractory cytopenia of childhood. Myelodysplatic Syndrome with excess blasts (MDS-EB): MDS with excess blasts-1 (MDS-EB-1),MDS with excess blasts-2 (MDS-EB-2). Myelodysplatic Syndrome with ring sideroblasts: MDS-RS with multilineage dysplasia (MDS-RS-MLD),MDS-RS with single lineage dysplasia (MDS-RS-SLD),Myelodysplastic
PRE218	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	Specify Myelodysplastic syndrome, unclassifiable (MDS-U)	MDS-U with 1% blood blasts,MDS-U based on defining cytogenetic abnormality,MDS-U with single lineage dysplasia and pancytopenia		Specify Myelodysplastic syndrome, unclassifiable (MDS-U)	MDS-U with 1% blood blasts,MDS-U based on defining cytogenetic abnormality,MDS-U with single lineage dysplasia and pancytopenia
PRE219	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE220	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	Was the disease MDS therapy related?	no,Unknown,yes		Was the disease MDS therapy related?	no,Unknown,yes
PRE221	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	Did the recipient have a predisposing condition?	no,Unknown,yes		Did the recipient have a predisposing condition?	no,Unknown,yes
PRE222	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	Specify condition	Aplastic anemia,DDX41-associated familial MDS,Fanconi anemia,GATA2 deficiency (including Emberger syndrome, MonoMac syndrome, DCML deficiency) ,Li-Fraumeni Syndrome,Other condition,Paroxysmal nocturnal hemoglobinuria,Diamond-Blackfan Anemia,RUNX1 deficiency (previously “familial platelet disorder with propensity to myeloid malignancies”) ,SAMD9- or SAMD9L-associated familial MDS,Shwachman-Diamond Syndrome,Telomere biology disorder (including dyskeratosis congenita)		Specify condition	Aplastic anemia,DDX41-associated familial MDS,Fanconi anemia,GATA2 deficiency (including Emberger syndrome, MonoMac syndrome, DCML deficiency) ,Li-Fraumeni Syndrome,Other condition,Paroxysmal nocturnal hemoglobinuria,Diamond-Blackfan Anemia,RUNX1 deficiency (previously “familial platelet disorder with propensity to myeloid malignancies”) ,SAMD9- or SAMD9L-associated familial MDS,Shwachman-Diamond Syndrome,Telomere biology disorder (including dyskeratosis congenita)
PRE223	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	Specify other condition:	open text		Specify other condition:	open text
PRE224	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Date CBC drawn:	YYYY/MM/DD		Date CBC drawn:	YYYY/MM/DD
PRE225	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Blasts in bone marrow	Known,Unknown		Blasts in bone marrow	Known,Unknown
PRE226	Pre-Transplant	Disease Classification		yes	yes	Blasts in bone marrow	__ ___ ___%		Blasts in bone marrow	__ ___ ___%
PRE227	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Were cytogenetics tested (karyotyping or FISH)?	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)?	no,Unknown,yes
PRE228	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE229	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Sample source	Peripheral blood,Bone marrow		Sample source	Peripheral blood,Bone marrow
PRE230	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE231	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE232	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE233	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,del(13q) / 13q-,i17q,inv(3),-13,-20,-5,-7,-Y,Other abnormality,t(1;3),t(11;16),t(2;11),t(3;21),t(3;3),t(6;9),+19,+8		Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,del(13q) / 13q-,i17q,inv(3),-13,-20,-5,-7,-Y,Other abnormality,t(1;3),t(11;16),t(2;11),t(3;21),t(3;3),t(6;9),+19,+8
PRE234	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE235	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE236	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Were cytogenetics tested via karyotyping?	No,Yes		Were cytogenetics tested via karyotyping?	No,Yes
PRE237	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Sample source	Peripheral blood,Bone marrow		Sample source	Peripheral blood,Bone marrow
PRE238	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE239	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE240	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE241	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,del(13q) / 13q-,i17q,inv(3),-13,-20,-5,-7,-Y,Other abnormality,t(1;3),t(11;16),t(2;11),t(3;21),t(3;3),t(6;9),+19,+8		Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,del(13q) / 13q-,i17q,inv(3),-13,-20,-5,-7,-Y,Other abnormality,t(1;3),t(11;16),t(2;11),t(3;21),t(3;3),t(6;9),+19,+8
PRE242	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE243	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE244	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Did the recipient progress or transform to a different MDS subtype or AML between diagnosis and the start of the preparative regimen/ infusion?	No,Yes		Did the recipient progress or transform to a different MDS subtype or AML between diagnosis and the start of the preparative regimen/ infusion?	No,Yes
PRE245	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify the MDS subtype or AML after transformation	Transformed to AML,Chronic myelomonocytic leukemia (CMMoL),Myelodysplastic syndrome with isolated del(5q),Myelodysplastic syndrome with multilineage dysplasia (MDS-MLD),MDS / MPN with ring sideroblasts and thrombocytosis (MDS / MPN-RS-T),Myelodysplastic syndrome / myeloproliferative neoplasm, unclassifiable,Myelodysplastic syndrome with single lineage dysplasia (MDS-SLD),Myelodysplastic syndrome (MDS), unclassifiable,Refractory cytopenia of childhood. Myelodysplatic Syndrome with excess blasts (MDS-EB): MDS with excess blasts-1 (MDS-EB-1),MDS with excess blasts-2 (MDS-EB-2). Myelodysplatic syndrome with ring sideroblasts: MDS-RS with multilineage dysplasia (MDS-RS-MLD),MDS-RS with single lineage dysplasia (MDS-RS-SLD).		Specify the MDS subtype or AML after transformation	Transformed to AML,Chronic myelomonocytic leukemia (CMMoL),Myelodysplastic syndrome with isolated del(5q),Myelodysplastic syndrome with multilineage dysplasia (MDS-MLD),MDS / MPN with ring sideroblasts and thrombocytosis (MDS / MPN-RS-T),Myelodysplastic syndrome / myeloproliferative neoplasm, unclassifiable,Myelodysplastic syndrome with single lineage dysplasia (MDS-SLD),Myelodysplastic syndrome (MDS), unclassifiable,Refractory cytopenia of childhood. Myelodysplatic Syndrome with excess blasts (MDS-EB): MDS with excess blasts-1 (MDS-EB-1),MDS with excess blasts-2 (MDS-EB-2). Myelodysplatic syndrome with ring sideroblasts: MDS-RS with multilineage dysplasia (MDS-RS-MLD),MDS-RS with single lineage dysplasia (MDS-RS-SLD).
PRE246	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify Myelodysplastic syndrome, unclassifiable (MDS-U)	MDS-U with 1% blood blasts,MDS-U based on defining cytogenetic abnormality,MDS-U with single lineage dysplasia and pancytopenia		Specify Myelodysplastic syndrome, unclassifiable (MDS-U)	MDS-U with 1% blood blasts,MDS-U based on defining cytogenetic abnormality,MDS-U with single lineage dysplasia and pancytopenia
PRE247	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify the date of the most recent transformation:	YYYY/MM/DD		Specify the date of the most recent transformation:	YYYY/MM/DD
PRE248	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Date of MDS diagnosis:	YYYY/MM/DD		Date of MDS diagnosis:	YYYY/MM/DD
PRE249	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Date CBC drawn:	YYYY/MM/DD		Date CBC drawn:	YYYY/MM/DD
PRE250	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Blasts in bone marrow	Known,Unknown		Blasts in bone marrow	Known,Unknown
PRE251	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Blasts in bone marrow	__ ___ ___%		Blasts in bone marrow	__ ___ ___%
PRE252	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Were cytogenetics tested (karyotyping or FISH)?	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)?	no,Unknown,yes
PRE253	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE254	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Sample source	Peripheral blood,Bone marrow		Sample source	Peripheral blood,Bone marrow
PRE255	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE256	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE257	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE258	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,del(13q) / 13q-,i17q,inv(3),-13,-20,-5,-7,-Y,Other abnormality,t(1;3),t(11;16),t(2;11),t(3;21),t(3;3),t(6;9),+19,+8		Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,del(13q) / 13q-,i17q,inv(3),-13,-20,-5,-7,-Y,Other abnormality,t(1;3),t(11;16),t(2;11),t(3;21),t(3;3),t(6;9),+19,+8
PRE259	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE260	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE261	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Were cytogenetics tested via karyotyping?	No,Yes		Were cytogenetics tested via karyotyping?	No,Yes
PRE262	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Sample source	Peripheral blood,Bone marrow		Sample source	Peripheral blood,Bone marrow
PRE263	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE264	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE265	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE266	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,del(13q) / 13q-,i17q,inv(3),-13,-20,-5,-7,-Y,Other abnormality,t(1;3),t(11;16),t(2;11),t(3;21),t(3;3),t(6;9),+19,+8		Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(3q) / 3q-,del(5q) / 5q-,del(7q) / 7q-,del(9q) / 9q-,del(13q) / 13q-,i17q,inv(3),-13,-20,-5,-7,-Y,Other abnormality,t(1;3),t(11;16),t(2;11),t(3;21),t(3;3),t(6;9),+19,+8
PRE267	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE268	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. cytogenetic or FISH report)	No,Yes
PRE269	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	What was the disease status?	Complete remission (CR),Hematologic improvement (HI),Not assessed,No response (NR) / stable disease (SD),Progression from hematologic improvement (Prog from HI),Relapse from complete remission (Rel from CR)		What was the disease status?	Complete remission (CR),Hematologic improvement (HI),Not assessed,No response (NR) / stable disease (SD),Progression from hematologic improvement (Prog from HI),Relapse from complete remission (Rel from CR)
PRE270	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	Specify the cell line examined to determine HI status	HI-E,HI-N,HI-P		Specify the cell lines examined to determine HI status	HI-E,HI-N,HI-P
PRE271	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	Specify transfusion dependence	Low-transfusion burden (LTB),Non-transfused (NTD)		Specify transfusion dependence	Low-transfusion burden (LTB),Non-transfused (NTD)
PRE272	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE273	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	What was the MPN subtype at diagnosis?	Chronic eosinophilic leukemia, not otherwise specified (NOS),Primary myelofibrosis (PMF),Chronic neutrophilic leukemia,,Essential thrombocythemia,Myeloproliferative neoplasm (MPN), unclassifiable,Myeloid / lymphoid neoplasms with FGFR1 rearrangement,Myeloid / lymphoid neoplasms with PCM1-JAK2,Myeloid / lymphoid neoplasms with PDGFRA rearrangement,Myeloid / lymphoid neoplasms with PDGFRB rearrangement,Polycythemia vera (PCV),Mastocytosis: Cutaneous mastocytosis (CM), Systemic mastocytosis, Mast cell sarcoma (MCS)		What was the MPN subtype at diagnosis?	Chronic eosinophilic leukemia, not otherwise specified (NOS),Primary myelofibrosis (PMF),Chronic neutrophilic leukemia,,Essential thrombocythemia,Myeloproliferative neoplasm (MPN), unclassifiable,Myeloid / lymphoid neoplasms with FGFR1 rearrangement,Myeloid / lymphoid neoplasms with PCM1-JAK2,Myeloid / lymphoid neoplasms with PDGFRA rearrangement,Myeloid / lymphoid neoplasms with PDGFRB rearrangement,Polycythemia vera (PCV),Mastocytosis: Cutaneous mastocytosis (CM), Systemic mastocytosis, Mast cell sarcoma (MCS)
PRE274	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify systemic mastocytosis	Aggressive systemic mastocytosis (ASM),Indolent systemic mastocytosis (ISM),Mast cell leukemia (MCL),Systemic mastocytosis with an associated hematological neoplasm (SM-AHN),Smoldering systemic mastocytosis (SSM)		Specify systemic mastocytosis	Aggressive systemic mastocytosis (ASM),Indolent systemic mastocytosis (ISM),Mast cell leukemia (MCL),Systemic mastocytosis with an associated hematological neoplasm (SM-AHN),Smoldering systemic mastocytosis (SSM)
PRE275	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Was documentation submitted to the CIBMTR? (e.g. pathology report used for diagnosis)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. pathology report used for diagnosis)	No,Yes
PRE276	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Did the recipient have constitutional symptoms in six months before diagnosis? (symptoms are >10% weight loss in 6 months, night sweats, or unexplained fever higher than 37.5 °C)	No,Unknown,Yes		Did the recipient have constitutional symptoms in six months before diagnosis? (symptoms are >10% weight loss in 6 months, night sweats, or unexplained fever higher than 37.5 °C)	No,Unknown,Yes
PRE277	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Date CBC drawn:	YYYY/MM/DD		Date CBC drawn:	YYYY/MM/DD
PRE278	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Blasts in bone marrow	Known,Unknown		Blasts in bone marrow	Known,Unknown
PRE279	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Blasts in bone marrow	__ ___ ___%		Blasts in bone marrow	__ ___ ___%
PRE280	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were tests for driver mutations performed?	No,Unknown,Yes		Were tests for driver mutations performed?	No,Unknown,Yes
PRE281	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	JAK2	Negative,Not done,Positive		JAK2	Negative,Not done,Positive
PRE282	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	JAK2 V617F	Negative,Not done,Positive		JAK2 V617F	Negative,Not done,Positive
PRE283	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	JAK2 Exon 12	Negative,Not done,Positive		JAK2 Exon 12	Negative,Not done,Positive
PRE284	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	CALR	Negative,Not done,Positive		CALR	Negative,Not done,Positive
PRE285	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	CALR type 1	Negative,Not done,Positive		CALR type 1	Negative,Not done,Positive
PRE286	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	CALR type 2	Negative,Not done,Positive		CALR type 2	Negative,Not done,Positive
PRE287	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Not defined	Negative,Not done,Positive		Not defined	Negative,Not done,Positive
PRE288	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	MPL	Negative,Not done,Positive		MPL	Negative,Not done,Positive
PRE289	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	CSF3R	Negative,Not done,Positive		CSF3R	Negative,Not done,Positive
PRE290	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Was documentation submitted to the CIBMTR?	No,Yes		Was documentation submitted to the CIBMTR?	No,Yes
PRE291	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were cytogenetics tested (karyotyping or FISH)?	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)?	no,Unknown,yes
PRE292	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE293	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Sample source	Peripheral blood,Bone marrow		Sample source	Peripheral blood,Bone marrow
PRE294	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE295	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE296	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE297	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(5q) / 5q-,del(7q) / 7q-,del(13q) / 13q-,dup(1),i17q,inv(3),-5,-7,-Y,Other abnormality,t(1;any),t(11q23;any),t(12p11.2;any),t(3q21;any),t(6;9),+8,+9		Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(5q) / 5q-,del(7q) / 7q-,del(13q) / 13q-,dup(1),i17q,inv(3),-5,-7,-Y,Other abnormality,t(1;any),t(11q23;any),t(12p11.2;any),t(3q21;any),t(6;9),+8,+9
PRE298	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE299	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. FISH report)	No,Yes
PRE300	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were cytogenetics tested via karyotyping?	No,Yes		Were cytogenetics tested via karyotyping?	No,Yes
PRE301	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Sample source	Peripheral blood,Bone marrow		Sample source	Peripheral blood,Bone marrow
PRE302	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE303	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE304	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE305	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(5q) / 5q-,del(7q) / 7q-,del(13q) / 13q-,dup(1),i17q,inv(3),-5,-7,-Y,Other abnormality,t(1;any),t(11q23;any),t(12p11.2;any),t(3q21;any),t(6;9),+8,+9		Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(5q) / 5q-,del(7q) / 7q-,del(13q) / 13q-,dup(1),i17q,inv(3),-5,-7,-Y,Other abnormality,t(1;any),t(11q23;any),t(12p11.2;any),t(3q21;any),t(6;9),+8,+9
PRE306	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE307	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. karyotyping report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. karyotyping report)	No,Yes
PRE308	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Did the recipient progress or transform to a different MPN subtype or AML between diagnosis and the start of the preparative regimen / infusion?	No,Yes		Did the recipient progress or transform to a different MPN subtype or AML between diagnosis and the start of the preparative regimen / infusion?	No,Yes
PRE309	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify the MPN subtype or AML after transformation	Transformed to AML,Post-essential thrombocythemic myelofibrosis,Post-polycythemic myelofibrosis		Specify the MPN subtype or AML after transformation	Transformed to AML,Post-essential thrombocythemic myelofibrosis,Post-polycythemic myelofibrosis
PRE310	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify the date of the most recent transformation:	YYYY/MM/DD		Specify the date of the most recent transformation:	YYYY/MM/DD
PRE311	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Date of MPN diagnosis:	YYYY/MM/DD		Date of MPN diagnosis:	YYYY/MM/DD
PRE312	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify transfusion dependence at last evaluation prior to the start of the preparative regimen / infusion	High-transfusion burden (HTB)- (≥ 8 RBCs in 16weeks; ≥ 4 in 8 weeks),Low-transfusion burden (LTB)-(3-7 RBCs in 16 weeks in at least 2 transfusion episodes; maximum of 3 in 8 weeks),Non-transfused (NTD) –(0 RBCs in 16 weeks)		Specify transfusion dependence at last evaluation prior to the start of the preparative regimen / infusion	High-transfusion burden (HTB)- (≥ 8 RBCs in 16weeks; ≥ 4 in 8 weeks),Low-transfusion burden (LTB)-(3-7 RBCs in 16 weeks in at least 2 transfusion episodes; maximum of 3 in 8 weeks),Non-transfused (NTD) –(0 RBCs in 16 weeks)
PRE313	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Did the recipient have constitutional symptoms in six months before last evaluation prior to the start of the preparative regimen / infusion? (symptoms are >10% weight loss in 6 months, night sweats, or unexplained fever higher than 37.5 °C)	No,Unknown,Yes		Did the recipient have constitutional symptoms in six months before last evaluation prior to the start of the preparative regimen / infusion? (symptoms are >10% weight loss in 6 months, night sweats, or unexplained fever higher than 37.5 °C)	No,Unknown,Yes
PRE314	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Did the recipient have splenomegaly at last evaluation prior to the start of the preparative regimen / infusion?	No,Not applicable(splenectomy) ,Unknown,Yes		Did the recipient have splenomegaly at last evaluation prior to the start of the preparative regimen / infusion?	No,Not applicable(splenectomy) ,Unknown,Yes
PRE315	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify the method used to measure spleen size	CT/MRI scan,Physical exam,Ultrasound		Specify the method used to measure spleen size	CT/MRI scan,Physical exam,Ultrasound
PRE316	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify the spleen size:	: ___ ___ centimeters below left costal margin		Specify the spleen size:	: ___ ___ centimeters below left costal margin
PRE317	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify the spleen size:	:___ ___ centimeters		Specify the spleen size:	:___ ___ centimeters
PRE318	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Did the recipient have hepatomegaly at last evaluation prior to the start of the preparative regimen / infusion?	no,Unknown,yes		Did the recipient have hepatomegaly at last evaluation prior to the start of the preparative regimen / infusion?	no,Unknown,yes
PRE319	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify the method used to measure liver size	CT/MRI scan,Physical exam,Ultrasound		Specify the method used to measure liver size	CT/MRI scan,Physical exam,Ultrasound
PRE320	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify the liver size:	: ___ ___ centimeters below right costal margin		Specify the liver size:	: ___ ___ centimeters below right costal margin
PRE321	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Date CBC drawn:	YYYY/MM/DD		Date CBC drawn:	YYYY/MM/DD
PRE322	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Blasts in bone marrow	Known,Unknown		Blasts in bone marrow	Known,Unknown
PRE323	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Blasts in bone marrow	__ ___ ___%		Blasts in bone marrow	__ ___ ___%
PRE324	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were tests for driver mutations performed?	No,Unknown,Yes		Were tests for driver mutations performed?	No,Unknown,Yes
PRE325	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	JAK2	Negative,Not done,Positive		JAK2	Negative,Not done,Positive
PRE326	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	JAK2 V617F	Negative,Not done,Positive		JAK2 V617F	Negative,Not done,Positive
PRE327	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	CALR	Negative,Not done,Positive		CALR	Negative,Not done,Positive
PRE328	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	CALR type 1	Negative,Not done,Positive		CALR type 1	Negative,Not done,Positive
PRE329	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	CALR type 2	Negative,Not done,Positive		CALR type 2	Negative,Not done,Positive
PRE330	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Not defined	Negative,Not done,Positive		Not defined	Negative,Not done,Positive
PRE331	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	MPL	Negative,Not done,Positive		MPL	Negative,Not done,Positive
PRE332	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	CSF3R	Negative,Not done,Positive		CSF3R	Negative,Not done,Positive
PRE333	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Was documentation submitted to the CIBMTR?	No,Yes		Was documentation submitted to the CIBMTR?	No,Yes
PRE334	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were cytogenetics tested (karyotyping or FISH)?	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)?	no,Unknown,yes
PRE335	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE336	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Sample source	Peripheral blood,Bone marrow		Sample source	Peripheral blood,Bone marrow
PRE337	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE338	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE339	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE340	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE341	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were cytogenetics tested via karyotyping?	No,Yes		Were cytogenetics tested via karyotyping?	No,Yes
PRE342	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Sample source	Peripheral blood,Bone marrow		Sample source	Peripheral blood,Bone marrow
PRE343	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE344	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE345	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)		Specify number of distinct cytogenetic abnormalities	Four or more (4 or more),One (1),Three (3),Two (2)
PRE346	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(5q) / 5q-,del(7q) / 7q-,del(13q) / 13q-,dup(1),i17q,inv(3),-5,-7,-Y,Other abnormality,t(1;any),t(11q23;any),t(12p11.2;any),t(3q21;any),t(6;9),+8,+9		Specify abnormalities (check all that apply)	del(11q) / 11q-,del(12p) / 12p-,del(20q) / 20q-,del(5q) / 5q-,del(7q) / 7q-,del(13q) / 13q-,dup(1),i17q,inv(3),-5,-7,-Y,Other abnormality,t(1;any),t(11q23;any),t(12p11.2;any),t(3q21;any),t(6;9),+8,+9
PRE347	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE348	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Was documentation submitted to the CIBMTR? (e.g. karyotyping report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. karyotyping report)	No,Yes
PRE349	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	What was the disease status?	Clinical improvement (CI),Complete clinical remission (CR),Not assessed,Partial clinical remission (PR),Progressive disease,Relapse,Stable disease (SD)		What was the disease status?	Clinical improvement (CI),Complete clinical remission (CR),Not assessed,Partial clinical remission (PR),Progressive disease,Relapse,Stable disease (SD)
PRE350	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Was an anemia response achieved?	No,Yes		Was an anemia response achieved?	No,Yes
PRE351	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Was a spleen response achieved?	No,Yes		Was a spleen response achieved?	No,Yes
PRE352	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Was a symptom response achieved?	No,Yes		Was a symptom response achieved?	No,Yes
PRE353	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE354	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify the cytogenetic response	Complete response (CR Eradication of pre-existing abnormality,Not assessed,Not applicable,None of the above: Does not meet the CR or PR criteria, Partial response (PR) ≥ 50% reduction in abnormal metaphases ,Re-emergence of pre-existing cytogenetic abnormality		Specify the cytogenetic response	Complete response (CR Eradication of pre-existing abnormality,Not assessed,Not applicable,None of the above: Does not meet the CR or PR criteria, Partial response (PR) ≥ 50% reduction in abnormal metaphases ,Re-emergence of pre-existing cytogenetic abnormality
PRE355	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE356	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Specify the molecular response	Complete response (CR): Eradication of pre-existing abnormality ,Not assessed,Not applicable,None of the above: Does not meet the CR or PR criteria ,Partial response (PR): ≥50% decrease in allele burden ,Re-emergence of a pre-existing molecular abnormality		Specify the molecular response	Complete response (CR): Eradication of pre-existing abnormality ,Not assessed,Not applicable,None of the above: Does not meet the CR or PR criteria ,Partial response (PR): ≥50% decrease in allele burden ,Re-emergence of a pre-existing molecular abnormality
PRE357	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE358	Pre-Transplant	Disease Classification	Other Leukemia (OL)	yes	no	Specify the other leukemia classification	Chronic lymphocytic leukemia (CLL), NOS,Chronic lymphocytic leukemia (CLL), B-cell / small lymphocytic lymphoma (SLL),Hairy cell leukemia,Hairy cell leukemia variant,Monoclonal B-cell lymphocytosis,Other leukemia,Other leukemia, NOS,PLL, B-cell,Prolymphocytic leukemia (PLL), NOS,PLL, T-cell		Specify the other leukemia classification	Chronic lymphocytic leukemia (CLL), NOS,Chronic lymphocytic leukemia (CLL), B-cell / small lymphocytic lymphoma (SLL),Hairy cell leukemia,Hairy cell leukemia variant,Monoclonal B-cell lymphocytosis,Other leukemia,Other leukemia, NOS,PLL, B-cell,Prolymphocytic leukemia (PLL), NOS,PLL, T-cell
PRE359	Pre-Transplant	Disease Classification	Other Leukemia (OL)	yes	no	Specify other leukemia:	open text		Specify other leukemia:	open text
PRE360	Pre-Transplant	Disease Classification	Other Leukemia (OL)	yes	no	Was any 17p abnormality detected?	no,yes		Was any 17p abnormality detected?	no,yes
PRE361	Pre-Transplant	Disease Classification	Other Leukemia (OL)	yes	no	Did a histologic transformation to diffuse large B-cell lymphoma (Richter syndrome) occur at any time after CLL diagnosis?	no,yes		Did a histologic transformation to diffuse large B-cell lymphoma (Richter syndrome) occur at any time after CLL diagnosis?	no,yes
PRE362	Pre-Transplant	Disease Classification	Other Leukemia (OL)	yes	no	What was the disease status? (Atypical CML)	1st complete remission (no previous bone marrow or extramedullary relapse),1st relapse,2nd complete remission,2nd relapse,≥3rd complete remission,≥3rd relapse,No treatment,Primary induction failure		What was the disease status? (Atypical CML)	1st complete remission (no previous bone marrow or extramedullary relapse),1st relapse,2nd complete remission,2nd relapse,≥3rd complete remission,≥3rd relapse,No treatment,Primary induction failure
PRE363	Pre-Transplant	Disease Classification	Other Leukemia (OL)	yes	no	What was the disease status? (CLL, PLL, Hairy cell leukemia, Other leukemia)	Complete remission (CR),Not assessed,Untreated,Partial remission (PR),Progressive disease (Prog),Stable disease (SD)		What was the disease status? (CLL, PLL, Hairy cell leukemia, Other leukemia)	Complete remission (CR),Not assessed,Untreated,Partial remission (PR),Progressive disease (Prog),Stable disease (SD)
PRE364	Pre-Transplant	Disease Classification	Other Leukemia (OL)	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE365	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Specify the lymphoma histology	Hodgkin Lymphoma Hodgkin lymphoma, not otherwise specified (150) Lymphocyte depleted (154) Lymphocyte-rich (151) Mixed cellularity (153) Nodular lymphocyte predominant Hodgkin lymphoma (155) Nodular sclerosis (152) Non-Hodgkin Lymphoma B-cell Neoplasms ALK+ large B-cell lymphoma (1833) B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and classical Hodgkin lymphoma (149) Burkitt lymphoma (111) Burkitt-like lymphoma with 11q aberration (1834) Diffuse, large B-cell lymphoma- Activated B-cell type (non-GCB) (1821) Diffuse, large B-cell lymphoma- Germinal center B-cell type (1820) Diffuse large B-cell Lymphoma (cell of origin unknown) (107) DLBCL associated with chronic inflammation (1825) Duodenal-type follicular lymphoma (1815) EBV+ DLBCL, NOS (1823) EBV+ mucocutaneous ulcer (1824) Extranodal marginal zone B-cell lymphoma of mucosal associated lymphoid tissue type (MALT) (122) Follicular, mixed, small cleaved and large cell (Grade II follicle center lymphoma) (103) Follicular, predominantly large cell (Grade IIIA follicle center lymphoma) (162) Follicular, predominantly large cell (Grade IIIB follicle center lymphoma) (163) Follicular, predominantly large cell (Grade IIIA vs IIIB not specified) (1814) Follicular, predominantly small cleaved cell (Grade I follicle center lymphoma) (102) Follicular (grade unknown) (164) HHV8+ DLBCL, NOS (1826) High-grade B-cell lymphoma, with MYC and BCL2 and/or BCL6 rearrangements (1831) High-grade B-cell lymphoma, NOS (1830) Intravascular large B-cell lymphoma (136) Large B-cell lymphoma with IRF4 rearrangement (1832) Lymphomatoid granulomatosis (1835) Mantle cell lymphoma (115) Nodal marginal zone B-cell lymphoma (± monocytoid B-cells) (123) Pediatric nodal marginal zone lymphoma (1813) Pediatric-type follicular lymphoma (1816) Plasmablastic lymphoma (1836) Primary cutaneous DLBCL, leg type (1822) Primary cutaneous follicle center lymphoma (1817) Primary diffuse, large B-cell lymphoma of the CNS (118) Primary effusion lymphoma (138) Primary mediastinal (thymic) large B-cell lymphoma (125) Splenic B-cell lymphoma/leukemia, unclassifiable (1811) Splenic diffuse red pulp small B-cell lymphoma (1812) Splenic marginal zone B-cell lymphoma (124) T-cell / histiocytic rich large B-cell lymphoma (120) Waldenstrom macroglobulinemia / Lymphoplasmacytic lymphoma (173) Other B-cell lymphoma (129) – Go to question 380 T-cell and NK-cell Neoplasms Adult T-cell lymphoma / leukemia (HTLV1 associated) (134) Aggressive NK-cell leukemia (27) Anaplastic large-cell lymphoma (ALCL), ALK positive (143) Anaplastic large-cell lymphoma (ALCL), ALK negative (144) Angioimmunoblastic T-cell lymphoma (131) Breast implant–associated anaplastic large-cell lymphoma (1861) Chronic lymphoproliferative disorder of NK cells (1856) Enteropathy-type T-cell lymphoma (133) Extranodal NK / T-cell lymphoma, nasal type (137) Follicular T-cell lymphoma (1859) Hepatosplenic T-cell lymphoma (145) Indolent T-cell lymphoproliferative disorder of the GI tract (1858) Monomorphic epitheliotropic intestinal T-cell lymphoma (1857) Mycosis fungoides (141) Nodal peripheral T-cell lymphoma with TFH phenotype (1860) Peripheral T-cell lymphoma (PTCL), NOS (130) Primary cutaneous acral CD8+ T-cell lymphoma (1853) Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (1854) Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma (1852) Primary cutaneous CD30+ T-cell lymphoproliferative disorders [Primary cutaneous anaplastic large-cell lymphoma (C-ALCL), lymphoid papulosis] (147) Primary cutaneous γδ T-cell lymphoma (1851) Sézary syndrome (142) Subcutaneous panniculitis-like T-cell lymphoma (146) Systemic EBV+ T-cell lymphoma of childhood (1855) T-cell large granular lymphocytic leukemia (126) Other T-cell / NK-cell lymphoma (139) Posttransplant lymphoproliferative disorders (PTLD) Classical Hodgkin lymphoma PTLD (1876) Florid follicular hyperplasia PTLD (1873) Infectious mononucleosis PTLD (1872) Monomorphic PTLD (B- and T-/NK-cell types) (1875) Plasmacytic hyperplasia PTLD (1871) Polymorphic PTLD (1874)		Specify the lymphoma histology	Hodgkin Lymphoma Hodgkin lymphoma, not otherwise specified (150) Lymphocyte depleted (154) Lymphocyte-rich (151) Mixed cellularity (153) Nodular lymphocyte predominant Hodgkin lymphoma (155) Nodular sclerosis (152) Non-Hodgkin Lymphoma B-cell Neoplasms ALK+ large B-cell lymphoma (1833) B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and classical Hodgkin lymphoma (149) Burkitt lymphoma (111) Burkitt-like lymphoma with 11q aberration (1834) Diffuse, large B-cell lymphoma- Activated B-cell type (non-GCB) (1821) Diffuse, large B-cell lymphoma- Germinal center B-cell type (1820) Diffuse large B-cell Lymphoma (cell of origin unknown) (107) DLBCL associated with chronic inflammation (1825) Duodenal-type follicular lymphoma (1815) EBV+ DLBCL, NOS (1823) EBV+ mucocutaneous ulcer (1824) Extranodal marginal zone B-cell lymphoma of mucosal associated lymphoid tissue type (MALT) (122) Follicular, mixed, small cleaved and large cell (Grade II follicle center lymphoma) (103) Follicular, predominantly large cell (Grade IIIA follicle center lymphoma) (162) Follicular, predominantly large cell (Grade IIIB follicle center lymphoma) (163) Follicular, predominantly large cell (Grade IIIA vs IIIB not specified) (1814) Follicular, predominantly small cleaved cell (Grade I follicle center lymphoma) (102) Follicular (grade unknown) (164) HHV8+ DLBCL, NOS (1826) High-grade B-cell lymphoma, with MYC and BCL2 and/or BCL6 rearrangements (1831) High-grade B-cell lymphoma, NOS (1830) Intravascular large B-cell lymphoma (136) Large B-cell lymphoma with IRF4 rearrangement (1832) Lymphomatoid granulomatosis (1835) Mantle cell lymphoma (115) Nodal marginal zone B-cell lymphoma (± monocytoid B-cells) (123) Pediatric nodal marginal zone lymphoma (1813) Pediatric-type follicular lymphoma (1816) Plasmablastic lymphoma (1836) Primary cutaneous DLBCL, leg type (1822) Primary cutaneous follicle center lymphoma (1817) Primary diffuse, large B-cell lymphoma of the CNS (118) Primary effusion lymphoma (138) Primary mediastinal (thymic) large B-cell lymphoma (125) Splenic B-cell lymphoma/leukemia, unclassifiable (1811) Splenic diffuse red pulp small B-cell lymphoma (1812) Splenic marginal zone B-cell lymphoma (124) T-cell / histiocytic rich large B-cell lymphoma (120) Waldenstrom macroglobulinemia / Lymphoplasmacytic lymphoma (173) Other B-cell lymphoma (129) – Go to question 380 T-cell and NK-cell Neoplasms Adult T-cell lymphoma / leukemia (HTLV1 associated) (134) Aggressive NK-cell leukemia (27) Anaplastic large-cell lymphoma (ALCL), ALK positive (143) Anaplastic large-cell lymphoma (ALCL), ALK negative (144) Angioimmunoblastic T-cell lymphoma (131) Breast implant–associated anaplastic large-cell lymphoma (1861) Chronic lymphoproliferative disorder of NK cells (1856) Enteropathy-type T-cell lymphoma (133) Extranodal NK / T-cell lymphoma, nasal type (137) Follicular T-cell lymphoma (1859) Hepatosplenic T-cell lymphoma (145) Indolent T-cell lymphoproliferative disorder of the GI tract (1858) Monomorphic epitheliotropic intestinal T-cell lymphoma (1857) Mycosis fungoides (141) Nodal peripheral T-cell lymphoma with TFH phenotype (1860) Peripheral T-cell lymphoma (PTCL), NOS (130) Primary cutaneous acral CD8+ T-cell lymphoma (1853) Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder (1854) Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma (1852) Primary cutaneous CD30+ T-cell lymphoproliferative disorders [Primary cutaneous anaplastic large-cell lymphoma (C-ALCL), lymphoid papulosis] (147) Primary cutaneous γδ T-cell lymphoma (1851) Sézary syndrome (142) Subcutaneous panniculitis-like T-cell lymphoma (146) Systemic EBV+ T-cell lymphoma of childhood (1855) T-cell large granular lymphocytic leukemia (126) Other T-cell / NK-cell lymphoma (139) Posttransplant lymphoproliferative disorders (PTLD) Classical Hodgkin lymphoma PTLD (1876) Florid follicular hyperplasia PTLD (1873) Infectious mononucleosis PTLD (1872) Monomorphic PTLD (B- and T-/NK-cell types) (1875) Plasmacytic hyperplasia PTLD (1871) Polymorphic PTLD (1874)
PRE366	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Specify other lymphoma histology:	open text		Specify other lymphoma histology:	open text
PRE367	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Is the lymphoma histology reported at transplant a transformation from CLL?	no,yes		Is the lymphoma histology reported at transplant a transformation from CLL?	no,yes (Also complete Chronic Lymphocytic Leukemia (CLL) )
PRE368	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Was any 17p abnormality detected?	no,yes		Was any 17p abnormality detected?	no,yes
PRE369	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Is the lymphoma histology reported at transplant a transformation from a different lymphoma histology? (Not CLL)	No,Yes		Is the lymphoma histology reported at transplant a transformation from a different lymphoma histology? (Not CLL)	No,Yes
PRE370	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Specify the original lymphoma histology (prior to transformation)	Aggressive NK-cell leukemia,Anaplastic large-cell lymphoma (ALCL), ALK negative,Anaplastic large-cell lymphoma (ALCL), ALK positive,Angioimmunoblastic T-cell lymphoma,Adult T-cell lymphoma / leukemia (HTLV1 associated),Breast implant-associated anaplastic large-cell lymphoma,Burkitt-like lymphoma with 11q aberration,Chronic lymphoproliferative disorder of NK cells,Diffuse, Large B-cell Lymphoma (cell of origin unknown),B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and classical Hodgkin Lymphoma,DLBCL associated with chronic inflammation,EBV+ DLBCL, NOS,Diffuse, large B-cell lymphoma- Germinal center B-cell type,HHV8+ DLBCL, NOS,Diffuse, large B-cell lymphoma- Activated B-cell type (non-GCB),EBV+ mucocutaneous ulcer,Enteropathy-type T-cell lymphoma,Extranodal NK / T-cell lymphoma, nasal type,Duodenal-type follicular lymphoma,Pediatric-type follicular lymphoma,Follicular T-cell lymphoma,Follicular (grade unknown),Follicular, predominantly large cell (Grade IIIA follicle center lymphoma),Follicular, predominantly large cell (Grade IIIB follicle center lymphoma),Follicular, predominantly large cell (Grade IIIA vs IIIB not specified),Follicular, predominantly small cleaved cell (Grade I follicle center lymphoma),Follicular, mixed, small cleaved and large cell (Grade II follicle center lymphoma),Hepatosplenic T-cell lymphoma,High-grade B-cell lymphoma, with MYC and BCL2 and/or BCL6 rearrangements,High-grade B-cell lymphoma, NOS,Hodgkin lymphoma, not otherwise specified,Infectious mononucleosis PTLD,Intravascular large B-cell lymphoma,Indolent T-cell lymphoproliferative disorder of the GI tract,ALK+ large B-cell lymphoma,Large B-cell lymphoma with IRF4 rearrangement,Lymphocyte depleted,Lymphocyte-rich,Lymphomatoid granulomatosis,Extranodal marginal zone B-cell lymphoma of mucosal associated lymphoid tissue type (MALT),Mixed cellularity,Primary mediastinal (thymic) large B-cell lymphoma,Monomorphic epitheliotropic intestinal T-cell lymphoma,Mycosis fungoides,Mantle cell lymphoma,Nodular lymphocyte predominant Hodgkin lymphoma,Nodal marginal zone B-cell lymphoma (± monocytoid B-cells),Nodal peripheral T-cell lymphoma with TFH phenotype,Nodular sclerosis,Other T-cell / NK-cell lymphoma,Other B-cell lymphoma,Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma,Primary cutaneous CD30+ T-cell lymphoproliferative disorders [Primary cutaneous anaplastic large-cell lymphoma (C-ALCL), lymphoid papulosis],Primary cutaneous acral CD8+ T-cell lymphoma,Primary cutaneous CD4+ small / medium T-cell lymphoproliferative disorder,Primary cutaneous follicle center lymphoma,Primary cutaneous gamma-delta T-cell lymphoma,Primary diffuse, large B-cell lymphoma of the CNS,Primary cutaneous DLBCL, leg type,Pediatric nodal marginal zone lymphoma,Plasmacytic hyperplasia PTLD,Plasmablastic lymphoma,Primary effusion lymphoma,Peripheral T-cell lymphoma (PTCL), NOS,Florid follicular hyperplasia PTLD,Classical Hodgkin lymphoma PTLD,Monomorphic PTLD (B- and T-/NK-cell types),Polymorphic PTLD,Splenic B-cell lymphoma / leukemia, unclassifiable,Splenic diffuse red pulp small B-cell lymphoma,Splenic marginal zone B-cell lymphoma,Burkitt lymphoma,Subcutaneous panniculitis-like T-cell lymphoma,Systemic EBV+ T-cell lymphoma of childhood,Sézary syndrome,T-cell / histiocytic rich large B-cell lymphoma,T-cell large granular lymphocytic leukemia,Waldenstrom macroglobulinemia / Lymphoplasmacytic lymphoma		Specify the original lymphoma histology (prior to transformation)	Aggressive NK-cell leukemia,Anaplastic large-cell lymphoma (ALCL), ALK negative,Anaplastic large-cell lymphoma (ALCL), ALK positive,Angioimmunoblastic T-cell lymphoma,Adult T-cell lymphoma / leukemia (HTLV1 associated),Breast implant-associated anaplastic large-cell lymphoma,Burkitt-like lymphoma with 11q aberration,Chronic lymphoproliferative disorder of NK cells,Diffuse, Large B-cell Lymphoma (cell of origin unknown),B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and classical Hodgkin Lymphoma,DLBCL associated with chronic inflammation,EBV+ DLBCL, NOS,Diffuse, large B-cell lymphoma- Germinal center B-cell type,HHV8+ DLBCL, NOS,Diffuse, large B-cell lymphoma- Activated B-cell type (non-GCB),EBV+ mucocutaneous ulcer,Enteropathy-type T-cell lymphoma,Extranodal NK / T-cell lymphoma, nasal type,Duodenal-type follicular lymphoma,Pediatric-type follicular lymphoma,Follicular T-cell lymphoma,Follicular (grade unknown),Follicular, predominantly large cell (Grade IIIA follicle center lymphoma),Follicular, predominantly large cell (Grade IIIB follicle center lymphoma),Follicular, predominantly large cell (Grade IIIA vs IIIB not specified),Follicular, predominantly small cleaved cell (Grade I follicle center lymphoma),Follicular, mixed, small cleaved and large cell (Grade II follicle center lymphoma),Hepatosplenic T-cell lymphoma,High-grade B-cell lymphoma, with MYC and BCL2 and/or BCL6 rearrangements,High-grade B-cell lymphoma, NOS,Hodgkin lymphoma, not otherwise specified,Infectious mononucleosis PTLD,Intravascular large B-cell lymphoma,Indolent T-cell lymphoproliferative disorder of the GI tract,ALK+ large B-cell lymphoma,Large B-cell lymphoma with IRF4 rearrangement,Lymphocyte depleted,Lymphocyte-rich,Lymphomatoid granulomatosis,Extranodal marginal zone B-cell lymphoma of mucosal associated lymphoid tissue type (MALT),Mixed cellularity,Primary mediastinal (thymic) large B-cell lymphoma,Monomorphic epitheliotropic intestinal T-cell lymphoma,Mycosis fungoides,Mantle cell lymphoma,Nodular lymphocyte predominant Hodgkin lymphoma,Nodal marginal zone B-cell lymphoma (± monocytoid B-cells),Nodal peripheral T-cell lymphoma with TFH phenotype,Nodular sclerosis,Other T-cell / NK-cell lymphoma,Other B-cell lymphoma,Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma,Primary cutaneous CD30+ T-cell lymphoproliferative disorders [Primary cutaneous anaplastic large-cell lymphoma (C-ALCL), lymphoid papulosis],Primary cutaneous acral CD8+ T-cell lymphoma,Primary cutaneous CD4+ small / medium T-cell lymphoproliferative disorder,Primary cutaneous follicle center lymphoma,Primary cutaneous gamma-delta T-cell lymphoma,Primary diffuse, large B-cell lymphoma of the CNS,Primary cutaneous DLBCL, leg type,Pediatric nodal marginal zone lymphoma,Plasmacytic hyperplasia PTLD,Plasmablastic lymphoma,Primary effusion lymphoma,Peripheral T-cell lymphoma (PTCL), NOS,Florid follicular hyperplasia PTLD,Classical Hodgkin lymphoma PTLD,Monomorphic PTLD (B- and T-/NK-cell types),Polymorphic PTLD,Splenic B-cell lymphoma / leukemia, unclassifiable,Splenic diffuse red pulp small B-cell lymphoma,Splenic marginal zone B-cell lymphoma,Burkitt lymphoma,Subcutaneous panniculitis-like T-cell lymphoma,Systemic EBV+ T-cell lymphoma of childhood,Sézary syndrome,T-cell / histiocytic rich large B-cell lymphoma,T-cell large granular lymphocytic leukemia,Waldenstrom macroglobulinemia / Lymphoplasmacytic lymphoma
PRE371	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Specify other lymphoma histology:	open text		Specify other lymphoma histology:	open text
PRE372	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Date of original lymphoma diagnosis: (report the date of diagnosis of original lymphoma subtype)	YYYY/MM/DD		Date of original lymphoma diagnosis: (report the date of diagnosis of original lymphoma subtype)	YYYY/MM/DD
PRE373	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Was a PET (or PET/CT) scan performed? (at last evaluation prior to the start of the preparative regimen / infusion)	no,yes		Was a PET (or PET/CT) scan performed? (at last evaluation prior to the start of the preparative regimen / infusion)	no,yes
PRE374	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Was the PET (or PET/CT) scan positive for lymphoma involvement at any disease site?	no,yes		Was the PET (or PET/CT) scan positive for lymphoma involvement at any disease site?	no,yes
PRE375	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Date of PET scan	Known,Unknown		Date of PET scan	Known,Unknown
PRE376	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Date of PET (or PET/CT) scan:	YYYY/MM/DD		Date of PET (or PET/CT) scan:	YYYY/MM/DD
PRE377	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Deauville (five-point) score of the PET (or PET/CT) scan	Known,Unknown		Deauville (five-point) score of the PET (or PET/CT) scan	Known,Unknown
PRE378	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Scale	1- no uptake or no residual uptake 2- slight uptake, but below blood pool (mediastinum) 3- uptake above mediastinal, but below or equal to uptake in the liver 4- uptake slightly to moderately higher than liver 5- markedly increased uptake or any new lesion		Scale	1- no uptake or no residual uptake 2- slight uptake, but below blood pool (mediastinum) 3- uptake above mediastinal, but below or equal to uptake in the liver 4- uptake slightly to moderately higher than liver 5- markedly increased uptake or any new lesion
PRE379	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	What was the disease status?	CR1 - 1st complete remission: no bone marrow or extramedullary relapse prior to transplant,CR2 - 2nd complete remission,CR3+ - 3rd or subsequent complete remission,PIF res - Primary induction failure – resistant: NEVER in COMPLETE remission but with stable or progressive disease on treatment.,PIF sen / PR1 - Primary induction failure – sensitive: NEVER in COMPLETE remission but with partial remission on treatment.,PIF unk - Primary induction failure – sensitivity unknown,REL1 res - 1st relapse – resistant: stable or progressive disease with treatment,REL1 sen - 1st relapse – sensitive: partial remission (if complete remission was achieved, classify as CR2),REL1 unk - 1st relapse – sensitivity unknown,REL1 unt - 1st relapse – untreated; includes either bone marrow or extramedullary relapse,REL2 res - 2nd relapse – resistant: stable or progressive disease with treatment,REL2 sen - 2nd relapse – sensitive: partial remission (if complete remission achieved, classify as CR3+),REL2 unk - 2nd relapse – sensitivity unknown,REL2 unt - 2nd relapse – untreated: includes either bone marrow or extramedullary relapse,REL3+ res - 3rd or subsequent relapse – resistant: stable or progressive disease with treatment,REL3+ sen - 3rd or subsequent relapse – sensitive: partial remission (if complete remission achieved, classify as CR3+),REL3+ unk - 3rd relapse or greater – sensitivity unknown,REL3+ unt - 3rd or subsequent relapse – untreated; includes either bone marrow or extramedullary relapse,Disease untreated		What was the disease status?	CR1 - 1st complete remission: no bone marrow or extramedullary relapse prior to transplant,CR2 - 2nd complete remission,CR3+ - 3rd or subsequent complete remission,PIF res - Primary induction failure – resistant: NEVER in COMPLETE remission but with stable or progressive disease on treatment.,PIF sen / PR1 - Primary induction failure – sensitive: NEVER in COMPLETE remission but with partial remission on treatment.,PIF unk - Primary induction failure – sensitivity unknown,REL1 res - 1st relapse – resistant: stable or progressive disease with treatment,REL1 sen - 1st relapse – sensitive: partial remission (if complete remission was achieved, classify as CR2),REL1 unk - 1st relapse – sensitivity unknown,REL1 unt - 1st relapse – untreated; includes either bone marrow or extramedullary relapse,REL2 res - 2nd relapse – resistant: stable or progressive disease with treatment,REL2 sen - 2nd relapse – sensitive: partial remission (if complete remission achieved, classify as CR3+),REL2 unk - 2nd relapse – sensitivity unknown,REL2 unt - 2nd relapse – untreated: includes either bone marrow or extramedullary relapse,REL3+ res - 3rd or subsequent relapse – resistant: stable or progressive disease with treatment,REL3+ sen - 3rd or subsequent relapse – sensitive: partial remission (if complete remission achieved, classify as CR3+),REL3+ unk - 3rd relapse or greater – sensitivity unknown,REL3+ unt - 3rd or subsequent relapse – untreated; includes either bone marrow or extramedullary relapse,Disease untreated
PRE380	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Total number of lines of therapy received (between diagnosis and HCT / infusion)	1 line,2 lines,3+ lines		Total number of lines of therapy received (between diagnosis and HCT / infusion)	1 line,2 lines,3+ lines
PRE381	Pre-Transplant	Disease Classification	Hodgkin and Non-Hodgkin Lymphoma	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE382	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Specify the multiple myeloma/plasma cell disorder (PCD) classification	Amyloidosis,Monoclonal gammopathy of renal significance (MGRS),Multiple myeloma,Multiple myeloma-light chain only,Multiple myeloma-non-secretory,Osteosclerotic myeloma / POEMS syndrome,Other plasma cell disorder (PCD),Plasma cell leukemia (PCL),Smoldering myeloma,Solitary plasmacytoma		Specify the multiple myeloma/plasma cell disorder (PCD) classification	Amyloidosis,Monoclonal gammopathy of renal significance (MGRS),Multiple myeloma,Multiple myeloma-light chain only,Multiple myeloma-non-secretory,Osteosclerotic myeloma / POEMS syndrome,Other plasma cell disorder (PCD),Plasma cell leukemia (PCL),Smoldering myeloma,Solitary plasmacytoma
PRE383	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Specify other plasma cell disorder:	open text		Specify other plasma cell disorder:	open text
PRE384	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Specify heavy and/or light chain type (check all that apply)	IgA (heavy chain only),IgA kappa,IgA lambda,IgD (heavy chain only),IgD kappa,IgD lambda,IgE (heavy chain only),IgE kappa,IgE lambda,IgG (heavy chain only),IgG kappa,IgG lambda,IgM (heavy chain only),IgM kappa,IgM lambda,Kappa (light chain only),Lambda (light chain only)		Specify heavy and/or light chain type (check all that apply)	IgA (heavy chain only),IgA kappa,IgA lambda,IgD (heavy chain only),IgD kappa,IgD lambda,IgE (heavy chain only),IgE kappa,IgE lambda,IgG (heavy chain only),IgG kappa,IgG lambda,IgM (heavy chain only),IgM kappa,IgM lambda,Kappa (light chain only),Lambda (light chain only)
PRE385	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Specify Amyloidosis classification	AH amyloidosis,AHL amyloidosis,AL amyloidosis		Specify Amyloidosis classification	AH amyloidosis,AHL amyloidosis,AL amyloidosis
PRE386	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Select monoclonal gammopathy of renal significance (MGRS) classification	C3 glomerulopathy with monoclonal gammopathy,Crystal-storing histiocytosis,Immunotactoid glomerulopathy (ITGN)/ Glomerulonephritis with organized monoclonal microtubular immunoglobulin deposits (GOMMID),Light chain fanconi syndrome,Monoclonal immunoglobulin deposition disease (MIDD),Non-amyloid fibrillary glomerulonephritis,Proliferative glomerulonephritis with monoclonal immunoglobulin G deposits (PGNMID),Proximal tubulopathy without crystals,Type 1 cryoglobulinemic glomerulonephritis,Unknown		Select monoclonal gammopathy of renal significance (MGRS) classification	C3 glomerulopathy with monoclonal gammopathy,Crystal-storing histiocytosis,Immunotactoid glomerulopathy (ITGN)/ Glomerulonephritis with organized monoclonal microtubular immunoglobulin deposits (GOMMID),Light chain fanconi syndrome,Monoclonal immunoglobulin deposition disease (MIDD),Non-amyloid fibrillary glomerulonephritis,Proliferative glomerulonephritis with monoclonal immunoglobulin G deposits (PGNMID),Proximal tubulopathy without crystals,Type 1 cryoglobulinemic glomerulonephritis,Unknown
PRE387	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Select monoclonal immunoglobulin deposition disease (MIDD) subtype	Heavy chain deposition disease (HCDD),Light chain deposition disease (LCDD),Light and heavy chain deposition disease (LHCDD)		Select monoclonal immunoglobulin deposition disease (MIDD) subtype	Heavy chain deposition disease (HCDD),Light chain deposition disease (LCDD),Light and heavy chain deposition disease (LHCDD)
PRE388	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Was documentation submitted to the CIBMTR? (e.g. pathology report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. pathology report)	No,Yes
PRE389	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Solitary plasmacytoma was	Bone derived,Extramedullary		Solitary plasmacytoma was	Bone derived,Extramedullary
PRE390	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	What was the Durie-Salmon staging? (at diagnosis)	Stage I (All of the following: Hgb > 10g/dL; serum calcium normal or <10.5 mg/dL; bone x-ray normal bone structure (scale 0), or solitary bone plasmacytoma only; low M-component production rates IgG < 5g/dL, IgA < 3g/dL; urine light chain M-component on electrophoresis <4g/24h) – ,Stage II (Fitting neither Stage I or Stage III) ,Stage III (One of more of the following: Hgb < 8.5 g/dL; serum calcium > 12 mg/dL; advanced lytic bone lesions (scale 3); high M-component production rates IgG >7g/dL, IgA > 5g/dL; Bence Jones protein >12g/24h) ,Unknown		What was the Durie-Salmon staging? (at diagnosis)	Stage I (All of the following: Hgb > 10g/dL; serum calcium normal or <10.5 mg/dL; bone x-ray normal bone structure (scale 0), or solitary bone plasmacytoma only; low M-component production rates IgG < 5g/dL, IgA < 3g/dL; urine light chain M-component on electrophoresis <4g/24h) – ,Stage II (Fitting neither Stage I or Stage III) ,Stage III (One of more of the following: Hgb < 8.5 g/dL; serum calcium > 12 mg/dL; advanced lytic bone lesions (scale 3); high M-component production rates IgG >7g/dL, IgA > 5g/dL; Bence Jones protein >12g/24h) ,Unknown
PRE391	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	What was the Durie-Salmon sub classification? (at diagnosis)	A - relatively normal renal function (serum creatinine < 2.0 mg/dL,B - abnormal renal function (serum creatinine ≥ 2.0 mg/dL)		What was the Durie-Salmon sub classification? (at diagnosis)	A - relatively normal renal function (serum creatinine < 2.0 mg/dL,B - abnormal renal function (serum creatinine ≥ 2.0 mg/dL)
PRE392	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Did the recipient have a preceding or concurrent plasma cell disorder?	No,Yes		Did the recipient have a preceding or concurrent plasma cell disorder?	No,Yes
PRE393	Pre-Transplant	Disease Classification	Preceding or Concurrent Plasma Cell Disorder	yes	yes	Specify preceding / concurrent disorder	Amyloidosis,Monoclonal gammopathy of renal significance,Monoclonal gammopathy of unknown significance,Multiple myeloma,Multiple myeloma - light chain only,Multiple myeloma - non-secretory,Osteosclerotic myeloma / POEMS syndrome,Other disease,Plasma cell leukemia,Smoldering myeloma,Solitary plasmacytoma		Specify preceding / concurrent disorder	Amyloidosis,Monoclonal gammopathy of renal significance,Monoclonal gammopathy of unknown significance,Multiple myeloma,Multiple myeloma - light chain only,Multiple myeloma - non-secretory,Osteosclerotic myeloma / POEMS syndrome,Other disease,Plasma cell leukemia,Smoldering myeloma,Solitary plasmacytoma
PRE394	Pre-Transplant	Disease Classification	Preceding or Concurrent Plasma Cell Disorder	yes	yes	Specify other preceding/concurrent disorder:	open text		Specify other preceding/concurrent disorder:	open text
PRE395	Pre-Transplant	Disease Classification	Preceding or Concurrent Plasma Cell Disorder	yes	yes	Date of diagnosis of preceding / concurrent disorder:	YYYY/MM/DD		Date of diagnosis of preceding / concurrent disorder:	YYYY/MM/DD
PRE396	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Serum beta2 - microglobulin	Known,Unknown		Serum beta2 - microglobulin	Known,Unknown
PRE397	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Serum beta2-microglobulin:	: ___ ___ ___ ● ___ ___ ___ μg/dL : ___ ___ ___ ● ___ ___ ___ mg/L : ___ ___ ___ ● ___ ___ ___ nmol/L		Serum beta2-microglobulin:	: ___ ___ ___ ● ___ ___ ___ μg/dL : ___ ___ ___ ● ___ ___ ___ mg/L : ___ ___ ___ ● ___ ___ ___ nmol/L
PRE398	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	I.S.S Stage	Known,Unknown		I.S.S Stage	Known,Unknown
PRE399	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	I.S.S Stage	1 (Serum β2-microglobulin < 3.5 mg/L, Serum albumin ≥ 3.5 g/dL), 2(Not fitting stage 1 or 3) ,3 (Serum β2-microglobulin ≥ 5.5 mg/L; Serum albumin —)		I.S.S Stage	1 (Serum β2-microglobulin < 3.5 mg/L, Serum albumin ≥ 3.5 g/dL), 2(Not fitting stage 1 or 3) ,3 (Serum β2-microglobulin ≥ 5.5 mg/L; Serum albumin —)
PRE400	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	R-I.S.S Stage	Known,Unknown		R-I.S.S Stage	Known,Unknown
PRE401	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	R-I.S.S Stage	1 (ISS stage I and no high-risk cytogenetic abnormalities by FISH [deletion 17p / 17p-, t(4;14), t(14;16)] and normal LDH levels),2(Not R-ISS stage I or III),3(ISS stage III and either high-risk cytogenetic abnormalities by FISH [deletion 17p / 17p-, t(4;14), t(14;16)] or high LDH levels)		R-I.S.S Stage	1 (ISS stage I and no high-risk cytogenetic abnormalities by FISH [deletion 17p / 17p-, t(4;14), t(14;16)] and normal LDH levels),2(Not R-ISS stage I or III),3(ISS stage III and either high-risk cytogenetic abnormalities by FISH [deletion 17p / 17p-, t(4;14), t(14;16)] or high LDH levels)
PRE402	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Plasma cells in blood by flow cytometry	Known,Unknown		Plasma cells in peripheral blood by flow cytometry	Known,Unknown
PRE403	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Plasma cells in blood by flow cytometry	___ ___• ___ ___ %		Plasma cells in blood by flow cytometry	___ ___• ___ ___ %
PRE404	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Plasma cells in blood by morphologic assessment	Known,Unknown		Plasma cells in peripheral blood by morphologic assessment	Known,Unknown
PRE405	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Plasma cells in blood by morphologic assessment	___ ___• ___ ___ %		Plasma cells in blood by morphologic assessment	___ ___• ___ ___ %
PRE406	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Plasma cells in blood by morphologic assessment	___ ___ ___ ___ ___ • ___ ___ □ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ • ___ ___ □ x 106/L		Plasma cells in blood by morphologic assessment	___ ___ ___ ___ ___ • ___ ___ □ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ • ___ ___ □ x 106/L
PRE407	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Were cytogenetics tested (karyotyping or FISH)? (at diagnosis)	no,Unknown,yes		Were cytogenetics tested (karyotyping or FISH)? (at diagnosis)	no,Unknown,yes
PRE408	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Were cytogenetics tested via FISH?	No,Yes		Were cytogenetics tested via FISH?	No,Yes
PRE409	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Results of tests	Abnormalities identified,No abnormalities		Results of tests	Abnormalities identified,No abnormalities
PRE410	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE411	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Specify abnormalities (check all that apply)	Any abnormality at 1p,Any abnormality at 1q,del(13q) / 13q-,del(17p) / 17p-,Hyperdiploid (> 50),Hypodiploid (< 46),-13,-17,MYC rearrangement,Other abnormality,t(11;14),t(14;16),t(14;20),t(4;14),t(6;14),+11,+15,+19,+3,+5,+7,+9		Specify abnormalities (check all that apply)	Any abnormality at 1p,Any abnormality at 1q,del(13q) / 13q-,del(17p) / 17p-,Hyperdiploid (> 50),Hypodiploid (< 46),-13,-17,MYC rearrangement,Other abnormality,t(11;14),t(14;16),t(14;20),t(4;14),t(6;14),+11,+15,+19,+3,+5,+7,+9
PRE412	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE413	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Was documentation submitted to the CIBMTR? (e.g. FISH report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. FISH report)	No,Yes
PRE414	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Were cytogenetics tested via karyotyping?	No,Yes		Were cytogenetics tested via karyotyping?	No,Yes
PRE415	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases		Results of tests	Abnormalities identified,No abnormalities,No evaluable metaphases
PRE416	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text		International System for Human Cytogenetic Nomenclature (ISCN) compatible string:	open text
PRE417	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Specify abnormalities (check all that apply)	Any abnormality at 1p,Any abnormality at 1q,del(13q) / 13q-,del(17p) / 17p-,Hyperdiploid (> 50),Hypodiploid (< 46),-13,-17,MYC rearrangement,Other abnormality,t(11;14),t(14;16),t(14;20),t(4;14),t(6;14),+11,+15,+19,+3,+5,+7,+9		Specify abnormalities (check all that apply)	Any abnormality at 1p,Any abnormality at 1q,del(13q) / 13q-,del(17p) / 17p-,Hyperdiploid (> 50),Hypodiploid (< 46),-13,-17,MYC rearrangement,Other abnormality,t(11;14),t(14;16),t(14;20),t(4;14),t(6;14),+11,+15,+19,+3,+5,+7,+9
PRE418	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Specify other abnormality:	open text		Specify other abnormality:	open text
PRE419	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Was documentation submitted to the CIBMTR? (e.g. karyotyping report)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. karyotyping report)	No,Yes
PRE420	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	What is the hematologic disease status?	Complete remission (CR),Progressive disease (PD),Partial remission (PR),Relapse from CR (Rel) (untreated),Stringent complete remission (sCR),Stable disease (SD),Unknown,Very good partial remission (VGPR)		What is the hematologic disease status?	Complete remission (CR),Progressive disease (PD),Partial remission (PR),Relapse from CR (Rel) (untreated),Stringent complete remission (sCR),Stable disease (SD),Unknown,Very good partial remission (VGPR)
PRE421	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE422	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Specify amyloidosis hematologic response (for Amyloid patients only)	Complete response (CR),No response (NR) / stable disease (SD),Progressive disease (PD),Partial response (PR),Relapse from CR (Rel) (untreated),Unknown,Very good partial response (VGPR)		Specify amyloidosis hematologic response (for Amyloid patients only)	Complete response (CR),No response (NR) / stable disease (SD),Progressive disease (PD),Partial response (PR),Relapse from CR (Rel) (untreated),Unknown,Very good partial response (VGPR)
PRE423	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE424	Pre-Transplant	Disease Classification	Solid Tumors	yes	no	Specify the solid tumor classification	Breast cancer,Bone sarcoma (excluding Ewing family tumors),Cervical,Central nervous system tumor, including CNS PNET,Colorectal,Ovarian (epithelial),Ewing family tumors, extraosseous (including PNET),Ewing family tumors of bone (including PNET),External genitalia,Fibrosarcoma,Gastric,Germ cell tumor, extragonadal,Hepatobiliary,Head / neck,Hemangiosarcoma,Lung, not otherwise specified,Leiomyosarcoma,Lymphangio sarcoma,Liposarcoma,Medulloblastoma,Mediastinal neoplasm,Melanoma,Neuroblastoma,Neurogenic sarcoma,Lung, non-small cell,Other solid tumor,Prostate,Renal cell,Retinoblastoma,Rhabdomyosarcoma,Lung, small cell,Synovial sarcoma,Solid tumor, not otherwise specified,Pancreatic,Soft tissue sarcoma (excluding Ewing family tumors),Testicular,Thymoma,Uterine,Vaginal,Wilms Tumor		Specify the solid tumor classification	Breast cancer,Bone sarcoma (excluding Ewing family tumors),Cervical,Central nervous system tumor, including CNS PNET,Colorectal,Ovarian (epithelial),Ewing family tumors, extraosseous (including PNET),Ewing family tumors of bone (including PNET),External genitalia,Fibrosarcoma,Gastric,Germ cell tumor, extragonadal,Hepatobiliary,Head / neck,Hemangiosarcoma,Lung, not otherwise specified,Leiomyosarcoma,Lymphangio sarcoma,Liposarcoma,Medulloblastoma,Mediastinal neoplasm,Melanoma,Neuroblastoma,Neurogenic sarcoma,Lung, non-small cell,Other solid tumor,Prostate,Renal cell,Retinoblastoma,Rhabdomyosarcoma,Lung, small cell,Synovial sarcoma,Solid tumor, not otherwise specified,Pancreatic,Soft tissue sarcoma (excluding Ewing family tumors),Testicular,Thymoma,Uterine,Vaginal,Wilms Tumor
PRE425	Pre-Transplant	Disease Classification	Solid Tumors	yes	no	Specify other solid tumor:	open text		Specify other solid tumor:	open text
PRE426	Pre-Transplant	Disease Classification	Aplastic Anemia	yes	no	Specify the aplastic anemia classification – If the recipient developed MDS or AML, indicate MDS or AML as the primary disease.	Acquired amegakaryocytosis (not congenital),Acquired pure red cell aplasia (not congenital),Acquired AA, not otherwise specified,Other acquired cytopenic syndrome,Acquried AA secondary to chemotherapy,Acquired AA, secondary to hepatitis,Acquired AA secondary to immunotherapy or immune effector cell therapy,Acquired AA, secondary to toxin / other drug		Specify the aplastic anemia classification – If the recipient developed MDS or AML, indicate MDS or AML as the primary disease.	Acquired amegakaryocytosis (not congenital),Acquired pure red cell aplasia (not congenital),Acquired AA, not otherwise specified,Other acquired cytopenic syndrome,Acquried AA secondary to chemotherapy,Acquired AA, secondary to hepatitis,Acquired AA secondary to immunotherapy or immune effector cell therapy,Acquired AA, secondary to toxin / other drug
PRE427	Pre-Transplant	Disease Classification	Aplastic Anemia	yes	no	Specify severity	Not severe,Severe / very severe		Specify severity	Not severe,Severe / very severe
PRE428	Pre-Transplant	Disease Classification	Aplastic Anemia	yes	no	Specify other acquired cytopenic syndrome:	open text		Specify other acquired cytopenic syndrome:	open text
PRE429	Pre-Transplant	Disease Classification	Inherited Bone Marrow Failure Syndromes	yes	no	Specify the inherited bone marrow failure syndrome classification	Dyskeratosis congenita,Fanconi anemia,Severe congenital neutropenia,Diamond-Blackfan anemia,Shwachman-Diamond		Specify the inherited bone marrow failure syndrome classification	Dyskeratosis congenita,Fanconi anemia,Severe congenital neutropenia,Diamond-Blackfan anemia,Shwachman-Diamond, Other inherited bone failure syndromes
PRE430	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Specify the hemoglobinopathy classification	Other hemoglobinopathy,Sickle cell disease,Transfusion dependent thalassemia		Specify the hemoglobinopathy classification	Other hemoglobinopathy,Sickle cell disease,Transfusion dependent thalassemia
PRE431	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Specify transfusion dependent thalassemia	Transfusion dependent beta thalassemia,Other transfusion dependent thalassemia		Specify transfusion dependent thalassemia	Transfusion dependent beta thalassemia,Other transfusion dependent thalassemia
PRE432	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Specify other hemoglobinopathy:	open text		Specify other hemoglobinopathy:	open text
PRE433	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Was tricuspid regurgitant jet velocity (TRJV) measured by echocardiography?	No,Unknown,Yes		Was tricuspid regurgitant jet velocity (TRJV) measured by echocardiography?	No,Unknown,Yes
PRE434	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	TRJV measurement	Known,Unknown		TRJV measurement	Known,Unknown
PRE435	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	TRJV measurement:	*__ __● ___ m/sec*		TRJV measurement:	*__ __● ___ m/sec*
PRE436	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Was liver iron content (LIC) tested within 6 months prior to infusion?	No,Yes		Was liver iron content (LIC) tested within 6 months prior to infusion?	No,Yes
PRE437	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Liver iron content:	___ ___ ___ ● ___mg Fe/g liver dry weight ___ ___ ___ ● ___g Fe/kg liver dry weight ___ ___ ___ ● ___µmol Fe / g liver dry weight		Liver iron content:	___ ___ ___ ● ___mg Fe/g liver dry weight ___ ___ ___ ● ___g Fe/kg liver dry weight ___ ___ ___ ● ___µmol Fe / g liver dry weight
PRE438	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Method used to estimate LIC?	FerriScan,Liver Biopsy,Other,SQUID MRI,T2 MRI		Method used to estimate LIC?	FerriScan,Liver Biopsy,Other,SQUID MRI,T2 MRI
PRE439	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Is the recipient red blood cell transfusion dependent? (requiring transfusion to maintain HGB 9-10 g/dL)	No,Yes		Is the recipient red blood cell transfusion dependent? (requiring transfusion to maintain HGB 9-10 g/dL)	No,Yes
PRE440	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Year of first transfusion: (since diagnosis):	YYYY		Year of first transfusion: (since diagnosis):	YYYY
PRE441	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Was iron chelation therapy given at any time since diagnosis?	No,Unknown,Yes		Was iron chelation therapy given at any time since diagnosis?	No,Unknown,Yes
PRE442	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Did iron chelation therapy meet the following criteria: initiated within 18 months of the first transfusion and administered for at least 5 days / week (either oral or parenteral iron chelation medication)?	No, iron chelation therapy given, but not meeting criteria,Iron chelation therapy given, but details of administration unknown,Yes, iron chelation therapy given as specified		Did iron chelation therapy meet the following criteria: initiated within 18 months of the first transfusion and administered for at least 5 days / week (either oral or parenteral iron chelation medication)?	No, iron chelation therapy given, but not meeting criteria,Iron chelation therapy given, but details of administration unknown,Yes, iron chelation therapy given as specified
PRE443	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Specify reason criteria not met	Non-adherence,Other,Toxicity due to iron chelation therapy		Specify reason criteria not met	Non-adherence,Other,Toxicity due to iron chelation therapy
PRE444	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Specify other reason criteria not met:	open text		Specify other reason criteria not met:	open text
PRE445	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Year iron chelation therapy started	Known,Unknown		Year iron chelation therapy started	Known,Unknown
PRE446	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Year started:	YYYY		Year started:	YYYY
PRE447	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Did the recipient have hepatomegaly? (≥ 2 cm below costal margin)	no,Unknown,yes		Did the recipient have hepatomegaly? (≥ 2 cm below costal margin)	no,Unknown,yes
PRE448	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Liver size as measured below the costal margin at most recent evaluation:	__ __ cm		Liver size as measured below the costal margin at most recent evaluation:	__ __ cm
PRE449	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Was a liver biopsy performed at any time since diagnosis?	no,yes		Was a liver biopsy performed at any time since diagnosis?	no,yes
PRE450	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Date functional status assessed	Known,Unknown		Date functional status assessed	Known,Unknown
PRE451	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
PRE452	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Date estimated	checked		Date estimated	checked
PRE453	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Was there evidence of liver cirrhosis?	No,Unknown,Yes		Was there evidence of liver cirrhosis?	No,Unknown,Yes
PRE454	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Was there evidence of liver fibrosis?	No,Unknown,Yes		Was there evidence of liver fibrosis?	No,Unknown,Yes
PRE455	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Type of fibrosis	Bridging,Other,Periportal,Unknown		Type of fibrosis	Bridging,Other,Periportal,Unknown
PRE456	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Was there evidence of chronic hepatitis?	No,Unknown,Yes		Was there evidence of chronic hepatitis?	No,Unknown,Yes
PRE457	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Was documentation submitted to the CIBMTR? (e.g. liver biopsy)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. liver biopsy)	No,Yes
PRE458	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Is there evidence of abnormal cardiac iron deposition based on MRI of the heart at time of infusion?	No,Yes		Is there evidence of abnormal cardiac iron deposition based on MRI of the heart at time of infusion?	No,Yes
PRE459	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Did the recipient have a splenectomy?	no,Unknown,yes		Did the recipient have a splenectomy?	no,Unknown,yes
PRE460	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	TIBC:	: ___ ___ ___● ___ ___ µg / dL : ___ ___ ___● ___ ___µmol / L		TIBC:	: ___ ___ ___● ___ ___ µg / dL : ___ ___ ___● ___ ___µmol / L
PRE461	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Total serum bilirubin	Known,Unknown		Total serum bilirubin	Known,Unknown
PRE462	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Total serum bilirubin:	: ___ ___ ___● ___ ___ mg/dL : ___ ___ ___● ___ ___µmol / L		Total serum bilirubin:	: ___ ___ ___● ___ ___ mg/dL : ___ ___ ___● ___ ___µmol / L
PRE463	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Upper limit of normal for total serum bilirubin:	__ __ __ ● __		Upper limit of normal for total serum bilirubin:	__ __ __ ● __
PRE464	Pre-Transplant	Disease Classification	Disorders of the Immune System	yes	no	Specify disorder of immune system classification	Ataxia telangiectasia,Bare lymphocyte syndrome,Cartilage hair hypoplasia,CD40 ligand deficiency,Chronic granulomatous disease,DiGeorge anomaly,Griscelli syndrome type 2,HIV infection,Hermansky-Pudlak syndrome type 2,Leukocyte adhesion deficiencies, including GP180, CD-18, LFA and WBC adhesion deficiencies,Neutrophil actin deficiency,Chediak-Higashi syndrome,Other immunodeficiencies,Omenn syndrome,Other pigmentary dilution disorder,Other SCID,Reticular dysgenesis,Adenosine deaminase (ADA) deficiency / severe combined immunodeficiency (SCID),SCID, not otherwise specified,Absence of T and B cells SCID,Absence of T, normal B cell SCID,Immune deficiency, not otherwise specified,Common variable immunodeficiency,Wiskott-Aldrich syndrome,X-linked lymphoproliferative syndrome		Specify disorder of immune system classification	Ataxia telangiectasia,Bare lymphocyte syndrome,Cartilage hair hypoplasia,CD40 ligand deficiency,Chronic granulomatous disease,DiGeorge anomaly,Griscelli syndrome type 2,HIV infection,Hermansky-Pudlak syndrome type 2,Leukocyte adhesion deficiencies, including GP180, CD-18, LFA and WBC adhesion deficiencies,Neutrophil actin deficiency,Chediak-Higashi syndrome,Other immunodeficiencies,Omenn syndrome,Other pigmentary dilution disorder,Other SCID,Reticular dysgenesis,Adenosine deaminase (ADA) deficiency / severe combined immunodeficiency (SCID),SCID, not otherwise specified,Absence of T and B cells SCID,Absence of T, normal B cell SCID,Immune deficiency, not otherwise specified,Common variable immunodeficiency,Wiskott-Aldrich syndrome,X-linked lymphoproliferative syndrome
PRE465	Pre-Transplant	Disease Classification	Disorders of the Immune System	yes	no	Specify other SCID:	open text		Specify other SCID:	open text
PRE466	Pre-Transplant	Disease Classification	Disorders of the Immune System	yes	no	Specify other immunodeficiency:	open text		Specify other immunodeficiency:	open text
PRE467	Pre-Transplant	Disease Classification	Disorders of the Immune System	yes	no	Specify other pigmentary dilution disorder:	open text		Specify other pigmentary dilution disorder:	open text
PRE468	Pre-Transplant	Disease Classification	Disorders of the Immune System	yes	no	Did the recipient have an active or recent infection with a viral pathogen within 60 days of HCT?	No,Yes		Did the recipient have an active or recent infection with a viral pathogen within 60 days of HCT?	No,Yes
PRE469	Pre-Transplant	Disease Classification	Disorders of the Immune System	yes	no	Specify viral pathogen (check all that apply)	Adenovirus,BK Virus,Chikaugunya Virus,Cytomegalovirus (CMV),Coronavirus,Dengue Virus,Epstein-Barr Virus (EBV),Enterovirus D68 (EV-D68),Enterovirus (ECHO, Coxsackie),Enterovirus, NOS,Enterovirus (polio),Hepatitis A Virus,Hepatitis B Virus,Hepatitis C Virus,Hepatitis E,Human herpesvirus 6 (HHV-6),Human Immunodeficiency Virus 1 or 2,Human metapneumovirus,Human Papillomavirus (HPV),Herpes Simplex Virus (HSV),Human T-lymphotropic Virus 1 or 2,Influenza A Virus,Influenza B Virus,Influenza, NOS,JC Virus (Progressive Multifocal Leukoencephalopathy (PML)),Measles Virus (Rubeola),Mumps Virus,Norovirus,Human Parainfluenza Virus (all species),Rhinovirus (all species),Rotavirus (all species),Respiratory Syncytial Virus (RSV),Rubella Virus,Varicella Virus,West Nile Virus (WNV)		Specify viral pathogen (check all that apply)	Adenovirus,BK Virus,Chikaugunya Virus,Cytomegalovirus (CMV),Coronavirus,Dengue Virus,Epstein-Barr Virus (EBV),Enterovirus D68 (EV-D68),Enterovirus (ECHO, Coxsackie),Enterovirus, NOS,Enterovirus (polio),Hepatitis A Virus,Hepatitis B Virus,Hepatitis C Virus,Hepatitis E,Human herpesvirus 6 (HHV-6),Human Immunodeficiency Virus 1 or 2,Human metapneumovirus,Human Papillomavirus (HPV),Herpes Simplex Virus (HSV),Human T-lymphotropic Virus 1 or 2,Influenza A Virus,Influenza B Virus,Influenza, NOS,JC Virus (Progressive Multifocal Leukoencephalopathy (PML)),Measles Virus (Rubeola),Mumps Virus,Norovirus,Human Parainfluenza Virus (all species),Rhinovirus (all species),Rotavirus (all species),Respiratory Syncytial Virus (RSV),Rubella Virus,Varicella Virus,West Nile Virus (WNV)
PRE470	Pre-Transplant	Disease Classification	Disorders of the Immune System	yes	no	Has the recipient ever been infected with PCP / PJP?	No,Yes		Has the recipient ever been infected with PCP / PJP?	No,Yes
PRE471	Pre-Transplant	Disease Classification	Disorders of the Immune System	yes	no	Does the recipient have GVHD due to maternal cell engraftment pre-HCT? (SCID only)	No,Yes		Does the recipient have GVHD due to maternal cell engraftment pre-HCT? (SCID only)	No,Yes
PRE472	Pre-Transplant	Disease Classification	Inherited Abnormalities of Platelets	yes	no	Specify inherited abnormalities of platelets classification	Congenital amegakaryocytosis / congenital thrombocytopenia (501),Glanzmann thrombasthenia (502),Other inherited platelet abnormality (509)		Specify inherited abnormalities of platelets classification	Congenital amegakaryocytosis / congenital thrombocytopenia (501),Glanzmann thrombasthenia (502),Other inherited platelet abnormality (509)
PRE473	Pre-Transplant	Disease Classification	Inherited Abnormalities of Platelets	yes	no	Specify other inherited platelet abnormality:	open text		Specify other inherited platelet abnormality:	open text
PRE474	Pre-Transplant	Disease Classification	Inherited Disorders of Metabolism	yes	no	Specify inherited disorders of metabolism classification	Adrenoleukodystrophy (ALD) (543),Aspartyl glucosaminidase (561),ß-glucuronidase deficiency (VII) (537),Fucosidosis (562),Gaucher disease (541),Glucose storage disease (548),Hunter syndrome (II) (533),Hurler syndrome (IH) (531),I-cell disease (546),Krabbe disease (globoid leukodystrophy) (544),Lesch-Nyhan (HGPRT deficiency) (522),Mannosidosis (563),Maroteaux-Lamy (VI) (536),Metachromatic leukodystrophy (MLD) (542),Mucolipidoses, not otherwise specified (540),Morquio (IV) (535),Mucopolysaccharidosis (V) (538),Mucopolysaccharidosis, not otherwise specified (530),Niemann-Pick disease (545),Neuronal ceroid lipofuscinosis (Batten disease) (523),Other inherited metabolic disorder (529),Osteopetrosis (malignant infantile osteopetrosis) (521),Polysaccharide hydrolase abnormality, not otherwise specified (560),Sanfilippo (III) (534),Scheie syndrome (IS) (532),Inherited metabolic disorder, not otherwise specified (520),Wolman disease (547)		Specify inherited disorders of metabolism classification	Hereditary diffuse leukoencephalopathy with spheroids, Adrenoleukodystrophy (ALD) (543),Aspartyl glucosaminidase (561),ß-glucuronidase deficiency (VII) (537),Fucosidosis (562),Gaucher disease (541),Glucose storage disease (548),Hunter syndrome (II) (533),Hurler syndrome (IH) (531),I-cell disease (546),Krabbe disease (globoid leukodystrophy) (544),Lesch-Nyhan (HGPRT deficiency) (522),Mannosidosis (563),Maroteaux-Lamy (VI) (536),Metachromatic leukodystrophy (MLD) (542),Mucolipidoses, not otherwise specified (540),Morquio (IV) (535),Mucopolysaccharidosis (V) (538),Mucopolysaccharidosis, not otherwise specified (530),Niemann-Pick disease (545),Neuronal ceroid lipofuscinosis (Batten disease) (523),Other inherited metabolic disorder (529),Osteopetrosis (malignant infantile osteopetrosis) (521),Polysaccharide hydrolase abnormality, not otherwise specified (560),Sanfilippo (III) (534),Scheie syndrome (IS) (532),Inherited metabolic disorder, not otherwise specified (520),Wolman disease (547)
PRE475	Pre-Transplant	Disease Classification	Inherited Disorders of Metabolism	yes	no	Specify other inherited metabolic disorder:	open text		Specify other inherited metabolic disorder:	open text
PRE476	Pre-Transplant	Disease Classification	Inherited Disorders of Metabolism	yes	no	Loes composite score	__ __ Adrenoleukodystrophy (ALD) only		Loes composite score	__ __ Adrenoleukodystrophy (ALD) only
PRE477	Pre-Transplant	Disease Classification	Histiocytic Disorders	yes	no	Specify histiocytic disorder classification	Histiocytic disorder, not otherwise specified (570),Langerhans cell histiocytosis (histiocytosis-X) (572),Hemophagocytic lymphohistiocytosis (HLH) (571),Hemophagocytosis (reactive or viral associated) (573),Malignant histiocytosis (574),Other histiocytic disorder (579)		Specify histiocytic disorder classification	Histiocytic disorder, not otherwise specified (570),Langerhans cell histiocytosis (histiocytosis-X) (572),Hemophagocytic lymphohistiocytosis (HLH) (571),Hemophagocytosis (reactive or viral associated) (573),Malignant histiocytosis (574),Other histiocytic disorder (579)
PRE478	Pre-Transplant	Disease Classification	Histiocytic Disorders	yes	no	Specify other histiocytic disorder:	open text		Specify other histiocytic disorder:	open text
PRE479	Pre-Transplant	Disease Classification	Histiocytic Disorders	yes	no	Did the recipient have an active or recent infection with a viral pathogen within 60 days of HCT? Hemophagocytic lymphohistiocytosis (HLH) only	No,Yes		Did the recipient have an active or recent infection with a viral pathogen within 60 days of HCT? Hemophagocytic lymphohistiocytosis (HLH) only	No,Yes
PRE480	Pre-Transplant	Disease Classification	Histiocytic Disorders	yes	no	Specify viral pathogen (check all that apply)	Adenovirus,BK Virus,Chikaugunya Virus,Cytomegalovirus (CMV),Coronavirus,Dengue Virus,Epstein-Barr Virus (EBV),Enterovirus D68 (EV-D68),Enterovirus (ECHO, Coxsackie),Enterovirus, NOS,Enterovirus (polio),Hepatitis A Virus,Hepatitis B Virus,Hepatitis C Virus,Hepatitis E,Human herpesvirus 6 (HHV-6),Human Immunodeficiency Virus 1 or 2,Human metapneumovirus,Human Papillomavirus (HPV),Herpes Simplex Virus (HSV),Human T-lymphotropic Virus 1 or 2,Influenza A Virus,Influenza B Virus,Influenza, NOS,JC Virus (Progressive Multifocal Leukoencephalopathy (PML)),Measles Virus (Rubeola),Mumps Virus,Norovirus,Human Parainfluenza Virus (all species),Rhinovirus (all species),Rotavirus (all species),Respiratory Syncytial Virus (RSV),Rubella Virus,Varicella Virus,West Nile Virus (WNV)		Specify viral pathogen (check all that apply)	Adenovirus,BK Virus,Chikaugunya Virus,Cytomegalovirus (CMV),Coronavirus,Dengue Virus,Epstein-Barr Virus (EBV),Enterovirus D68 (EV-D68),Enterovirus (ECHO, Coxsackie),Enterovirus, NOS,Enterovirus (polio),Hepatitis A Virus,Hepatitis B Virus,Hepatitis C Virus,Hepatitis E,Human herpesvirus 6 (HHV-6),Human Immunodeficiency Virus 1 or 2,Human metapneumovirus,Human Papillomavirus (HPV),Herpes Simplex Virus (HSV),Human T-lymphotropic Virus 1 or 2,Influenza A Virus,Influenza B Virus,Influenza, NOS,JC Virus (Progressive Multifocal Leukoencephalopathy (PML)),Measles Virus (Rubeola),Mumps Virus,Norovirus,Human Parainfluenza Virus (all species),Rhinovirus (all species),Rotavirus (all species),Respiratory Syncytial Virus (RSV),Rubella Virus,Varicella Virus,West Nile Virus (WNV)
PRE481	Pre-Transplant	Disease Classification	Histiocytic Disorders	yes	no	Has the recipient ever been infected with PCP / PJP?	No,Yes		Has the recipient ever been infected with PCP / PJP?	No,Yes
PRE482	Pre-Transplant	Disease Classification	Autoimmune Diseases	yes	no	Specify autoimmune disease classification	Antiphospholipid syndrome,Behcet syndrome,Churg-Strauss,Classical polyarteritis nodosa,Crohn's disease,Diabetes mellitus type I,Evans syndrome,Giant cell arteritis,Hemolytic anemia,Idiopathic thrombocytopenic purpura (ITP),Juvenile idiopathic arthritis (JIA): oligoarticular,Juvenile idiopathic arthritis (JIA): other,Juvenile idiopathic arthritis (JIA): polyarticular,Juvenile idiopathic arthritis (JIA): systemic (Still's disease),Microscopic polyarteritis nodosa,Multiple sclerosis,Myasthenia gravis,Other autoimmune disorder,Overlap necrotizing arteritis,Other arthritis,Other autoimmune bowel disorder,Other autoimmune cytopenia,Other autoimmune neurological disorder,Other connective tissue disease,Other vasculitis,Psoriatic arthritis / psoriasis,Polymyositis / dermatomyositis,Rheumatoid arthritis,Sjogren syndrome,Systemic lupus erythematosius (SLE),Systemic sclerosis,Takayasu,Ulcerative colitis,Wegener granulomatosis		Specify autoimmune disease classification	Antiphospholipid syndrome,Behcet syndrome,Churg-Strauss,Classical polyarteritis nodosa,Crohn's disease,Diabetes mellitus type I,Evans syndrome,Giant cell arteritis,Hemolytic anemia,Idiopathic thrombocytopenic purpura (ITP),Juvenile idiopathic arthritis (JIA): oligoarticular,Juvenile idiopathic arthritis (JIA): other,Juvenile idiopathic arthritis (JIA): polyarticular,Juvenile idiopathic arthritis (JIA): systemic (Still's disease),Microscopic polyarteritis nodosa,Multiple sclerosis,Myasthenia gravis,Other autoimmune disorder,Overlap necrotizing arteritis,Other arthritis,Other autoimmune bowel disorder,Other autoimmune cytopenia,Other autoimmune neurological disorder,Other connective tissue disease,Other vasculitis,Psoriatic arthritis / psoriasis,Polymyositis / dermatomyositis,Rheumatoid arthritis,Sjogren syndrome,Systemic lupus erythematosius (SLE),Systemic sclerosis,Takayasu,Ulcerative colitis,Wegener granulomatosis
PRE483	Pre-Transplant	Disease Classification	Autoimmune Diseases	yes	no	Specify other autoimmune cytopenia:	open text		Specify other autoimmune cytopenia:	open text
PRE484	Pre-Transplant	Disease Classification	Autoimmune Diseases	yes	no	Specify other autoimmune bowel disorder:	open text		Specify other autoimmune bowel disorder:	open text
PRE485	Pre-Transplant	Disease Classification	Autoimmune Diseases	yes	no	Specify other autoimmune disease:	open text		Specify other autoimmune disease:	open text
PRE486	Pre-Transplant	Disease Classification	Tolerance Induction Associated with Solid Organ Transplant	yes	no	Specify solid organ transplanted (check all that apply)	Kidney,Liver,Other organ,Pancreas		Specify solid organ transplanted (check all that apply)	Kidney,Liver,Other organ,Pancreas
PRE487	Pre-Transplant	Disease Classification	Tolerance Induction Associated with Solid Organ Transplant	yes	no	Specify other organ:	open text		Specify other organ:	open text
PRE488	Pre-Transplant	Disease Classification	Tolerance Induction Associated with Solid Organ Transplant	yes	no	Specify other disease:	open text		Specify other disease:	open text
PRE489	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	WBC	Known,Unknown		WBC	Known,Unknown
PRE490	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	WBC	___ ___ ___ ___ ___ ___ ● ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ● ___ x 106/L		WBC	___ ___ ___ ___ ___ ___ ● ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ● ___ x 106/L
PRE491	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Neutrophils	Known,Unknown		Neutrophils	Known,Unknown
PRE492	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Neutrophils	___ ___%		Neutrophils	___ ___%
PRE493	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Blasts in blood	Known,Unknown		Blasts in blood	Known,Unknown
PRE494	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Blasts in blood	___ ___%		Blasts in blood	___ ___%
PRE495	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Hemoglobin	Known,Unknown		Hemoglobin	Known,Unknown
PRE496	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	At Diagnosis: Hemoglobin	___ ___ ___ ___ ● ___ ___ g/dL ___ ___ ___ ___ ● ___ ___ g/L ___ ___ ___ ___ ● ___ ___ mmol/L		At Diagnosis: Hemoglobin	___ ___ ___ ___ ● ___ ___ g/dL ___ ___ ___ ___ ● ___ ___ g/L ___ ___ ___ ___ ● ___ ___ mmol/L
PRE497	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Were RBCs transfused ≤ 30 days before date of test?	No,Yes		Were RBCs transfused ≤ 30 days before date of test?	No,Yes
PRE498	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Platelets	Known,Unknown		Platelets	Known,Unknown
PRE499	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Platelets	___ ___ ___ ___ ___ ___ ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ___ ___ x 106/L		Platelets	___ ___ ___ ___ ___ ___ ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ___ ___ x 106/L
PRE500	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Were platelets transfused ≤ 7 days before date of test?	No,Yes		Were platelets transfused ≤ 7 days before date of test?	No,Yes
PRE501	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	WBC	Known,Unknown		WBC	Known,Unknown
PRE502	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Neutrophils	Known,Unknown		Neutrophils	Known,Unknown
PRE503	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Neutrophils	___ ___%		Neutrophils	___ ___%
PRE504	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Blasts in blood	Known,Unknown		Blasts in blood	Known,Unknown
PRE505	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Blasts in blood	___ ___%		Blasts in blood	___ ___%
PRE506	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Hemoglobin	Known,Unknown		Hemoglobin	Known,Unknown
PRE507	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Prior to Infusion: Hemoglobin	___ ___ ___ ___ ● ___ ___ g/dL ___ ___ ___ ___ ● ___ ___ g/L ___ ___ ___ ___ ● ___ ___ mmol/L		Prior to Infusion: Hemoglobin	___ ___ ___ ___ ● ___ ___ g/dL ___ ___ ___ ___ ● ___ ___ g/L ___ ___ ___ ___ ● ___ ___ mmol/L
PRE508	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Were RBCs transfused ≤ 30 days before date of test?	No,Yes		Were RBCs transfused ≤ 30 days before date of test?	No,Yes
PRE509	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Platelets	Known,Unknown		Platelets	Known,Unknown
PRE510	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Platelets	___ ___ ___ ___ ___ ___ ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ___ ___ x 106/L		Platelets	___ ___ ___ ___ ___ ___ ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ___ ___ x 106/L
PRE511	Pre-Transplant	Disease Classification	Myelodysplastic Syndrome (MDS)	yes	yes	Were platelets transfused ≤ 7 days before date of test?	No,Yes		Were platelets transfused ≤ 7 days before date of test?	No,Yes
PRE512	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	WBC	Known,Unknown		WBC	Known,Unknown
PRE513	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	WBC	___ ___ ___ ___ ___ ___ ● ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ● ___ x 106/L		WBC	___ ___ ___ ___ ___ ___ ● ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ● ___ x 106/L
PRE514	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Neutrophils	Known,Unknown		Neutrophils	Known,Unknown
PRE515	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Neutrophils	___ ___%		Neutrophils	___ ___%
PRE516	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Blasts in blood	Known,Unknown		Blasts in blood	Known,Unknown
PRE517	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Blasts in blood	___ ___%		Blasts in blood	___ ___%
PRE518	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Hemoglobin	Known,Unknown		Hemoglobin	Known,Unknown
PRE519	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Hemoglobin	___ ___ ___ ___ ● ___ ___ g/dL ___ ___ ___ ___ ● ___ ___ g/L ___ ___ ___ ___ ● ___ ___ mmol/L		Hemoglobin	___ ___ ___ ___ ● ___ ___ g/dL ___ ___ ___ ___ ● ___ ___ g/L ___ ___ ___ ___ ● ___ ___ mmol/L
PRE520	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were RBCs transfused ≤ 30 days before date of test?	No,Yes		Were RBCs transfused ≤ 30 days before date of test?	No,Yes
PRE521	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Platelets	Known,Unknown		Platelets	Known,Unknown
PRE522	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Platelets	___ ___ ___ ___ ___ ___ ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ___ ___ x 106/L		Platelets	___ ___ ___ ___ ___ ___ ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ___ ___ x 106/L
PRE523	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were platelets transfused ≤ 7 days before date of test?	No,Yes		Were platelets transfused ≤ 7 days before date of test?	No,Yes
PRE524	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	WBC	Known,Unknown		WBC	Known,Unknown
PRE525	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	WBC	___ ___ ___ ___ ___ ___ ● ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ● ___ x 106/L		WBC	___ ___ ___ ___ ___ ___ ● ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ● ___ x 106/L
PRE526	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Neutrophils	Known,Unknown		Neutrophils	Known,Unknown
PRE527	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Neutrophils	___ ___%		Neutrophils	___ ___%
PRE528	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Blasts in blood	Known,Unknown		Blasts in blood	Known,Unknown
PRE529	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Blasts in blood	___ ___%		Blasts in blood	___ ___%
PRE530	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Hemoglobin	Known,Unknown		Hemoglobin	Known,Unknown
PRE531	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Hemoglobin	___ ___ ___ ___ ● ___ ___ g/dL ___ ___ ___ ___ ● ___ ___ g/L ___ ___ ___ ___ ● ___ ___ mmol/L		Hemoglobin	___ ___ ___ ___ ● ___ ___ g/dL ___ ___ ___ ___ ● ___ ___ g/L ___ ___ ___ ___ ● ___ ___ mmol/L
PRE532	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were RBCs transfused ≤ 30 days before date of test?	No,Yes		Were RBCs transfused ≤ 30 days before date of test?	No,Yes
PRE533	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Platelets	Known,Unknown		Platelets	Known,Unknown
PRE534	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Platelets	___ ___ ___ ___ ___ ___ ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ___ ___ x 106/L		Platelets	___ ___ ___ ___ ___ ___ ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ___ ___ x 106/L
PRE535	Pre-Transplant	Disease Classification	Myeloproliferative Neoplasms (MPN)	yes	yes	Were platelets transfused ≤ 7 days before date of test?	No,Yes		Were platelets transfused ≤ 7 days before date of test?	No,Yes
PRE536	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Serum albumin	Known,Unknown		Serum albumin	Known,Unknown
PRE537	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Serum albumin:	: ___ ___ ● ___ g/dL : ___ ___ ● ___ g/L		Serum albumin:	: ___ ___ ● ___ g/dL : ___ ___ ● ___ g/L
PRE538	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	LDH	Known,Unknown		LDH	Known,Unknown
PRE539	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	LDH	___ ___ ___ ___ ___ ● ___ ___ o U/L ___ ___ ___ ___ ___ ● ___ ___ o μkat/L		LDH	___ ___ ___ ___ ___ ● ___ ___ o U/L ___ ___ ___ ___ ___ ● ___ ___ o μkat/L
PRE540	Pre-Transplant	Disease Classification	Multiple Myeloma / Plasma Cell Disorder (PCD)	yes	no	Upper limit of normal for LDH:	___ ___ ___ ___ ___ • ___ ___		Upper limit of normal for LDH:	___ ___ ___ ___ ___ • ___ ___
PRE541	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Serum iron	Known,Unknown		Serum iron	Known,Unknown
PRE542	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Serum iron	: ___ ___ ___● ___ ___ µg / dL : ___ ___ ___● ___ ___µmol / L		Serum iron	: ___ ___ ___● ___ ___ µg / dL : ___ ___ ___● ___ ___µmol / L
PRE543	Pre-Transplant	Disease Classification	Hemoglobinopathies	yes	no	Total iron binding capacity (TIBC)	Known,Unknown		Total iron binding capacity (TIBC)	Known,Unknown
PRE544	Pre-Transplant	GVHD Prophylaxis	Allogeneic Recipient	yes	no	Was GVHD prophylaxis planned?	No,Yes		Was GVHD prophylaxis planned?	No,Yes
PRE545	Pre-Transplant	GVHD Prophylaxis	Allogeneic Recipient	yes	no	Specify drugs / intervention (check all that apply)	Abatacept,Anti CD 25(Zenapax, Daclizumab, AntiTAC),Blinded randomized trial,Bortezomib,CD34 enriched(CD34+ selection),Corticosteriods (systemic),Cyclophosphamide (Cytoxan),Cyclosporine (CSA, Neoral, Sandimmune),Extra-corporeal photopheresis (ECP),Ex-vivo T-cell depletion,Filgotinib,Maraviroc,Mycophenolate mofetil (MMF) (Cellcept),Methotrexate (MTX) (Amethopterin),Other agent,Ruxolitinib,Sirolimus (Rapamycin, Rapamune),Tacrolimus(FK 506),Tocilizumab		Specify drugs / intervention (check all that apply)	Abatacept,Anti CD 25(Zenapax, Daclizumab, AntiTAC),Blinded randomized trial,Bortezomib,CD34 enriched(CD34+ selection),Corticosteriods (systemic),Cyclophosphamide (Cytoxan),Cyclosporine (CSA, Neoral, Sandimmune),Extra-corporeal photopheresis (ECP),Ex-vivo T-cell depletion,Filgotinib,Maraviroc,Mycophenolate mofetil (MMF) (Cellcept),Methotrexate (MTX) (Amethopterin),Other agent,Ruxolitinib,Sirolimus (Rapamycin, Rapamune),Tacrolimus(FK 506),Tocilizumab
PRE546	Pre-Transplant	GVHD Prophylaxis	Allogeneic Recipient	yes	no	Specify other agent:	open text (do not report ATG, campath)		Specify other agent:	open text (do not report ATG, campath)
PRE547	Pre-Transplant	Post-HCT Disease Therapy Planned as of Day 0		no	no	Is additional post-HCT therapy planned?	no,yes		Is additional post-HCT therapy planned?	no,yes
PRE548	Pre-Transplant	Post-HCT Disease Therapy Planned as of Day 0		no	no	Specify post-HCT therapy planned	Azacitidine(Vidaza),Blinatumomab,Bortezomib (Velcade),Bosutinib,Brentuximab,Carfilzomib,Cellular therapy (e.g. DCI, DLI),Crenolanib,Daratumumab,Dasatinib,Decitabine,Elotuzumab,Enasidenib,Gilteritinib,Ibrutinib,Imanitib mesylate (Gleevec, Glivec),Intrathecal chemotherapy,Ivosidenib,Ixazomib,Lenalidomide (Revlimid),Lestaurtinib,Local radiotherapy,Midostaurin,Nilotinib,Obinutuzumab,Other,Pacritinib,Ponatinib,Quizartinib,Rituximab (Rituxan, Mabthera),Sorafenib,Sunitinib,Thalidomide (Thalomid),Unknown		Specify post-HCT therapy planned	Azacitidine(Vidaza),Blinatumomab,Bortezomib (Velcade),Bosutinib,Brentuximab,Carfilzomib,Cellular therapy (e.g. DCI, DLI),Crenolanib,Daratumumab,Dasatinib,Decitabine,Elotuzumab,Enasidenib,Gilteritinib,Ibrutinib,Imanitib mesylate (Gleevec, Glivec),Intrathecal chemotherapy,Ivosidenib,Ixazomib,Lenalidomide (Revlimid),Lestaurtinib,Local radiotherapy,Midostaurin,Nilotinib,Obinutuzumab,Other,Pacritinib,Ponatinib,Quizartinib,Rituximab (Rituxan, Mabthera),Sorafenib,Sunitinib,Thalidomide (Thalomid),Unknown
PRE549	Pre-Transplant	Post-HCT Disease Therapy Planned as of Day 0		no	no	Specify other therapy:	open text		Specify other therapy:	open text
PRE550	Pre-Transplant	Pre-HCT Preparative Regimen		no	no	Drug (drop down list)	Bendamustine,Busulfan,Carboplatin,Carmustine,Clofarabine,Cyclophosphamide,Cytarabine,Etoposide,Fludarabine,Gemcitabine,Ibritumomab tiuxetan,Ifosfamide,Lomustine,Melphalan,Methylprednisolone,Other,Pentostatin,Propylene glycol-free melphalan,Rituximab,Thiotepa,Tositumomab,Treosulfan		Drug (drop down list)	Bendamustine,Busulfan,Carboplatin,Carmustine,Clofarabine,Cyclophosphamide,Cytarabine,Etoposide,Fludarabine,Gemcitabine,Ibritumomab tiuxetan,Ifosfamide,Lomustine,Melphalan,Methylprednisolone,Other,Pentostatin,Propylene glycol-free melphalan,Rituximab,Thiotepa,Tositumomab,Treosulfan, Azathioprine, Bortezomib, Cisplatin, Hydroxyurea, and Vincristine.
PRE551	Pre-Transplant	Pre-HCT Preparative Regimen		no	no	Actual weight at initiation of pre-HCT preparative regimen:	___ ___ ___ . ___pounds ___ ___ ___ . ___kilograms		Actual weight at initiation of pre-HCT preparative regimen:	___ ___ ___ . ___pounds ___ ___ ___ . ___kilograms
PRE552	Pre-Transplant	Pre-HCT Preparative Regimen		no	no	Was a pre-HCT preparative regimen prescribed?	no,yes		Was a pre-HCT preparative regimen prescribed?	no,yes
PRE553	Pre-Transplant	Pre-HCT Preparative Regimen	Allogeneic Recipient	yes	no	Classify the recipient’s prescribed preparative regimen (Allogeneic HCTs only)	Myeloablative,Non-myeloablative (NST),Reduced intensity (RIC)		Classify the recipient’s prescribed preparative regimen (Allogeneic HCTs only)	Myeloablative,Non-myeloablative (NST),Reduced intensity (RIC)
PRE554	Pre-Transplant	Pre-HCT Preparative Regimen		no	no	Was irradiation planned as part of the pre-HCT preparative regimen?	no,yes		Was irradiation planned as part of the pre-HCT preparative regimen?	no,yes
PRE555	Pre-Transplant	Pre-HCT Preparative Regimen		no	no	What was the prescribed radiation field?	Total body by intensity-modulated radiation therapy (IMRT),Thoracoabdominal region,Total body,Total lymphoid or nodal regions		What was the prescribed radiation field?	Total body by intensity-modulated radiation therapy (IMRT),Thoracoabdominal region,Total body,Total lymphoid or nodal regions
PRE556	Pre-Transplant	Pre-HCT Preparative Regimen		no	no	Total prescribed dose: (dose per fraction x total number of fractions)	___ ___ ___ ___ . ___ Gy ___ ___ ___ ___ . ___ cGy		Total prescribed dose: (dose per fraction x total number of fractions)	___ ___ ___ ___ . ___ Gy ___ ___ ___ ___ . ___ cGy
PRE557	Pre-Transplant	Pre-HCT Preparative Regimen		no	no	Date started:	YYYY/MM/DD		Date started:	YYYY/MM/DD
PRE558	Pre-Transplant	Pre-HCT Preparative Regimen		no	no	Was the radiation fractionated?	no,yes		Was the radiation fractionated?	no,yes
PRE559	Pre-Transplant	Pre-HCT Preparative Regimen		no	no	Total number of fractions:	open text		Total number of fractions:	open text
PRE560	Pre-Transplant	Pre-HCT Preparative Regimen		no	yes	Specify other drug:	open text		Specify other drug:	open text
PRE561	Pre-Transplant	Pre-HCT Preparative Regimen		no	yes	Total prescribed dose:	__ __ __ __ __. __ mg/m2 __ __ __ __ __. __mg/kg __ __ __ __ __. __AUC (mg x h/L) __ __ __ __ __. __AUC (µmol x min/L) __ __ __ __ __. __CSS (ng/mL)		Total prescribed dose:	__ __ __ __ __. __ mg/m2 __ __ __ __ __. __mg/kg __ __ __ __ __. __AUC (mg x h/L) __ __ __ __ __. __AUC (µmol x min/L) __ __ __ __ __. __CSS (ng/mL)
PRE562	Pre-Transplant	Pre-HCT Preparative Regimen		no	yes	Date started:	YYYY/MM/DD		Date started:	YYYY/MM/DD
PRE563	Pre-Transplant	Pre-HCT Preparative Regimen		no	yes	Specify administration (busulfan only)	Both,IV,Oral		Specify administration (busulfan only)	Both,IV,Oral
PRE564	Pre-Transplant	Pre-Transplant Essential Data				Is the recipient participating in a clinical trial?	no,yes		Is the recipient participating in a clinical trial?	no,yes
PRE565	Pre-Transplant	Pre-Transplant Essential Data		no	no	Height at initiation of pre-HCT preparative regimen:	___ ___ ___ inches ___ ___ ___ cms		Height at initiation of pre-HCT preparative regimen:	___ ___ ___.___ inches ___ ___ ___ .___cms
PRE566	Pre-Transplant	Pre-Transplant Essential Data			yes	Date:	YYYY/MM/DD		Date:	YYYY/MM/DD
PRE567	Pre-Transplant	Pre-Transplant Essential Data		no	no	Sequence Number:	Auto Filled Field		Sequence Number:	Auto Filled Field
PRE568	Pre-Transplant	Pre-Transplant Essential Data		no	no	Date Received:	Auto Filled Field		Date Received:	Auto Filled Field
PRE569	Pre-Transplant	Pre-Transplant Essential Data		no	no	CIBMTR Center Number:	Auto Filled Field		CIBMTR Center Number:	Auto Filled Field
PRE570	Pre-Transplant	Pre-Transplant Essential Data		no	no	EBMT Code (CIC):	Auto Filled Field		EBMT Code (CIC):	Auto Filled Field
PRE571	Pre-Transplant	Pre-Transplant Essential Data		no	no	CIBMTR Research ID:	Auto Filled Field		CIBMTR Research ID:	Auto Filled Field
PRE572	Pre-Transplant	Pre-Transplant Essential Data		no	no	Event date:	Auto Filled Field created with CRID		Event date:	Auto Filled Field created with CRID
PRE573	Pre-Transplant	Pre-Transplant Essential Data		no	no	Date of birth:	YYYY/MM/DD		Date of birth:	YYYY/MM/DD
PRE574	Pre-Transplant	Pre-Transplant Essential Data		no	no	Sex	female,male		Sex	female,male
PRE575	Pre-Transplant	Pre-Transplant Essential Data		no	no	Ethnicity	Hispanic or Latino,Not applicable (not a resident of the USA),Not Hispanic or Latino,Unknown		Ethnicity	Hispanic or Latino,Not applicable (not a resident of the USA),Not Hispanic or Latino,Unknown
PRE576	Pre-Transplant	Pre-Transplant Essential Data		no	no	Race (check all that apply)	American Indian or Alaska Native,Asian,Black or African American,Not reported,Native Hawaiian or Other Pacific Islander,Unknown,White		Race (check all that apply)	American Indian or Alaska Native,Asian,Black or African American,Not reported,Native Hawaiian or Other Pacific Islander,Unknown,White
PRE577	Pre-Transplant	Pre-Transplant Essential Data		no	no	Race detail (check all that apply)	African American,African (both parents born in Africa),South Asian,American Indian, South or Central America,Alaskan Native or Aleut,North American Indian,Black Caribbean,Caribbean Indian,Other White,Eastern European,Filipino (Pilipino),Guamanian,Hawaiian,Japanese,Korean,Mediterranean,Middle Eastern,North American,North Coast of Africa,Chinese,Northern European,Other Pacific Islander,Other Black,Samoan,Black South or Central American,Other Southeast Asian,Unknown,Vietnamese,White Caribbean,Western European,White South or Central American		Race detail (check all that apply)	African American,African (both parents born in Africa),South Asian,American Indian, South or Central America,Alaskan Native or Aleut,North American Indian,Black Caribbean,Caribbean Indian,Other White,Eastern European,Filipino (Pilipino),Guamanian,Hawaiian,Japanese,Korean,Mediterranean,Middle Eastern,North American,North Coast of Africa,Chinese,Northern European,Other Pacific Islander,Other Black,Samoan,Black South or Central American,Other Southeast Asian,Unknown,Vietnamese,White Caribbean,Western European,White South or Central American
PRE578	Pre-Transplant	Pre-Transplant Essential Data		no	no	Country of primary residence	Andorra,United Arab Emirates,Afghanistan,Antigua and Barbuda,Anguilla,Albania,Armenia,Netherlands Antilles,Angola,Antarctica,Argentina,American Samoa,Austria,Australia,Aruba,Aland Islands,Azerbaijan,Bosnia and Herzegovina,Barbados,Bangladesh,Belgium,Burkina Faso,Bulgaria,Bahrain,Burundi,Benin,Saint Barthelemy,Bermuda,Brunei Darussalam,Bolivia,Bonaire, Sint Eustatius and Saba,Brazil,Bahamas,Bhutan,Bouvet Island,Botswana,Belarus,Belize,Canada,Cocos (Keeling) Islands,Congo, Democratic Republic of the,Central African Republic,Congo, Republic of the,Switzerland,Cote d'Ivoire,Cook Islands,Chile,Cameroon,China,Colombia,Costa Rica,Cuba,Cape Verde,Curacao,Christmas Island,Cyprus,Czech Republic,Germany,Djibouti,Denmark,Dominica,Dominican Republic,Algeria,Ecuador,Estonia,Egypt,Western Sahara,Eritrea,Spain,Ethiopia,Finland,Fiji,Falkland Islands,Micronesia,Faroe Islands,France,Gabon,United Kingdom (England, Wales, Scotland, Northern Ireland),Grenada,Georgia,French Guiana,Guernsey,Ghana,Gibraltar,Greenland,Gambia,Guinea,Guadeloupe,Equatorial Guinea,Greece,South Georgia and the South Sandwich Islands,Guatemala,Guam,Guinea-Bissau,Guyana,Hong Kong,Heard Island and McDonald Islands,Honduras,Croatia,Haiti,Hungary,Indonesia,Ireland,Israel,Isle of Man,India,British Indian Ocean Territory,Iraq,Iran,Iceland,Italy,Jersey,Jamaica,Jordan,Japan,Kenya,Kyrgyzstan,Cambodia,Kiribati,Comoros,Saint Kitts and Nevis,North Korea,South Korea,Kuwait,Cayman Islands,Kazakhstan,Laos,Lebanon,Saint Lucia,Liechtenstein,Sri Lanka,Liberia,Lesotho,Lithuania,Luxembourg,Latvia,Libya,Morocco,Monaco,Moldova,Montenegro,Saint Martin, French,Madagascar,Marshall Islands,Macedonia,Mali,Myanmar,Mongolia,Macau,Northern Mariana Islands,Martinique,Mauritania,Montserrat,Malta,Mauritius,Maldives,Malawi,Mexico,Malaysia,Mozambique,Namibia,New Caledonia,Niger,Norfolk Island,Nigeria,Nicaragua,Netherlands,Norway,Nepal,Nauru,Niue,New Zealand,Oman,Panama,Peru,French Polynesia,Papua New Guinea,Philippines,Pakistan,Poland,Saint Pierre and Miquelon,Pitcairn Islands,Puerto Rico,Palestine, State of,Portugal,Palau,Paraguay,Qatar,Reunion,Romania,Serbia,Russia,Rwanda,Saudi Arabia,Solomon Islands,Seychelles,Sudan,Sweden,Singapore,Saint Helena,Slovenia,Svalbard and Jan Mayen,Slovak Republic,Sierra Leone,San Marino,Senegal,Somalia,Suriname,South Sudan,Sao Tome and Principe,El Salvador,Sint Maarten, Dutch,Syria,Swaziland,Turks and Caicos Islands,Chad,French Southern Territories,Togo,Thailand,Tajikistan,Tokelau,Timor-Leste,Turkmenistan,Tunisia,Tonga,Turkey,Trinidad and Tobago,Tuvalu,Taiwan,Tanzania,Ukraine,Uganda,United States Minor Outlying Islands,United States,Uruguay,Uzbekistan,Holy See,Saint Vincent and the Grenadines,Venezuela,British Virgin Islands,United States Virgin Islands,Vietnam,Vanuatu,Wallis and Futuna Islands,Samoa,Yemen,Mayotte,South Africa,Zambia,Zimbabwe		Country of primary residence	Andorra,United Arab Emirates,Afghanistan,Antigua and Barbuda,Anguilla,Albania,Armenia,Netherlands Antilles,Angola,Antarctica,Argentina,American Samoa,Austria,Australia,Aruba,Aland Islands,Azerbaijan,Bosnia and Herzegovina,Barbados,Bangladesh,Belgium,Burkina Faso,Bulgaria,Bahrain,Burundi,Benin,Saint Barthelemy,Bermuda,Brunei Darussalam,Bolivia,Bonaire, Sint Eustatius and Saba,Brazil,Bahamas,Bhutan,Bouvet Island,Botswana,Belarus,Belize,Canada,Cocos (Keeling) Islands,Congo, Democratic Republic of the,Central African Republic,Congo, Republic of the,Switzerland,Cote d'Ivoire,Cook Islands,Chile,Cameroon,China,Colombia,Costa Rica,Cuba,Cape Verde,Curacao,Christmas Island,Cyprus,Czech Republic,Germany,Djibouti,Denmark,Dominica,Dominican Republic,Algeria,Ecuador,Estonia,Egypt,Western Sahara,Eritrea,Spain,Ethiopia,Finland,Fiji,Falkland Islands,Micronesia,Faroe Islands,France,Gabon,United Kingdom (England, Wales, Scotland, Northern Ireland),Grenada,Georgia,French Guiana,Guernsey,Ghana,Gibraltar,Greenland,Gambia,Guinea,Guadeloupe,Equatorial Guinea,Greece,South Georgia and the South Sandwich Islands,Guatemala,Guam,Guinea-Bissau,Guyana,Hong Kong,Heard Island and McDonald Islands,Honduras,Croatia,Haiti,Hungary,Indonesia,Ireland,Israel,Isle of Man,India,British Indian Ocean Territory,Iraq,Iran,Iceland,Italy,Jersey,Jamaica,Jordan,Japan,Kenya,Kyrgyzstan,Cambodia,Kiribati,Comoros,Saint Kitts and Nevis,North Korea,South Korea,Kuwait,Cayman Islands,Kazakhstan,Laos,Lebanon,Saint Lucia,Liechtenstein,Sri Lanka,Liberia,Lesotho,Lithuania,Luxembourg,Latvia,Libya,Morocco,Monaco,Moldova,Montenegro,Saint Martin, French,Madagascar,Marshall Islands,Macedonia,Mali,Myanmar,Mongolia,Macau,Northern Mariana Islands,Martinique,Mauritania,Montserrat,Malta,Mauritius,Maldives,Malawi,Mexico,Malaysia,Mozambique,Namibia,New Caledonia,Niger,Norfolk Island,Nigeria,Nicaragua,Netherlands,Norway,Nepal,Nauru,Niue,New Zealand,Oman,Panama,Peru,French Polynesia,Papua New Guinea,Philippines,Pakistan,Poland,Saint Pierre and Miquelon,Pitcairn Islands,Puerto Rico,Palestine, State of,Portugal,Palau,Paraguay,Qatar,Reunion,Romania,Serbia,Russia,Rwanda,Saudi Arabia,Solomon Islands,Seychelles,Sudan,Sweden,Singapore,Saint Helena,Slovenia,Svalbard and Jan Mayen,Slovak Republic,Sierra Leone,San Marino,Senegal,Somalia,Suriname,South Sudan,Sao Tome and Principe,El Salvador,Sint Maarten, Dutch,Syria,Swaziland,Turks and Caicos Islands,Chad,French Southern Territories,Togo,Thailand,Tajikistan,Tokelau,Timor-Leste,Turkmenistan,Tunisia,Tonga,Turkey,Trinidad and Tobago,Tuvalu,Taiwan,Tanzania,Ukraine,Uganda,United States Minor Outlying Islands,United States,Uruguay,Uzbekistan,Holy See,Saint Vincent and the Grenadines,Venezuela,British Virgin Islands,United States Virgin Islands,Vietnam,Vanuatu,Wallis and Futuna Islands,Samoa,Yemen,Mayotte,South Africa,Zambia,Zimbabwe
PRE579	Pre-Transplant	Pre-Transplant Essential Data		no	no	State of residence of recipient	Acre,Alagoas,Amapa,Amazonas,Bahia,Ceara,Distrito Federal,Espirito Santo,Goias,Maranhao,Mato Grosso,Mato Grosso do Sul,Minas Gerais,Para,Paraiba,Parana,Pernambuco,Piaui,Rio Grande do Norte,Rio Grande do Sul,Rio de Janeiro,Rondonia,Roraima,Santa Catarina,Sao Paulo,Sergipe,Tocantins		State of residence of recipient	Acre,Alagoas,Amapa,Amazonas,Bahia,Ceara,Distrito Federal,Espirito Santo,Goias,Maranhao,Mato Grosso,Mato Grosso do Sul,Minas Gerais,Para,Paraiba,Parana,Pernambuco,Piaui,Rio Grande do Norte,Rio Grande do Sul,Rio de Janeiro,Rondonia,Roraima,Santa Catarina,Sao Paulo,Sergipe,Tocantins
PRE580	Pre-Transplant	Pre-Transplant Essential Data		no	no	Province or territory of residence of recipient	Alberta,British Columbia,Manitoba,New Brunswick,Newfoundland and Labrador,Nova Scotia,Nunavut,Northwest Territories,Ontario,Prince Edward Island,Quebec,Saskatchewan,Yukon		Province or territory of residence of recipient	Alberta,British Columbia,Manitoba,New Brunswick,Newfoundland and Labrador,Nova Scotia,Nunavut,Northwest Territories,Ontario,Prince Edward Island,Quebec,Saskatchewan,Yukon
PRE581	Pre-Transplant	Pre-Transplant Essential Data		no	no	State of residence of recipient	Alaska,Alabama,Arkansas,Arizona,California,Colorado,Connecticut,District of Columbia,Delaware,Florida,Georgia,Hawaii,Iowa,Idaho,Illinois,Indiana,Kansas,Kentucky,Louisiana,Massachusetts,Maryland,Maine,Michigan,Minnesota,Missouri,Mississippi,Montana,North Carolina,North Dakota,Nebraska,New Hampshire,New Jersey,New Mexico,Nevada,New York,Ohio,Oklahoma,Oregon,Pennsylvania,Rhode Island,South Carolina,South Dakota,Tennessee,Texas,Utah,Virginia,Vermont,Washington,Wisconsin,West Virginia,Wyoming		State of residence of recipient	Alaska,Alabama,Arkansas,Arizona,California,Colorado,Connecticut,District of Columbia,Delaware,Florida,Georgia,Hawaii,Iowa,Idaho,Illinois,Indiana,Kansas,Kentucky,Louisiana,Massachusetts,Maryland,Maine,Michigan,Minnesota,Missouri,Mississippi,Montana,North Carolina,North Dakota,Nebraska,New Hampshire,New Jersey,New Mexico,Nevada,New York,Ohio,Oklahoma,Oregon,Pennsylvania,Rhode Island,South Carolina,South Dakota,Tennessee,Texas,Utah,Virginia,Vermont,Washington,Wisconsin,West Virginia,Wyoming
PRE582	Pre-Transplant	Pre-Transplant Essential Data		no	no	NMDP Recipient ID (RID):	open text		NMDP Recipient ID (RID):	open text
PRE583	Pre-Transplant	Pre-Transplant Essential Data		no	no	Zip or postal code for place of recipient's residence (USA and Canada residents only):	open text		Zip or postal code for place of recipient's residence (USA and Canada residents only):	open text
PRE584	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Recipient	yes	no	Has the recipient signed an IRB / ethics committee (or similar body) approved consent form to donate research blood samples to the NMDP / CIBMTR (For allogeneic HCTs only)?	No (recipient declined),Not applicable (center not participating), Not approached,Yes (recipient consented)		Has the recipient signed an IRB / ethics committee (or similar body) approved consent form to donate research blood samples to the NMDP / CIBMTR (For allogeneic HCTs only)?	No (recipient declined),Not applicable (center not participating), Not approached,Yes (recipient consented)
PRE585	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Recipient	yes	no	Date form was signed:	YYYY/MM/DD		Date form was signed:	YYYY/MM/DD
PRE586	Pre-Transplant	Pre-Transplant Essential Data	Related Donors	yes	no	Did the recipient submit a research sample to the NMDP/CIBMTR repository? (Related donors only)	no,yes		Did the recipient submit a research sample to the NMDP/CIBMTR repository? (Related donors only)	no,yes
PRE587	Pre-Transplant	Pre-Transplant Essential Data	Related Donors	yes	no	Research sample recipient ID:	open text		Research sample recipient ID:	open text
PRE589	Pre-Transplant	Pre-Transplant Essential Data	Clinical Trial Participants	yes	no	Specify other sponsor:	open text		Specify other sponsor:	open text
PRE591	Pre-Transplant	Pre-Transplant Essential Data	Clinical Trial Participants	yes	no	Subject ID:	open text		Subject ID:	open text
PRE592	Pre-Transplant	Pre-Transplant Essential Data	Clinical Trial Participants	yes	no	Specify the ClinicalTrials.gov identification number:	open text		Specify the ClinicalTrials.gov identification number:	open text
PRE593	Pre-Transplant	Pre-Transplant Essential Data	Autologous Transplant	yes	no	Is a subsequent HCT planned as part of the overall treatment protocol? (not as a reaction to post-HCT disease assessment) (For autologous HCTs only)	no,yes		Is a subsequent HCT planned as part of the overall treatment protocol? (not as a reaction to post-HCT disease assessment) (For autologous HCTs only)	no,yes
PRE594	Pre-Transplant	Pre-Transplant Essential Data	Autologous Transplant	yes	no	Specify subsequent HCT planned	Allogeneic,Autologous		Specify subsequent HCT planned	Allogeneic,Autologous
PRE595	Pre-Transplant	Pre-Transplant Essential Data				Has the recipient ever had a prior HCT?	No,Yes		Has the recipient ever had a prior HCT?	No,Yes
PRE596	Pre-Transplant	Pre-Transplant Essential Data				Specify the number of prior HCTs:	open text		Specify the number of prior HCTs:	open text
PRE597	Pre-Transplant	Pre-Transplant Essential Data				Were all prior HCTs reported to the CIBMTR?	No,Unknown,Yes		Were all prior HCTs reported to the CIBMTR?	No,Unknown,Yes
PRE598	Pre-Transplant	Pre-Transplant Essential Data	Prior Transplant	yes	yes	Date of the prior HCT:	YYYY/MM/DD		Date of the prior HCT:	YYYY/MM/DD
PRE599	Pre-Transplant	Pre-Transplant Essential Data	Prior Transplant	yes	yes	Date estimated	checked		Date estimated	checked
PRE600	Pre-Transplant	Pre-Transplant Essential Data	Prior Transplant	yes	yes	Was the prior HCT performed at a different institution?	No,Yes		Was the prior HCT performed at a different institution?	No,Yes
PRE601	Pre-Transplant	Pre-Transplant Essential Data	Prior Transplant	yes	yes	Name:	open text		Name:	open text
PRE602	Pre-Transplant	Pre-Transplant Essential Data	Prior Transplant	yes	yes	City:	open text		City:	open text
PRE603	Pre-Transplant	Pre-Transplant Essential Data	Prior Transplant	yes	yes	State:	open text		State:	open text
PRE604	Pre-Transplant	Pre-Transplant Essential Data	Prior Transplant	yes	yes	Country:	open text		Country:	open text
PRE605	Pre-Transplant	Pre-Transplant Essential Data	Prior Transplant	yes	yes	What was the HPC source for the prior HCT? (check all that apply)	Allogeneic - related, Allogeneic -unrelated, Autologous		What was the HPC source for the prior HCT? (check all that apply)	Allogeneic - related, Allogeneic -unrelated, Autologous
PRE606	Pre-Transplant	Pre-Transplant Essential Data		no	no	Reason for current HCT	Graft failure / insufficient hematopoietic recovery,Insufficient chimerism,New malignancy (including PTLD and EBV lymphoma),Other,Persistent primary disease,Planned subsequent HCT, per protocol,Recurrent primary disease		Reason for current HCT	Graft failure / insufficient hematopoietic recovery,Insufficient chimerism,New malignancy (including PTLD and EBV lymphoma),Other,Persistent primary disease,Planned subsequent HCT, per protocol,Recurrent primary disease
PRE607	Pre-Transplant	Pre-Transplant Essential Data		no	no	Date of graft failure / rejection:	YYYY/MM/DD		Date of graft failure / rejection:	YYYY/MM/DD
PRE608	Pre-Transplant	Pre-Transplant Essential Data		no	no	Date of relapse:	YYYY/MM/DD		Date of relapse:	YYYY/MM/DD
PRE609	Pre-Transplant	Pre-Transplant Essential Data		no	no	Date of secondary malignancy:	YYYY/MM/DD		Date of secondary malignancy:	YYYY/MM/DD
PRE610	Pre-Transplant	Pre-Transplant Essential Data		no	no	Specify other reason:	open text		Specify other reason:	open text
PRE611	Pre-Transplant	Pre-Transplant Essential Data		no	no	Has the recipient ever had a prior cellular therapy? (do not include DLIs)	No,Unknown,Yes		Has the recipient ever had a prior cellular therapy? (do not include DLIs)	No,Unknown,Yes
PRE612	Pre-Transplant	Pre-Transplant Essential Data	Prior Cellular Therapies	yes	no	Were all prior cellular therapies reported to the CIBMTR?	No,Unknown,Yes		Were all prior cellular therapies reported to the CIBMTR?	No,Unknown,Yes
PRE613	Pre-Transplant	Pre-Transplant Essential Data	Prior Cellular Therapies	yes	no	Date of the prior cellular therapy:	YYYY/MM/DD		Date of the prior cellular therapy:	YYYY/MM/DD
PRE614	Pre-Transplant	Pre-Transplant Essential Data	Prior Cellular Therapies	yes	no	Was the cellular therapy performed at a different institution?	No,Yes		Was the cellular therapy performed at a different institution?	No,Yes
PRE615	Pre-Transplant	Pre-Transplant Essential Data	Prior Cellular Therapies	yes	no	Name:	open text		Name:	open text
PRE616	Pre-Transplant	Pre-Transplant Essential Data	Prior Cellular Therapies	yes	no	City:	open text		City:	open text
PRE617	Pre-Transplant	Pre-Transplant Essential Data	Prior Cellular Therapies	yes	no	State:	open text		State:	open text
PRE618	Pre-Transplant	Pre-Transplant Essential Data	Prior Cellular Therapies	yes	no	Country:	open text		Country:	open text
PRE619	Pre-Transplant	Pre-Transplant Essential Data	Prior Cellular Therapies	yes	no	Specify the source(s) for the prior cellular therapy (check all that apply)	Allogeneic-related,Allogeneic-unrelated,Autologous		Specify the source(s) for the prior cellular therapy (check all that apply)	Allogeneic-related,Allogeneic-unrelated,Autologous
PRE620	Pre-Transplant	Pre-Transplant Essential Data		no	no	Multiple donors?	no,yes		Multiple donors?	no,yes
PRE621	Pre-Transplant	Pre-Transplant Essential Data		no	no	Specify number of donors:	open text		Specify number of donors:	open text
PRE622	Pre-Transplant	Pre-Transplant Essential Data		no	yes	Specify donor	Allogeneic-related donor,Allogeneic-unrelated donor,Autologous		Specify donor	Allogeneic-related donor,Allogeneic-unrelated donor,Autologous
PRE623	Pre-Transplant	Pre-Transplant Essential Data		no	yes	Specify product type (check all that apply)	Bone marrow,Other product,PBSC,Single cord blood unit		Specify product type (check all that apply)	Bone marrow,Other product,PBSC,Single cord blood unit
PRE624	Pre-Transplant	Pre-Transplant Essential Data		no	yes	Specify other product:	open text		Specify other product:	open text
PRE625	Pre-Transplant	Pre-Transplant Essential Data		yes	yes	Is the product genetically modified?	No,Yes		Is the product genetically modified?	No,Yes
PRE626	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Specify the related donor type	HLA-matched other relative,HLA-mismatched relative,HLA-identical sibling (may include non-monozygotic twin),Syngeneic (monozygotic twin)		Specify the related donor type	HLA-matched other relative,HLA-mismatched relative,HLA-identical sibling (may include non-monozygotic twin),Syngeneic (monozygotic twin)
PRE627	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Specify the biological relationship of the donor to the recipient	Fraternal twin,Father,Grandchild,Grandparent,Mother,Maternal aunt,Maternal cousin,Maternal uncle,Other biological relative,Paternal aunt,Paternal cousin,Paternal uncle,Recipient's child,Sibling		Specify the biological relationship of the donor to the recipient	Fraternal twin,Father,Grandchild,Grandparent,Mother,Maternal aunt,Maternal cousin,Maternal uncle,Other biological relative,Paternal aunt,Paternal cousin,Paternal uncle,Recipient's child,Sibling
PRE628	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Specify other biological relative:	open text		Specify other biological relative:	open text
PRE629	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Degree of mismatch (related donors only)	1 HLA antigen mismatch, greater than or equal to 2 HLA antigen mismatch (does include haploidentical donor)		Degree of mismatch (related donors only)	1 HLA antigen mismatch, greater than or equal to 2 HLA antigen mismatch (does include haploidentical donor)
PRE630	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Specify unrelated donor type	HLA matched unrelated,HLA mismatched unrelated		Specify unrelated donor type	HLA matched unrelated,HLA mismatched unrelated
PRE631	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Did NMDP / Be the Match facilitate the procurement, collection, or transportation of the product?	No,Yes		Did NMDP / Be the Match facilitate the procurement, collection, or transportation of the product?	No,Yes
PRE632	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Was this donor used for any prior HCTs? (for this recipient)	no,yes		Was this donor used for any prior HCTs? (for this recipient)	no,yes
PRE633	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Global Registration Identifier for Donors (GRID)	open text		Global Registration Identifier for Donors (GRID)	open text
PRE634	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	NMDP cord blood unit ID:	open text		NMDP cord blood unit ID:	open text
PRE635	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Registry donor ID:	open text		Registry donor ID:	open text
PRE636	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Non-NMDP cord blood unit ID:	open text		Non-NMDP cord blood unit ID:	open text
PRE637	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Is the CBU ID also the ISBT DIN number?	No,Unknown,Yes		Is the CBU ID also the ISBT DIN number?	No,Unknown,Yes
PRE638	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Specify the ISBT DIN number:	open text		Specify the ISBT DIN number:	open text
PRE639	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Registry or UCB Bank ID	(A) Austrian Bone Marrow Donors,(ACB) Austrian Cord Blood Registry,(ACCB) StemCyte, Inc,(AE) Emirates Bone Marrow Donor Registry,(AM) Armenian Bone Marrow Donor Registry Charitable Trust,(AOCB) University of Colorado Cord Blood Bank,(AR) Argentine CPH Donors Registry,(ARCB) BANCEL - Argentina Cord Blood Bank,(AUCB) Australian Cord Blood Registry,(AUS) Australian / New Zealand Bone Marrow Donor Registry,(B) Marrow Donor Program Belgium,(BCB) Belgium Cord Blood Registry,(BG) Bulgarian Bone Marrow Donor Registry,(BR) INCA/REDOMO,(BSCB) British Bone Marrow Registry - Cord Blood,(CB) Cord Blood Registry,(CH) Swiss BloodStem Cells - Adult Donors,(CHCB) Swiss Blood Stem Cells - Cord Blood,(CKCB) Celgene Cord Blood Bank,(CN) China Marrow Donor Program (CMDP),(CNCB) Shan Dong Cord Blood Bank,(CND) Canadian Blood Services Bone Marrow Donor Registry,(CS2) Czech National Marrow Donor Registry,(CSCR) Czech Stem Cells Registry,(CY) Cyprus Paraskevaidio Bone Marrow Donor Registry,(CY2) The Cyprus Bone Marrow Donor Registry,(D) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Adult Donors,(DCB) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Cord Blood,(DK) The Danish Bone Marrow Donor Registry,(DK2) Bone Marrow Donors Copenhagen (BMDC),(DUCB) German Branch of the European Cord Blood Bank,(E) REDMO,(ECB) Spanish Cord Blood Registry,(F) France Greffe de Moelle - Adult Donors,(FCB) France Greffe de Moelle - Cord Blood,(FI) Finnish Bone Marrow Donor Registry,(FICB) Finnish Cord Blood Registry,(GB) The Anthony Nolan Trust,(GB3) Welsh Bone Marrow Donor Registry,(GB4) British Bone Marrow Registry,(GR) Unrelated Hematopoietic Stem Cell Donor Registry Greece,(GRCB) Michigan Community Blood Centers Cord Blood Bank,(H) Hungarian Bone Marrow Donor Registry,(HEM) Hema-Quebec,(HK) Hong Kong Bone Marrow Donor Registry,(HR) Croatian Bone Marrow Donor Registry,(I) Italian Bone Marrow Donor Registry,(I3CB) Sheba Medical Centre Cord Blood Registry,(ICB) Italian Cord Blood Bank Network,(IL) Hadassah BMDR,(IL2) Ezer Mizion Bone Marrow Donor Registry,(IL3) Sheba Medical Center Donor Registry,(ILCB) Isreal Cord Blood Bank,(IN) Asian Indian Donor Marrow Registry,(IN2) Dept. of Transfusion Medicine,(IRL) The Irish Unrelated Bone Marrow Panel,(JP) Japan Marrow Donor Program,(KR) Korea Marrow Donor Program,(LT) Lithuanian National Bone Marrow Donor Registry,(LVCB) Leuven Cord Blood Bank,(MACB) Victoria Angel Registry of Hope,(MX) Mexican Bone Marrow Donor Registry,(N) The Norwegian Bone Marrow Donor Registry,(NL) Europdonor Foundation- Adult Donors,(NLCB) Europdonor Foundation - Cord Blood,(NYCB) National Cord Blood Program, New York Blood Center,(OTH) Other Registry,(P) Portuguese Bone Marrow Donors Registry,(PL) National Polish Bone Marrow Registry,(PL2) Unrelated Bone Marrow Donor Registry -Adult Donors,(PL3) Against Leukemia Foundation Marrow Donor Registry,(PL4) Ursula Jaworska Foundation - Bone Marrow Donor Registry,(PL5) Polish Central Bone Marrow Donor Registry - Adult Donors,(PMCB) Elie Katz Umbilical Cord Blood Program,(R) Russian Bone Marrow Donor Registry,(R2) Karelian Registry of Unrelated Donors of Hematopoietic Stem Cells,(S) Tobias Registry of Swedish Bone Marrow Donors,(SG) Singapore Bone Marrow Donor Programme (BMDP),(SK) Slovak National Bone Marrow Donor Registry,(SKCB) Eurocord Slovakia / Slovak Pacental Stem Cell Registry,(SLCBB) St Louis Cord Blood Bank,(SLO) Slovenia Donor,(SM) San Marino Bone Marrow Donor Registry,(T1CB) TRAN - Cord Blood,(TACB) StemCyte, Inc. Taiwan,(TECB) Healthbanks Biotech, Co., Ltd,(TH) Thai Stem Cell Donor Registry (TSCDR),(TOCB) Tokyo Cord Blood Bank,(TPCB) BIONET / BabyBanks,(TRAN) TRAN - Adult Donors,(TRIS) Bone Marrow Bank of Istanbul Medical Faculty,(TW) Buddhist Tzu Chi Stem Cells Center - Adult Donors,(TWCB) Buddhist Tzu Chi Stem Cells Center - Cord Blood,(U1CB) National Marrow Donor Program - Cord Blood,(USA1) National Marrow Donor Program - Adult Donors,(USA2) America Bone Marrow Donor Registry,(UY) SINDOME,(VIAC) Viacord,(W3CB) Polish Central Bone Marrow Donor Registry - Cord Blood,(WACB) Unrelated Bone Marrow Donor Registry - Cord Blood,(ZA) South African Bone Marrow Registry		Registry or UCB Bank ID	(A) Austrian Bone Marrow Donors,(ACB) Austrian Cord Blood Registry,(ACCB) StemCyte, Inc,(AE) Emirates Bone Marrow Donor Registry,(AM) Armenian Bone Marrow Donor Registry Charitable Trust,(AOCB) University of Colorado Cord Blood Bank,(AR) Argentine CPH Donors Registry,(ARCB) BANCEL - Argentina Cord Blood Bank,(AUCB) Australian Cord Blood Registry,(AUS) Australian / New Zealand Bone Marrow Donor Registry,(B) Marrow Donor Program Belgium,(BCB) Belgium Cord Blood Registry,(BG) Bulgarian Bone Marrow Donor Registry,(BR) INCA/REDOMO,(BSCB) British Bone Marrow Registry - Cord Blood,(CB) Cord Blood Registry,(CH) Swiss BloodStem Cells - Adult Donors,(CHCB) Swiss Blood Stem Cells - Cord Blood,(CKCB) Celgene Cord Blood Bank,(CN) China Marrow Donor Program (CMDP),(CNCB) Shan Dong Cord Blood Bank,(CND) Canadian Blood Services Bone Marrow Donor Registry,(CS2) Czech National Marrow Donor Registry,(CSCR) Czech Stem Cells Registry,(CY) Cyprus Paraskevaidio Bone Marrow Donor Registry,(CY2) The Cyprus Bone Marrow Donor Registry,(D) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Adult Donors,(DCB) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Cord Blood,(DK) The Danish Bone Marrow Donor Registry,(DK2) Bone Marrow Donors Copenhagen (BMDC),(DUCB) German Branch of the European Cord Blood Bank,(E) REDMO,(ECB) Spanish Cord Blood Registry,(F) France Greffe de Moelle - Adult Donors,(FCB) France Greffe de Moelle - Cord Blood,(FI) Finnish Bone Marrow Donor Registry,(FICB) Finnish Cord Blood Registry,(GB) The Anthony Nolan Trust,(GB3) Welsh Bone Marrow Donor Registry,(GB4) British Bone Marrow Registry,(GR) Unrelated Hematopoietic Stem Cell Donor Registry Greece,(GRCB) Michigan Community Blood Centers Cord Blood Bank,(H) Hungarian Bone Marrow Donor Registry,(HEM) Hema-Quebec,(HK) Hong Kong Bone Marrow Donor Registry,(HR) Croatian Bone Marrow Donor Registry,(I) Italian Bone Marrow Donor Registry,(I3CB) Sheba Medical Centre Cord Blood Registry,(ICB) Italian Cord Blood Bank Network,(IL) Hadassah BMDR,(IL2) Ezer Mizion Bone Marrow Donor Registry,(IL3) Sheba Medical Center Donor Registry,(ILCB) Isreal Cord Blood Bank,(IN) Asian Indian Donor Marrow Registry,(IN2) Dept. of Transfusion Medicine,(IRL) The Irish Unrelated Bone Marrow Panel,(JP) Japan Marrow Donor Program,(KR) Korea Marrow Donor Program,(LT) Lithuanian National Bone Marrow Donor Registry,(LVCB) Leuven Cord Blood Bank,(MACB) Victoria Angel Registry of Hope,(MX) Mexican Bone Marrow Donor Registry,(N) The Norwegian Bone Marrow Donor Registry,(NL) Europdonor Foundation- Adult Donors,(NLCB) Europdonor Foundation - Cord Blood,(NYCB) National Cord Blood Program, New York Blood Center,(OTH) Other Registry,(P) Portuguese Bone Marrow Donors Registry,(PL) National Polish Bone Marrow Registry,(PL2) Unrelated Bone Marrow Donor Registry -Adult Donors,(PL3) Against Leukemia Foundation Marrow Donor Registry,(PL4) Ursula Jaworska Foundation - Bone Marrow Donor Registry,(PL5) Polish Central Bone Marrow Donor Registry - Adult Donors,(PMCB) Elie Katz Umbilical Cord Blood Program,(R) Russian Bone Marrow Donor Registry,(R2) Karelian Registry of Unrelated Donors of Hematopoietic Stem Cells,(S) Tobias Registry of Swedish Bone Marrow Donors,(SG) Singapore Bone Marrow Donor Programme (BMDP),(SK) Slovak National Bone Marrow Donor Registry,(SKCB) Eurocord Slovakia / Slovak Pacental Stem Cell Registry,(SLCBB) St Louis Cord Blood Bank,(SLO) Slovenia Donor,(SM) San Marino Bone Marrow Donor Registry,(T1CB) TRAN - Cord Blood,(TACB) StemCyte, Inc. Taiwan,(TECB) Healthbanks Biotech, Co., Ltd,(TH) Thai Stem Cell Donor Registry (TSCDR),(TOCB) Tokyo Cord Blood Bank,(TPCB) BIONET / BabyBanks,(TRAN) TRAN - Adult Donors,(TRIS) Bone Marrow Bank of Istanbul Medical Faculty,(TW) Buddhist Tzu Chi Stem Cells Center - Adult Donors,(TWCB) Buddhist Tzu Chi Stem Cells Center - Cord Blood,(U1CB) National Marrow Donor Program - Cord Blood,(USA1) National Marrow Donor Program - Adult Donors,(USA2) America Bone Marrow Donor Registry,(UY) SINDOME,(VIAC) Viacord,(W3CB) Polish Central Bone Marrow Donor Registry - Cord Blood,(WACB) Unrelated Bone Marrow Donor Registry - Cord Blood,(ZA) South African Bone Marrow Registry
PRE640	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Specify other Registry or UCB Bank:	open text		Specify other Registry or UCB Bank:	open text
PRE641	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Donor date of birth	Known,Unknown		Donor date of birth	Known,Unknown
PRE642	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Donor date of birth:	YYYY/MM/DD		Donor date of birth:	YYYY/MM/DD
PRE643	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Donor age	Known,Unknown		Donor age	Known,Unknown
PRE644	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Donor age: Months (use only if less than 1 years old), Years	open text		Donor age: Months (use only if less than 1 years old), Years	open text
PRE645	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Donor sex	female,male		Donor sex	female,male
PRE646	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Specify blood type (donor) (non-NMDP allogeneic donors only)	A,AB,B,O		Specify blood type (donor) (non-NMDP allogeneic donors only)	A,AB,B,O
PRE647	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Specify Rh factor (donor) (non-NMDP allogeneic donors only)	Negative,Positive		Specify Rh factor (donor) (non-NMDP allogeneic donors only)	Negative,Positive
PRE648	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Donor CMV-antibodies (IgG or Total) (Allogeneic HCTs only)	Indeterminate, Not applicable (cord blood unit), Non-reactive, Not done, Reactive		Donor CMV-antibodies (IgG or Total) (Allogeneic HCTs only)	Indeterminate, Not applicable (cord blood unit), Non-reactive, Not done, Reactive
PRE649	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Has the donor signed an IRB / ethics committee (or similar body) approved consent form to donate research blood samples to the NMDP / CIBMTR? (Related donors only)	No (donor declined), Not applicable (center not participating), Not approached, Yes (donor consented)		Has the donor signed an IRB / ethics committee (or similar body) approved consent form to donate research blood samples to the NMDP / CIBMTR? (Related donors only)	No (donor declined), Not applicable (center not participating), Not approached, Yes (donor consented)
PRE650	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Date form was signed:	YYYY/MM/DD		Date form was signed:	YYYY/MM/DD
PRE651	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Did the donor submit a research sample to the NMDP/CIBMTR repository? (Related donors only)	no,yes		Did the donor submit a research sample to the NMDP/CIBMTR repository? (related donors only)	no,yes
PRE652	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Donors	yes	yes	Research sample donor ID:	open text		Research sample donor ID:	open text
PRE653	Pre-Transplant	Pre-Transplant Essential Data	Autologous Transplant	yes	yes	Specify number of products infused from this donor:	open text		Specify number of products infused from this donor:	open text
PRE654	Pre-Transplant	Pre-Transplant Essential Data	Autologous Transplant	yes	yes	Specify the number of these products intended to achieve hematopoietic engraftment:	open text		Specify the number of these products intended to achieve hematopoietic engraftment:	open text
PRE655	Pre-Transplant	Pre-Transplant Essential Data	Autologous Transplant	yes	yes	What agents were used to mobilize the autologous recipient for this HCT? (check all that apply)	G-CSF (TBO-filgrastim, filgrastim, Granix, Neupogen) ,GM-CSF (sargramostim, Leukine), Pegylated G-CSF (pegfilgrastim, Neulasta), Plerixafor (Mozobil), Combined with chemotherapy, Anti-CD20 (rituximab, Rituxan), Other agent		What agents were used to mobilize the autologous recipient for this HCT? (check all that apply)	G-CSF (TBO-filgrastim, filgrastim, Granix, Neupogen) ,GM-CSF (sargramostim, Leukine), Pegylated G-CSF (pegfilgrastim, Neulasta), Plerixafor (Mozobil), Combined with chemotherapy, Anti-CD20 (rituximab, Rituxan), Other agent
PRE656	Pre-Transplant	Pre-Transplant Essential Data	Autologous Transplant	yes	yes	Specify other agent:	open text		Specify other agent:	open text
PRE658	Pre-Transplant	Pre-Transplant Essential Data	Autologous Transplant	yes	yes	Specify other name:	open text		Specify other name:	open text
PRE659	Pre-Transplant	Pre-Transplant Essential Data		no	no	What scale was used to determine the recipient’s functional status?	Karnofsky,Lansky		What scale was used to determine the recipient’s functional status?	Karnofsky,Lansky
PRE660	Pre-Transplant	Pre-Transplant Essential Data		no	no	Karnofsky Scale (recipient age ≥ 16 years)	100 Normal; no complaints; no evidence of disease,10 Moribund; fatal process progressing rapidly,20 Very sick; hospitalization necessary,30 Severely disabled; hospitalization indicated, although death not imminent,40 Disabled; requires special care and assistance,50 Requires considerable assistance and frequent medical care,60 Requires occasional assistance but is able to care for most needs,70 Cares for self; unable to carry on normal activity or to do active work,80 Normal activity with effort,90 Able to carry on normal activity		Karnofsky Scale (recipient age ≥ 16 years)	100 Normal; no complaints; no evidence of disease,10 Moribund; fatal process progressing rapidly,20 Very sick; hospitalization necessary,30 Severely disabled; hospitalization indicated, although death not imminent,40 Disabled; requires special care and assistance,50 Requires considerable assistance and frequent medical care,60 Requires occasional assistance but is able to care for most needs,70 Cares for self; unable to carry on normal activity or to do active work,80 Normal activity with effort,90 Able to carry on normal activity
PRE661	Pre-Transplant	Pre-Transplant Essential Data		no	no	Lansky Scale (recipient age ≥ 1 year and < 16 years)	100 Fully active,10 Completely disabled, not even passive play,20 Limited to very passive activity initiated by others (e.g., TV),30 Needs considerable assistance for quiet activity,40 Able to initiate quiet activities,50 Considerable assistance required for any active play; fully able to engage in quiet play,60 Ambulatory up to 50% of time, limited active play with assistance / supervision,70 Both greater restrictions of, and less time spent in, active play,80 Restricted in strenuous play, tires more easily, otherwise active,90 Minor restriction in physically strenuous play		Lansky Scale (recipient age ≥ 1 year and < 16 years)	100 Fully active,10 Completely disabled, not even passive play,20 Limited to very passive activity initiated by others (e.g., TV),30 Needs considerable assistance for quiet activity,40 Able to initiate quiet activities,50 Considerable assistance required for any active play; fully able to engage in quiet play,60 Ambulatory up to 50% of time, limited active play with assistance / supervision,70 Both greater restrictions of, and less time spent in, active play,80 Restricted in strenuous play, tires more easily, otherwise active,90 Minor restriction in physically strenuous play
PRE662	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Recipient	yes	no	Specify blood type (of recipient) (For allogeneic HCTs only)	A,AB,B,O		Specify blood type (of recipient) (For allogeneic HCTs only)	A,AB,B,O
PRE663	Pre-Transplant	Pre-Transplant Essential Data	Allogeneic Recipient	yes	no	Specify Rh factor (of recipient) (For allogeneic HCTs only)	Negative,Positive		Specify Rh factor (of recipient) (For allogeneic HCTs only)	Negative,Positive
PRE664	Pre-Transplant	Pre-Transplant Essential Data		no	no	Recipient CMV-antibodies (IgG or Total)	Indeterminate,Non-reactive,Not done,Reactive		Recipient CMV-antibodies (IgG or Total)	Indeterminate,Non-reactive,Not done,Reactive
PRE665	Pre-Transplant	Pre-Transplant Essential Data				Has the patient been infected with COVID-19 (SARS-CoV-2) based on a positive test result at any time prior to the start of the preparative regimen / infusion?	No,Yes		Has the patient been infected with COVID-19 (SARS-CoV-2) based on a positive test result at any time prior to the start of the preparative regimen / infusion?	No,Yes
PRE666	Pre-Transplant	Pre-Transplant Essential Data				Did the patient require hospitalization for management of COVID-19 (SARS-CoV-2) infection?	No,Yes		Did the patient require hospitalization for management of COVID-19 (SARS-CoV-2) infection?	No,Yes
PRE667	Pre-Transplant	Pre-Transplant Essential Data				Was mechanical ventilation given for COVID-19 (SARS-CoV-2) infection?	No,Yes		Was mechanical ventilation given for COVID-19 (SARS-CoV-2) infection?	No,Yes
PRE668	Pre-Transplant	Pre-Transplant Essential Data		no	yes	Was a vaccine for COVID-19 (SARS-CoV-2) received?	No,Unknown,Yes		Was a vaccine for COVID-19 (SARS-CoV-2) received?	No,Unknown,Yes
PRE669	Pre-Transplant	Pre-Transplant Essential Data	COVID-19 Vaccine	yes	yes	Specify vaccine brand	AstraZeneca,Johnson & Johnson/Janssen,Moderna,Novavax,Other (specify),Pfizer-BioNTech		Specify vaccine brand	AstraZeneca,Johnson & Johnson/Janssen,Moderna,Novavax,Other (specify),Pfizer-BioNTech
PRE670	Pre-Transplant	Pre-Transplant Essential Data	COVID-19 Vaccine	yes	yes	Specify other type:	open text		Specify other type:	open text
PRE671	Pre-Transplant	Pre-Transplant Essential Data	COVID-19 Vaccine	yes	yes	Select dose(s) received	Booster dose,First dose (with planned second dose) ,One dose (without planned second dose) ,Second dose,Third dose		Select dose(s) received	Booster dose,First dose (with planned second dose) ,One dose (without planned second dose) ,Second dose,Third dose
PRE672	Pre-Transplant	Pre-Transplant Essential Data	COVID-19 Vaccine	yes	yes	Date received:	YYYY/MM/DD		Date received:	YYYY/MM/DD
PRE673	Pre-Transplant	Pre-Transplant Essential Data	COVID-19 Vaccine	yes	yes	Date estimated	checked		Date estimated	checked
PRE674	Pre-Transplant	Pre-Transplant Essential Data		no	no	Is there a history of mechanical ventilation? (excluding COVID-19 (SARS-CoV-2))?	no,yes		Is there a history of mechanical ventilation? (excluding COVID-19 (SARS-CoV-2))?	no,yes
PRE675	Pre-Transplant	Pre-Transplant Essential Data		no	no	Is there a history of invasive fungal infection?	No,Yes		Is there a history of invasive fungal infection?	No,Yes
PRE676	Pre-Transplant	Pre-Transplant Essential Data		no	no	Does the recipient have known complex congenital heart disease? (corrected or uncorrected) (excluding simple ASD, VSD, or PDA repair) (pediatric only)	No,Yes		Does the recipient have known complex congenital heart disease? (corrected or uncorrected) (excluding simple ASD, VSD, or PDA repair) (pediatric only)	No,Yes
PRE677	Pre-Transplant	Pre-Transplant Essential Data		no	no	Were there any co-existing diseases or organ impairment present according to the HCT comorbidity index (HCT-CI)? (Source: Sorror, M. L. (2013). How I assess comorbidities before hematopoietic cell transplantation. Blood, 121(15), 2854-2863.)	No,Yes		Were there any co-existing diseases or organ impairment present according to the HCT comorbidity index (HCT-CI)? (Source: Sorror, M. L. (2013). How I assess comorbidities before hematopoietic cell transplantation. Blood, 121(15), 2854-2863.)	No,Yes
PRE678	Pre-Transplant	Pre-Transplant Essential Data	Comorbid Conditions	Yes	no	Specify co-existing diseases or organ impairment (check all that apply)	Arrhythmia - Any history of atrial fibrillation or flutter, sick sinus syndrome, or ventricular arrhythmias requiring treatment Cardiac -Any history of coronary artery disease (one or more vessel-coronary artery stenosis requiring medical treatment, stent, or bypass graft), congestive heart failure, myocardial infarction, OR ejection fraction ≤ 50% on the most recent test Cerebrovascular disease -Any history of transient ischemic attack, subarachnoid hemorrhage or cerebral thrombosis, embolism, or hemorrhage Diabetes -Requiring treatment with insulin or oral hypoglycemic drugs in the last 4 weeks but not diet alone Heart valve disease -At least a moderate to severe degree of valve stenosis or insufficiency as determined by Echo; prosthetic mitral or aortic valve; or symptomatic mitral valve prolapse Hepatic, mild - Bilirubin > upper limit of normal to 1.5 × upper limit of normal, or AST/ALT > upper limit of normal to 2.5 × upper limit of normal at the time of transplant OR any history of hepatitis B or hepatitis C infection Hepatic, moderate/severe -Liver cirrhosis, bilirubin > 1.5 × upper limit of normal, or AST/ALT > 2.5 × upper limit of normal Infection -Includes a documented infection, fever of unknown origin, or pulmonary nodules suspicious for fungal pneumonia or a positive PPD test requiring prophylaxis against tuberculosis. Patients must have started antimicrobial treatment before Day 0 with continuation of antimicrobial treatment after Day 0 Inflammatory bowel disease -Any history of Crohn’s disease or ulcerative colitis requiring treatment Obesity -Patients older than 18 years with a body mass index (BMI) > 35 kg/m2 prior to the start of conditioning or a BMI of the 95th percentile of higher for patients aged 18 years or younger Peptic ulcer -Any history of peptic (gastric or duodenal) ulcer confirmed by endoscopy or radiologic diagnosis requiring treatment Psychiatric disturbance -Presence of any mood (e.g., depression), anxiety, or other psychiatric disorder (e.g. bipolar disorder or schizophrenia) requiring continuous treatment in the last 4 weeks Pulmonary, moderate -Corrected diffusion capacity of carbon monoxide and/or FEV1 of 66-80% or dyspnea on slight activity attributed to pulmonary disease at transplant Pulmonary, severe -Corrected diffusion capacity of carbon monoxide and/or FEV1 of ≤ 65% or dyspnea at rest attributed to pulmonary disease or the need for intermittent or continuous oxygen during the 4 weeks prior to transplant Renal, moderate / severe -Serum creatinine > 2 mg/dL or > 177 μmol/L; on dialysis during the 4 weeks prior to transplant; OR prior renal transplantation -go to question 102 Rheumatologic -Any history of a rheumatologic disease (e.g., systemic lupus erythematosis, rheumatoid arthritis, polymyositis, mixed connective tissue disease, or polymyalgia rheumatica, etc.) requiring treatment. (Do NOT include degenerative joint disease, osteoarthritis) Prior malignancy-Treated at any time point in the patient’s past history, other than the primary disease for which this infusion is being performed -go to question 103		Specify co-existing diseases or organ impairment (check all that apply)	Arrhythmia - Any history of atrial fibrillation or flutter, sick sinus syndrome, or ventricular arrhythmias requiring treatment Cardiac -Any history of coronary artery disease (one or more vessel-coronary artery stenosis requiring medical treatment, stent, or bypass graft), congestive heart failure, myocardial infarction, OR ejection fraction ≤ 50% on the most recent test Cerebrovascular disease -Any history of transient ischemic attack, subarachnoid hemorrhage or cerebral thrombosis, embolism, or hemorrhage Diabetes -Requiring treatment with insulin or oral hypoglycemic drugs in the last 4 weeks but not diet alone Heart valve disease -At least a moderate to severe degree of valve stenosis or insufficiency as determined by Echo; prosthetic mitral or aortic valve; or symptomatic mitral valve prolapse Hepatic, mild - Bilirubin > upper limit of normal to 1.5 × upper limit of normal, or AST/ALT > upper limit of normal to 2.5 × upper limit of normal at the time of transplant OR any history of hepatitis B or hepatitis C infection Hepatic, moderate/severe -Liver cirrhosis, bilirubin > 1.5 × upper limit of normal, or AST/ALT > 2.5 × upper limit of normal Infection -Includes a documented infection, fever of unknown origin, or pulmonary nodules suspicious for fungal pneumonia or a positive PPD test requiring prophylaxis against tuberculosis. Patients must have started antimicrobial treatment before Day 0 with continuation of antimicrobial treatment after Day 0 Inflammatory bowel disease -Any history of Crohn’s disease or ulcerative colitis requiring treatment Obesity -Patients older than 18 years with a body mass index (BMI) > 35 kg/m2 prior to the start of conditioning or a BMI of the 95th percentile of higher for patients aged 18 years or younger Peptic ulcer -Any history of peptic (gastric or duodenal) ulcer confirmed by endoscopy or radiologic diagnosis requiring treatment Psychiatric disturbance -Presence of any mood (e.g., depression), anxiety, or other psychiatric disorder (e.g. bipolar disorder or schizophrenia) requiring continuous treatment in the last 4 weeks Pulmonary, moderate -Corrected diffusion capacity of carbon monoxide and/or FEV1 of 66-80% or dyspnea on slight activity attributed to pulmonary disease at transplant Pulmonary, severe -Corrected diffusion capacity of carbon monoxide and/or FEV1 of ≤ 65% or dyspnea at rest attributed to pulmonary disease or the need for intermittent or continuous oxygen during the 4 weeks prior to transplant Renal, moderate / severe -Serum creatinine > 2 mg/dL or > 177 μmol/L; on dialysis during the 4 weeks prior to transplant; OR prior renal transplantation -go to question 102 Rheumatologic -Any history of a rheumatologic disease (e.g., systemic lupus erythematosis, rheumatoid arthritis, polymyositis, mixed connective tissue disease, or polymyalgia rheumatica, etc.) requiring treatment. (Do NOT include degenerative joint disease, osteoarthritis) Prior malignancy-Treated at any time point in the patient’s past history, other than the primary disease for which this infusion is being performed -go to question 103
PRE679	Pre-Transplant	Pre-Transplant Essential Data	Comorbid Conditions	Yes	no	Was the recipient on dialysis immediately prior to start of preparative regimen?	No,Unknown,Yes		Was the recipient on dialysis immediately prior to start of preparative regimen?	No,Unknown,Yes
PRE680	Pre-Transplant	Pre-Transplant Essential Data	Comorbid Conditions	Yes	no	Specify prior malignancy (check all that apply)	Breast cancer Central nervous system (CNS) malignancy (e.g., glioblastoma, astrocytoma) Gastrointestinal malignancy (e.g., colon, rectum, stomach, pancreas, intestine, esophageal) Genitourinary malignancy (e.g., kidney, bladder, ovary, testicle, genitalia, uterus, cervix, prostate) Acute myeloid leukemia Chronic myeloid leukemia Acute lymphoblastic leukemia Chronic lymphoblastic leukemia Leukemia Lung cancer Lymphoma (includes Hodgkin & non-Hodgkin lymphoma) MDS / MPN Melanoma Multiple myeloma / plasma cell disorder (PCD) Oropharyngeal cancer (e.g., tongue, buccal mucosa) Sarcoma Thyroid cancer Other skin malignancy (basal cell, squamous cell) Other hematologic malignancy Other solid tumor		Specify prior malignancy (check all that apply)	Breast cancer Central nervous system (CNS) malignancy (e.g., glioblastoma, astrocytoma) Gastrointestinal malignancy (e.g., colon, rectum, stomach, pancreas, intestine, esophageal) Genitourinary malignancy (e.g., kidney, bladder, ovary, testicle, genitalia, uterus, cervix, prostate) Acute myeloid leukemia Chronic myeloid leukemia Acute lymphoblastic leukemia Chronic lymphoblastic leukemia Lung cancer Lymphoma (includes Hodgkin & non-Hodgkin lymphoma) MDS / MPN Melanoma Multiple myeloma / plasma cell disorder (PCD) Oropharyngeal cancer (e.g., tongue, buccal mucosa) Sarcoma Thyroid cancer Other skin malignancy (basal cell, squamous cell) Other hematologic malignancy Other solid tumor
PRE681	Pre-Transplant	Pre-Transplant Essential Data	Comorbid Conditions	Yes	no	Specify other hematologic malignancy: (prior)	open text		Specify other hematologic malignancy: (prior)	open text
PRE682	Pre-Transplant	Pre-Transplant Essential Data		no	no	Specify other solid tumor: (prior)	open text		Specify other solid tumor: (prior)	open text
PRE683	Pre-Transplant	Pre-Transplant Essential Data		no	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRE684	Pre-Transplant	Pre-Transplant Essential Data		no	no	Upper limit of normal for your institution:	open text		Upper limit of normal for your institution:	open text
PRE685	Pre-Transplant	Pre-Transplant Essential Data		no	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRE686	Pre-Transplant	Pre-Transplant Essential Data		no	no	Did the recipient have a prior solid organ transplant?	No,Yes		Did the recipient have a prior solid organ transplant?	No,Yes
PRE687	Pre-Transplant	Pre-Transplant Essential Data	Prior Solid Organ Transplant	yes	yes	Specify organ	Bowel,Heart,Kidney(s),Liver,Lung,Other organ,Pancreas		Specify organ	Bowel,Heart,Kidney(s),Liver,Lung,Other organ,Pancreas
PRE688	Pre-Transplant	Pre-Transplant Essential Data	Prior Solid Organ Transplant	yes	yes	Specify other organ:	open text		Specify other organ:	open text
PRE689	Pre-Transplant	Pre-Transplant Essential Data	Prior Solid Organ Transplant	yes	yes	Year of prior solid organ transplant:	YYYY		Year of prior solid organ transplant:	YYYY
PRE690	Pre-Transplant	Pre-Transplant Essential Data			yes	First Name (person completing form):	open text		First Name (person completing form):	open text
PRE691	Pre-Transplant	Pre-Transplant Essential Data			yes	Last Name:	open text		Last Name:	open text
PRE692	Pre-Transplant	Pre-Transplant Essential Data			yes	E-mail address:	open text		E-mail address:	open text
PRE693	Pre-Transplant	Pre-Transplant Essential Data		no	no	Glomerular filtration rate (GFR) before start of preparative regimen (pediatric only)	Known,Unknown		Glomerular filtration rate (GFR) before start of preparative regimen (pediatric only)	Known,Unknown
PRE695	Pre-Transplant	Pre-Transplant Essential Data		no	no	Serum ferritin (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	Known,Unknown		Serum ferritin (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	Known,Unknown
PRE696	Pre-Transplant	Pre-Transplant Essential Data		no	no	Serum ferritin (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	___ ___ ___ ___ ___ ng/mL (μg/L)		Serum ferritin (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	___ ___ ___ ___ ___ ng/mL (μg/L)
PRE697	Pre-Transplant	Pre-Transplant Essential Data		no	no	Serum albumin (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	Known,Unknown		Serum albumin (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	Known,Unknown
PRE698	Pre-Transplant	Pre-Transplant Essential Data		no	no	Serum albumin (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	___ ___ ● __g/dL ___ ___ ● __ g/L		Serum albumin (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	___ ___ ● __g/dL ___ ___ ● __ g/L
PRE699	Pre-Transplant	Pre-Transplant Essential Data		no	no	Platelets (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	Known,Unknown		Platelets (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	Known,Unknown
PRE700	Pre-Transplant	Pre-Transplant Essential Data		no	no	Platelets (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	___ ___ ___ ___ ___ ___ ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ___ x 106/L		Platelets (within 4 weeks prior to the start of the preparative regimen, use result closest to the start date)	___ ___ ___ ___ ___ ___ ___ x 109/L (x 103/mm3) ___ ___ ___ ___ ___ ___ ___ x 106/L
PRE701	Pre-Transplant	Pre-Transplant Essential Data		no	no	Were platelets transfused ≤ 7 days before date of test?	No,Unknown,Yes		Were platelets transfused < 7 days before date of test?	No,Unknown,Yes
PRE702	Pre-Transplant	Prior Exposure: Potential Study Eligibility		no	no	Specify if the recipient received any of the following (at any time prior to HCT / infusion) (check all that apply)	Blinatumomab(Blincyto),Gemtuzumab ozogamicin (Mylotarg),Inotuzumab ozogamicin (Besponsa) ,Mogamulizumab (Poteligeo) ,None,Thiotepa		Specify if the recipient received any of the following (at any time prior to HCT / infusion) (check all that apply)	Blinatumomab(Blincyto),Gemtuzumab ozogamicin (Mylotarg),Inotuzumab ozogamicin (Besponsa) ,Mogamulizumab (Poteligeo) ,None,Thiotepa

Sheet 4: Transplant Procedure&Produc

				Information Collection Domain: Transplant Procedure and Product Information
Item ID	Time Point		Information Collection Domain Additional Sub Domain	Response required if Additional Sub Domain applies	Information Collection may be requested multiple times	Current Information Collection Data Element (if applicable)	Current Information Collection Data Element Response Option(s)	Information Collection update:	Proposed Information Collection Data Element (if applicable)	Proposed Information Collection Data Element Response Option(s)	Rationale for Information Collection Update
PRO001	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Registry donor ID:	open text		Registry donor ID:	open text
PRO002	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Non-NMDP cord blood unit ID:	open text		Non-NMDP cord blood unit ID:	open text
PRO003	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Global Registration Identifier for Donors (GRID)	open text		Global Registration Identifier for Donors (GRID)	open text
PRO004	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	ISBT DIN:	open text		ISBT DIN:	open text
PRO005	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Registry or UCB Bank ID	(A) Austrian Bone Marrow Donors,(ACB) Austrian Cord Blood Registry,(ACCB) StemCyte, Inc,(AE) Emirates Bone Marrow Donor Registry,(AM) Armenian Bone Marrow Donor Registry Charitable Trust,(AOCB) University of Colorado Cord Blood Bank,(AR) Argentine CPH Donors Registry,(ARCB) BANCEL - Argentina Cord Blood Bank,(AUCB) Australian Cord Blood Registry,(AUS) Australian / New Zealand Bone Marrow Donor Registry,(B) Marrow Donor Program Belgium,(BCB) Belgium Cord Blood Registry,(BG) Bulgarian Bone Marrow Donor Registry,(BR) INCA/REDOMO,(BSCB) British Bone Marrow Registry - Cord Blood,(CB) Cord Blood Registry,(CH) Swiss BloodStem Cells - Adult Donors,(CHCB) Swiss Blood Stem Cells - Cord Blood,(CKCB) Celgene Cord Blood Bank,(CN) China Marrow Donor Program (CMDP),(CNCB) Shan Dong Cord Blood Bank,(CND) Canadian Blood Services Bone Marrow Donor Registry,(CS2) Czech National Marrow Donor Registry,(CSCR) Czech Stem Cells Registry,(CY) Cyprus Paraskevaidio Bone Marrow Donor Registry,(CY2) The Cyprus Bone Marrow Donor Registry,(D) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Adult Donors,(DCB) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Cord Blood,(DK) The Danish Bone Marrow Donor Registry,(DK2) Bone Marrow Donors Copenhagen (BMDC),(DUCB) German Branch of the European Cord Blood Bank,(E) REDMO,(ECB) Spanish Cord Blood Registry,(F) France Greffe de Moelle - Adult Donors,(FCB) France Greffe de Moelle - Cord Blood,(FI) Finnish Bone Marrow Donor Registry,(FICB) Finnish Cord Blood Registry,(GB) The Anthony Nolan Trust,(GB3) Welsh Bone Marrow Donor Registry,(GB4) British Bone Marrow Registry,(GR) Unrelated Hematopoietic Stem Cell Donor Registry Greece,(GRCB) Michigan Community Blood Centers Cord Blood Bank,(H) Hungarian Bone Marrow Donor Registry,(HEM) Hema-Quebec,(HK) Hong Kong Bone Marrow Donor Registry,(HR) Croatian Bone Marrow Donor Registry,(I) Italian Bone Marrow Donor Registry,(I3CB) Sheba Medical Centre Cord Blood Registry,(ICB) Italian Cord Blood Bank Network,(IL) Hadassah BMDR,(IL2) Ezer Mizion Bone Marrow Donor Registry,(IL3) Sheba Medical Center Donor Registry,(ILCB) Isreal Cord Blood Bank,(IN) Asian Indian Donor Marrow Registry,(IN2) Dept. of Transfusion Medicine,(IRL) The Irish Unrelated Bone Marrow Panel,(JP) Japan Marrow Donor Program,(KR) Korea Marrow Donor Program,(LT) Lithuanian National Bone Marrow Donor Registry,(LVCB) Leuven Cord Blood Bank,(MACB) Victoria Angel Registry of Hope,(MX) Mexican Bone Marrow Donor Registry,(N) The Norwegian Bone Marrow Donor Registry,(NL) Europdonor Foundation- Adult Donors,(NLCB) Europdonor Foundation - Cord Blood,(NYCB) National Cord Blood Program, New York Blood Center,(OTH) Other Registry,(P) Portuguese Bone Marrow Donors Registry,(PL) National Polish Bone Marrow Registry,(PL2) Unrelated Bone Marrow Donor Registry -Adult Donors,(PL3) Against Leukemia Foundation Marrow Donor Registry,(PL4) Ursula Jaworska Foundation - Bone Marrow Donor Registry,(PL5) Polish Central Bone Marrow Donor Registry - Adult Donors,(PMCB) Elie Katz Umbilical Cord Blood Program,(R) Russian Bone Marrow Donor Registry,(R2) Karelian Registry of Unrelated Donors of Hematopoietic Stem Cells,(S) Tobias Registry of Swedish Bone Marrow Donors,(SG) Singapore Bone Marrow Donor Programme (BMDP),(SK) Slovak National Bone Marrow Donor Registry,(SKCB) Eurocord Slovakia / Slovak Pacental Stem Cell Registry,(SLCBB) St Louis Cord Blood Bank,(SLO) Slovenia Donor,(SM) San Marino Bone Marrow Donor Registry,(T1CB) TRAN - Cord Blood,(TACB) StemCyte, Inc. Taiwan,(TECB) Healthbanks Biotech, Co., Ltd,(TH) Thai Stem Cell Donor Registry (TSCDR),(TOCB) Tokyo Cord Blood Bank,(TPCB) BIONET / BabyBanks,(TRAN) TRAN - Adult Donors,(TRIS) Bone Marrow Bank of Istanbul Medical Faculty,(TW) Buddhist Tzu Chi Stem Cells Center - Adult Donors,(TWCB) Buddhist Tzu Chi Stem Cells Center - Cord Blood,(U1CB) National Marrow Donor Program - Cord Blood,(USA1) National Marrow Donor Program - Adult Donors,(USA2) America Bone Marrow Donor Registry,(UY) SINDOME,(VIAC) Viacord,(W3CB) Polish Central Bone Marrow Donor Registry - Cord Blood,(WACB) Unrelated Bone Marrow Donor Registry - Cord Blood,(ZA) South African Bone Marrow Registry		Registry or UCB Bank ID	(A) Austrian Bone Marrow Donors,(ACB) Austrian Cord Blood Registry,(ACCB) StemCyte, Inc,(AE) Emirates Bone Marrow Donor Registry,(AM) Armenian Bone Marrow Donor Registry Charitable Trust,(AOCB) University of Colorado Cord Blood Bank,(AR) Argentine CPH Donors Registry,(ARCB) BANCEL - Argentina Cord Blood Bank,(AUCB) Australian Cord Blood Registry,(AUS) Australian / New Zealand Bone Marrow Donor Registry,(B) Marrow Donor Program Belgium,(BCB) Belgium Cord Blood Registry,(BG) Bulgarian Bone Marrow Donor Registry,(BR) INCA/REDOMO,(BSCB) British Bone Marrow Registry - Cord Blood,(CB) Cord Blood Registry,(CH) Swiss BloodStem Cells - Adult Donors,(CHCB) Swiss Blood Stem Cells - Cord Blood,(CKCB) Celgene Cord Blood Bank,(CN) China Marrow Donor Program (CMDP),(CNCB) Shan Dong Cord Blood Bank,(CND) Canadian Blood Services Bone Marrow Donor Registry,(CS2) Czech National Marrow Donor Registry,(CSCR) Czech Stem Cells Registry,(CY) Cyprus Paraskevaidio Bone Marrow Donor Registry,(CY2) The Cyprus Bone Marrow Donor Registry,(D) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Adult Donors,(DCB) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Cord Blood,(DK) The Danish Bone Marrow Donor Registry,(DK2) Bone Marrow Donors Copenhagen (BMDC),(DUCB) German Branch of the European Cord Blood Bank,(E) REDMO,(ECB) Spanish Cord Blood Registry,(F) France Greffe de Moelle - Adult Donors,(FCB) France Greffe de Moelle - Cord Blood,(FI) Finnish Bone Marrow Donor Registry,(FICB) Finnish Cord Blood Registry,(GB) The Anthony Nolan Trust,(GB3) Welsh Bone Marrow Donor Registry,(GB4) British Bone Marrow Registry,(GR) Unrelated Hematopoietic Stem Cell Donor Registry Greece,(GRCB) Michigan Community Blood Centers Cord Blood Bank,(H) Hungarian Bone Marrow Donor Registry,(HEM) Hema-Quebec,(HK) Hong Kong Bone Marrow Donor Registry,(HR) Croatian Bone Marrow Donor Registry,(I) Italian Bone Marrow Donor Registry,(I3CB) Sheba Medical Centre Cord Blood Registry,(ICB) Italian Cord Blood Bank Network,(IL) Hadassah BMDR,(IL2) Ezer Mizion Bone Marrow Donor Registry,(IL3) Sheba Medical Center Donor Registry,(ILCB) Isreal Cord Blood Bank,(IN) Asian Indian Donor Marrow Registry,(IN2) Dept. of Transfusion Medicine,(IRL) The Irish Unrelated Bone Marrow Panel,(JP) Japan Marrow Donor Program,(KR) Korea Marrow Donor Program,(LT) Lithuanian National Bone Marrow Donor Registry,(LVCB) Leuven Cord Blood Bank,(MACB) Victoria Angel Registry of Hope,(MX) Mexican Bone Marrow Donor Registry,(N) The Norwegian Bone Marrow Donor Registry,(NL) Europdonor Foundation- Adult Donors,(NLCB) Europdonor Foundation - Cord Blood,(NYCB) National Cord Blood Program, New York Blood Center,(OTH) Other Registry,(P) Portuguese Bone Marrow Donors Registry,(PL) National Polish Bone Marrow Registry,(PL2) Unrelated Bone Marrow Donor Registry -Adult Donors,(PL3) Against Leukemia Foundation Marrow Donor Registry,(PL4) Ursula Jaworska Foundation - Bone Marrow Donor Registry,(PL5) Polish Central Bone Marrow Donor Registry - Adult Donors,(PMCB) Elie Katz Umbilical Cord Blood Program,(R) Russian Bone Marrow Donor Registry,(R2) Karelian Registry of Unrelated Donors of Hematopoietic Stem Cells,(S) Tobias Registry of Swedish Bone Marrow Donors,(SG) Singapore Bone Marrow Donor Programme (BMDP),(SK) Slovak National Bone Marrow Donor Registry,(SKCB) Eurocord Slovakia / Slovak Pacental Stem Cell Registry,(SLCBB) St Louis Cord Blood Bank,(SLO) Slovenia Donor,(SM) San Marino Bone Marrow Donor Registry,(T1CB) TRAN - Cord Blood,(TACB) StemCyte, Inc. Taiwan,(TECB) Healthbanks Biotech, Co., Ltd,(TH) Thai Stem Cell Donor Registry (TSCDR),(TOCB) Tokyo Cord Blood Bank,(TPCB) BIONET / BabyBanks,(TRAN) TRAN - Adult Donors,(TRIS) Bone Marrow Bank of Istanbul Medical Faculty,(TW) Buddhist Tzu Chi Stem Cells Center - Adult Donors,(TWCB) Buddhist Tzu Chi Stem Cells Center - Cord Blood,(U1CB) National Marrow Donor Program - Cord Blood,(USA1) National Marrow Donor Program - Adult Donors,(USA2) America Bone Marrow Donor Registry,(UY) SINDOME,(VIAC) Viacord,(W3CB) Polish Central Bone Marrow Donor Registry - Cord Blood,(WACB) Unrelated Bone Marrow Donor Registry - Cord Blood,(ZA) South African Bone Marrow Registry
PRO006	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Donor DOB:	YYYY/MM/DD		Donor DOB:	YYYY/MM/DD
PRO007	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Donor age:	open text, check "Months" or check "Years"		Donor age:	open text, check "Months" or check "Years"
PRO008	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Donor sex	female,male		Donor sex	female,male
PRO009	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specify the person for whom this typing is being done	Donor,Recipient-final typing		Specify the person for whom this typing is being done	Donor,Recipient-final typing
PRO010	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Was documentation submitted to the CIBMTR (e.g. lab report)	No,Yes		Was documentation submitted to the CIBMTR (e.g. lab report)	No,Yes
PRO011	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Locus A	Known,Unknown		Locus A	Known,Unknown
PRO012	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	First A* allele designations:	open text		First A* allele designations:	open text
PRO013	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Second A* allele designations:	open text		Second A* allele designations:	open text
PRO014	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Locus B	Known,Unknown		Locus B	Known,Unknown
PRO015	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	First B* allele designations:	open text		First B* allele designations:	open text
PRO016	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Second B* allele designations:	open text		Second B* allele designations:	open text
PRO017	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Locus C	Known,Unknown		Locus C	Known,Unknown
PRO018	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	First C* allele designations:	open text		First C* allele designations:	open text
PRO019	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Second C* allele designations:	open text		Second C* allele designations:	open text
PRO020	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Locus DRB1	Known,Unknown		Locus DRB1	Known,Unknown
PRO021	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	First DRB1* allele designations:	open text		First DRB1* allele designations:	open text
PRO022	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Second DRB1* allele designations:	open text		Second DRB1* allele designations:	open text
PRO023	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Locus DRB3	Known,Unknown		Locus DRB3	Known,Unknown
PRO024	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	First DRB3* allele designations:	open text		First DRB3* allele designations:	open text
PRO025	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Second DRB3* allele designations:	open text		Second DRB3* allele designations:	open text
PRO026	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Locus DRB4	Known,Unknown		Locus DRB4	Known,Unknown
PRO027	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	First DRB4* allele designations:	open text		First DRB4* allele designations:	open text
PRO028	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Second DRB4* allele designations:	open text		Second DRB4* allele designations:	open text
PRO029	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Locus DRB5	Known,Unknown		Locus DRB5	Known,Unknown
PRO030	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	First DRB5* allele designations:	open text		First DRB5* allele designations:	open text
PRO031	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Second DRB5* allele designations:	open text		Second DRB5* allele designations:	open text
PRO032	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Locus DQB1	Known,Unknown		Locus DQB1	Known,Unknown
PRO033	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	First DQB1* allele designations:	open text		First DQB1* allele designations:	open text
PRO034	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Second DQB1* allele designations:	open text		Second DQB1* allele designations:	open text
PRO035	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Locus DPB1	Known,Unknown		Locus DPB1	Known,Unknown
PRO036	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	First DPB1* allele designations:	open text		First DPB1* allele designations:	open text
PRO037	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Second DPB1* allele designations:	open text		Second DPB1* allele designations:	open text
PRO038	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Locus DQA1	Known,Unknown		Locus DQA1	Known,Unknown
PRO039	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	First DQA1* allele designations:	open text		First DQA1* allele designations:	open text
PRO040	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Second DQA1* allele designations:	open text		Second DQA1* allele designations:	open text
PRO041	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Locus DPA1	Known,Unknown		Locus DPA1	Known,Unknown
PRO042	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	First DPA1* allele designations:	open text		First DPA1* allele designations:	open text
PRO043	Transplant Procedure and Product Information	Confirmation of HLA Typing		no	no	Second DPA1* allele designations:	open text		Second DPA1* allele designations:	open text
PRO044	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	A Antigens. Number of antigens provided	one,two		A Antigens. Number of antigens provided	one,two
PRO045	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 1st antigen	A1,A10,A11,A19,A2,A203,A210,A23(9),A24(9),A2403,A25(10),A26(10),A28,A29(19),A3,A30(19),A31(19),A32(19),A33(19),A34(10),A36,A43,A66(10),A68(28),A69(28),A74(19),A80,A9,AX		Specificity – 1st antigen	A1,A10,A11,A19,A2,A203,A210,A23(9),A24(9),A2403,A25(10),A26(10),A28,A29(19),A3,A30(19),A31(19),A32(19),A33(19),A34(10),A36,A43,A66(10),A68(28),A69(28),A74(19),A80,A9,AX
PRO046	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 2nd antigen	A1,A10,A11,A19,A2,A203,A210,A23(9),A24(9),A2403,A25(10),A26(10),A28,A29(19),A3,A30(19),A31(19),A32(19),A33(19),A34(10),A36,A43,A66(10),A68(28),A69(28),A74(19),A80,A9,AX		Specificity – 2nd antigen	A1,A10,A11,A19,A2,A203,A210,A23(9),A24(9),A2403,A25(10),A26(10),A28,A29(19),A3,A30(19),A31(19),A32(19),A33(19),A34(10),A36,A43,A66(10),A68(28),A69(28),A74(19),A80,A9,AX
PRO047	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	B Antigens. Number of antigens provided	one,two		B Antigens. Number of antigens provided	one,two
PRO048	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 1st antigen	B12,B13,B14,B15,B16,B17,B18,B21,B22,B27,B2708,B35,B37,B38(16),B39(16),B3901,B3902,B40,B4005,B41,B42,B44(12),B45(12),B46,B47,B48,B49(21),B5,B50(21),B51(5),B5102,B5103,B52(5),B53,B54(22),B55(22),B56(22),B57(17),B58(17),B59,B60(40),B61(40),B62(15),B63(15),B64(14),B65(14),B67,B7,B70,B703,B71(70),B72(70),B73,B75(15),B76(15),B77(15),B78,B8,B81,B82,BX		Specificity – 1st antigen	B12,B13,B14,B15,B16,B17,B18,B21,B22,B27,B2708,B35,B37,B38(16),B39(16),B3901,B3902,B40,B4005,B41,B42,B44(12),B45(12),B46,B47,B48,B49(21),B5,B50(21),B51(5),B5102,B5103,B52(5),B53,B54(22),B55(22),B56(22),B57(17),B58(17),B59,B60(40),B61(40),B62(15),B63(15),B64(14),B65(14),B67,B7,B70,B703,B71(70),B72(70),B73,B75(15),B76(15),B77(15),B78,B8,B81,B82,BX
PRO049	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 2nd antigen	B12,B13,B14,B15,B16,B17,B18,B21,B22,B27,B2708,B35,B37,B38(16),B39(16),B3901,B3902,B40,B4005,B41,B42,B44(12),B45(12),B46,B47,B48,B49(21),B5,B50(21),B51(5),B5102,B5103,B52(5),B53,B54(22),B55(22),B56(22),B57(17),B58(17),B59,B60(40),B61(40),B62(15),B63(15),B64(14),B65(14),B67,B7,B70,B703,B71(70),B72(70),B73,B75(15),B76(15),B77(15),B78,B8,B81,B82,BX		Specificity – 2nd antigen	B12,B13,B14,B15,B16,B17,B18,B21,B22,B27,B2708,B35,B37,B38(16),B39(16),B3901,B3902,B40,B4005,B41,B42,B44(12),B45(12),B46,B47,B48,B49(21),B5,B50(21),B51(5),B5102,B5103,B52(5),B53,B54(22),B55(22),B56(22),B57(17),B58(17),B59,B60(40),B61(40),B62(15),B63(15),B64(14),B65(14),B67,B7,B70,B703,B71(70),B72(70),B73,B75(15),B76(15),B77(15),B78,B8,B81,B82,BX
PRO050	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	C Antigens. Number of antigens provided	one,two		C Antigens. Number of antigens provided	one,two
PRO051	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 1st antigen	Cw1,Cw10(W3),Cw2,Cw3,Cw4,Cw5,Cw6,Cw7,Cw8,Cw9(W3),CX		Specificity – 1st antigen	Cw1,Cw10(W3),Cw2,Cw3,Cw4,Cw5,Cw6,Cw7,Cw8,Cw9(W3),CX
PRO052	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 2nd antigen	Cw1,Cw10(W3),Cw2,Cw3,Cw4,Cw5,Cw6,Cw7,Cw8,Cw9(W3),CX		Specificity – 2nd antigen	Cw1,Cw10(W3),Cw2,Cw3,Cw4,Cw5,Cw6,Cw7,Cw8,Cw9(W3),CX
PRO053	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity Bw4 present?	no,yes		Specificity Bw4 present?	no,yes
PRO054	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity Bw6 present?	no,yes		Specificity Bw6 present?	no,yes
PRO055	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	DR Antigens. Number of antigens provided	one,two		DR Antigens. Number of antigens provided	one,two
PRO056	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 1st antigen	DR1,DR10,DR103,DR11(5),DR12(5),DR13(6),DR14(6),DR1403,DR1404,DR15(2),DR16(2),DR17(3),DR18(3),DR2,DR3,DR4,DR5,DR6,DR7,DR8,DR9,DRX		Specificity – 1st antigen	DR1,DR10,DR103,DR11(5),DR12(5),DR13(6),DR14(6),DR1403,DR1404,DR15(2),DR16(2),DR17(3),DR18(3),DR2,DR3,DR4,DR5,DR6,DR7,DR8,DR9,DRX
PRO057	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 2nd antigen	DR1,DR10,DR103,DR11(5),DR12(5),DR13(6),DR14(6),DR1403,DR1404,DR15(2),DR16(2),DR17(3),DR18(3),DR2,DR3,DR4,DR5,DR6,DR7,DR8,DR9,DRX		Specificity – 2nd antigen	DR1,DR10,DR103,DR11(5),DR12(5),DR13(6),DR14(6),DR1403,DR1404,DR15(2),DR16(2),DR17(3),DR18(3),DR2,DR3,DR4,DR5,DR6,DR7,DR8,DR9,DRX
PRO058	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity DR51 present?	no,yes		Specificity DR51 present?	no,yes
PRO059	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity DR52 present?	no,yes		Specificity DR52 present?	no,yes
PRO060	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity DR53 present?	no,yes		Specificity DR53 present?	no,yes
PRO061	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	DQ Antigens. Number of antigens provided	one,two		DQ Antigens. Number of antigens provided	one,two
PRO062	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 1st antigen	DQ1,DQ2,DQ3,DQ4,DQ5(1),DQ6(1),DQ7(3),DQ8(3),DQ9(3),DQX		Specificity – 1st antigen	DQ1,DQ2,DQ3,DQ4,DQ5(1),DQ6(1),DQ7(3),DQ8(3),DQ9(3),DQX
PRO063	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 2nd antigen	DQ1,DQ2,DQ3,DQ4,DQ5(1),DQ6(1),DQ7(3),DQ8(3),DQ9(3),DQX		Specificity – 2nd antigen	DQ1,DQ2,DQ3,DQ4,DQ5(1),DQ6(1),DQ7(3),DQ8(3),DQ9(3),DQX
PRO064	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	DP Antigens. Number of antigens provided	one,two		DP Antigens. Number of antigens provided	one,two
PRO065	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 1st antigen	DPw1,DPw2,DPw3,DPw4,DPw5,DPw6,DPX		Specificity – 1st antigen	DPw1,DPw2,DPw3,DPw4,DPw5,DPw6,DPX
PRO066	Transplant Procedure and Product Information	Confirmation of HLA Typing	Non NMDP Allogeneic or syngeneic Donor / Recipient or Non NMDP Cord Blood Unit Information	yes	no	Specificity – 2nd antigen	DPw1,DPw2,DPw3,DPw4,DPw5,DPw6,DPX		Specificity – 2nd antigen	DPw1,DPw2,DPw3,DPw4,DPw5,DPw6,DPX
PRO067	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion		no	no	HCT type (check only one)	Allogeneic, related,Allogeneic, unrelated,Autologous		HCT type (check only one)	Allogeneic, related,Allogeneic, unrelated,Autologous
PRO068	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Was the donor ever pregnant?	Not applicable (male donor or cord blood unit) ,No,Unknown,Yes		Was the donor ever pregnant?	Not applicable (male donor or cord blood unit) ,No,Unknown,Yes
PRO069	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Number of pregnancies	Known,Unknown		Number of pregnancies	Known,Unknown
PRO070	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Specify number of pregnancies:	open text		Specify number of pregnancies:	open text
PRO071	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Ethnicity (donor)	Hispanic or Latino,Not applicable (not a resident of the USA),Not Hispanic or Latino,Unknown		Ethnicity (donor)	Hispanic or Latino,Not applicable (not a resident of the USA),Not Hispanic or Latino,Unknown
PRO072	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Race (donor) (check all that apply)	American Indian or Alaska Native,Asian,Black or African American,Not reported,Native Hawaiian or Other Pacific Islander,Unknown,White		Race (donor) (check all that apply)	American Indian or Alaska Native,Asian,Black or African American,Not reported,Native Hawaiian or Other Pacific Islander,Unknown,White
PRO073	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Race detail (donor) (check all that apply)	African American,African (both parents born in Africa),South Asian,American Indian, South or Central America,Alaskan Native or Aleut,North American Indian,Black Caribbean,Caribbean Indian,Other White,Eastern European,Filipino (Pilipino),Guamanian,Hawaiian,Japanese,Korean,Mediterranean,Middle Eastern,North American,North Coast of Africa,Chinese,Northern European,Other Pacific Islander,Other Black,Samoan,Black South or Central American,Other Southeast Asian,Unknown,Vietnamese,White Caribbean,Western European,White South or Central American		Race detail (donor) (check all that apply)	African American,African (both parents born in Africa),South Asian,American Indian, South or Central America,Alaskan Native or Aleut,North American Indian,Black Caribbean,Caribbean Indian,Other White,Eastern European,Filipino (Pilipino),Guamanian,Hawaiian,Japanese,Korean,Mediterranean,Middle Eastern,North American,North Coast of Africa,Chinese,Northern European,Other Pacific Islander,Other Black,Samoan,Black South or Central American,Other Southeast Asian,Unknown,Vietnamese,White Caribbean,Western European,White South or Central American
PRO074	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Was the donor a carrier for potentially transferable genetic diseases?	No,Yes		Was the donor a carrier for potentially transferable genetic diseases?	No,Yes
PRO075	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Specify potentially transferable genetic disease (check all that apply)	Other hemoglobinopathy,Other disease,Sickle cell anemia,Thalassemia		Specify potentially transferable genetic disease (check all that apply)	Other hemoglobinopathy,Other disease,Sickle cell anemia,Thalassemia
PRO076	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Specify other disease:	open text		Specify other disease:	open text
PRO077	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Was the donor / product tested for other transferable genetic or clonal abnormalities?	No,Unknown,Yes		Was the donor / product tested for other transferable genetic or clonal abnormalities?	No,Unknown,Yes
PRO078	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Clonal hematopoiesis of indeterminate potential (CHIP)	No,Yes		Clonal hematopoiesis of indeterminate potential (CHIP)	No,Yes
PRO079	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	What was the method of testing used?	open text		What was the method of testing used?	open text
PRO080	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Monoclonal B-cell lymphocytosis	No,Yes		Monoclonal B-cell lymphocytosis	No,Yes
PRO081	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Other transferable genetic or clonal abnormality	No,Yes		Other transferable genetic or clonal abnormality	No,Yes
PRO082	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Non NMDP Allogeneic Donor / Infant Demographic Information	yes	no	Specify other transferable genetic or clonal abnormality:	open text		Specify other transferable genetic or clonal abnormality:	open text
PRO083	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Did this donor have a central line placed?	no,yes		Did this donor have a central line placed?	no,yes
PRO084	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Was the donor hospitalized (inpatient) during or after the collection?	no,yes		Was the donor hospitalized (inpatient) during or after the collection?	no,yes
PRO085	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Did the donor experience any life-threatening complications during or after the collection?	no,yes		Did the donor experience any life-threatening complications during or after the collection?	no,yes
PRO086	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Specify:	open text		Specify:	open text
PRO087	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Did the allogeneic donor give one or more autologous transfusion units?	No,Yes		Did the allogeneic donor give one or more autologous transfusion units?	No,Yes
PRO088	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Date of collection:	YYYY/MM/DD		Date of collection:	YYYY/MM/DD
PRO089	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Number of units:	open text		Number of units:	open text
PRO090	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Did the donor receive blood transfusions as a result of the collection?	Allogeneic transfusions,Autologous transfusions,No		Did the donor receive blood transfusions as a result of the collection?	Allogeneic transfusions,Autologous transfusions,No
PRO091	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Specify number of autologous units:	open text		Specify number of autologous units:	open text
PRO092	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Specify number of allogeneic units:	open text		Specify number of allogeneic units:	open text
PRO093	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Did the donor die as a result of the collection?	no,yes		Did the donor die as a result of the collection?	no,yes
PRO094	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion	Allo Related Donor / Infant Demographic Information	yes	no	Specify cause of death:	open text		Specify cause of death:	open text
PRO095	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion		no	yes	First Name (person completing form):	open text		First Name (person completing form):	open text
PRO096	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion		no	yes	Last Name:	open text		Last Name:	open text
PRO097	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion		no	yes	E-mail address:	open text		E-mail address:	open text
PRO098	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion		no	yes	Date:	YYYY/MM/DD		Date:	YYYY/MM/DD
PRO099	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Product type (check only one)	Bone marrow,Other product,PBSC,Single cord blood unit		Product type	Bone marrow,Other product,PBSC,Single cord blood unit
PRO100	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify:	open text		Specify:	open text
PRO101	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	NMDP Product	No,Yes		NMDP Product	No,Yes
PRO102	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	NMDP cord blood unit ID:	open text		NMDP cord blood unit ID:	open text
PRO103	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	NMDP donor ID:	open text		NMDP donor ID:	open text
PRO104	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Registry donor ID:	open text		Registry donor ID:	open text
PRO105	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Non-NMDP cord blood unit ID:	open text		Non-NMDP cord blood unit ID:	open text
PRO106	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Global Registration Identifier for Donors (GRID)	open text		Global Registration Identifier for Donors (GRID)	open text
PRO107	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	ISBT DIN:	open text		ISBT DIN:	open text
PRO108	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Registry or UCB Bank ID	(A) Austrian Bone Marrow Donors,(ACB) Austrian Cord Blood Registry,(ACCB) StemCyte, Inc,(AE) Emirates Bone Marrow Donor Registry,(AM) Armenian Bone Marrow Donor Registry Charitable Trust,(AOCB) University of Colorado Cord Blood Bank,(AR) Argentine CPH Donors Registry,(ARCB) BANCEL - Argentina Cord Blood Bank,(AUCB) Australian Cord Blood Registry,(AUS) Australian / New Zealand Bone Marrow Donor Registry,(B) Marrow Donor Program Belgium,(BCB) Belgium Cord Blood Registry,(BG) Bulgarian Bone Marrow Donor Registry,(BR) INCA/REDOMO,(BSCB) British Bone Marrow Registry - Cord Blood,(CB) Cord Blood Registry,(CH) Swiss BloodStem Cells - Adult Donors,(CHCB) Swiss Blood Stem Cells - Cord Blood,(CKCB) Celgene Cord Blood Bank,(CN) China Marrow Donor Program (CMDP),(CNCB) Shan Dong Cord Blood Bank,(CND) Canadian Blood Services Bone Marrow Donor Registry,(CS2) Czech National Marrow Donor Registry,(CSCR) Czech Stem Cells Registry,(CY) Cyprus Paraskevaidio Bone Marrow Donor Registry,(CY2) The Cyprus Bone Marrow Donor Registry,(D) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Adult Donors,(DCB) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Cord Blood,(DK) The Danish Bone Marrow Donor Registry,(DK2) Bone Marrow Donors Copenhagen (BMDC),(DUCB) German Branch of the European Cord Blood Bank,(E) REDMO,(ECB) Spanish Cord Blood Registry,(F) France Greffe de Moelle - Adult Donors,(FCB) France Greffe de Moelle - Cord Blood,(FI) Finnish Bone Marrow Donor Registry,(FICB) Finnish Cord Blood Registry,(GB) The Anthony Nolan Trust,(GB3) Welsh Bone Marrow Donor Registry,(GB4) British Bone Marrow Registry,(GR) Unrelated Hematopoietic Stem Cell Donor Registry Greece,(GRCB) Michigan Community Blood Centers Cord Blood Bank,(H) Hungarian Bone Marrow Donor Registry,(HEM) Hema-Quebec,(HK) Hong Kong Bone Marrow Donor Registry,(HR) Croatian Bone Marrow Donor Registry,(I) Italian Bone Marrow Donor Registry,(I3CB) Sheba Medical Centre Cord Blood Registry,(ICB) Italian Cord Blood Bank Network,(IL) Hadassah BMDR,(IL2) Ezer Mizion Bone Marrow Donor Registry,(IL3) Sheba Medical Center Donor Registry,(ILCB) Isreal Cord Blood Bank,(IN) Asian Indian Donor Marrow Registry,(IN2) Dept. of Transfusion Medicine,(IRL) The Irish Unrelated Bone Marrow Panel,(JP) Japan Marrow Donor Program,(KR) Korea Marrow Donor Program,(LT) Lithuanian National Bone Marrow Donor Registry,(LVCB) Leuven Cord Blood Bank,(MACB) Victoria Angel Registry of Hope,(MX) Mexican Bone Marrow Donor Registry,(N) The Norwegian Bone Marrow Donor Registry,(NL) Europdonor Foundation- Adult Donors,(NLCB) Europdonor Foundation - Cord Blood,(NYCB) National Cord Blood Program, New York Blood Center,(OTH) Other Registry,(P) Portuguese Bone Marrow Donors Registry,(PL) National Polish Bone Marrow Registry,(PL2) Unrelated Bone Marrow Donor Registry -Adult Donors,(PL3) Against Leukemia Foundation Marrow Donor Registry,(PL4) Ursula Jaworska Foundation - Bone Marrow Donor Registry,(PL5) Polish Central Bone Marrow Donor Registry - Adult Donors,(PMCB) Elie Katz Umbilical Cord Blood Program,(R) Russian Bone Marrow Donor Registry,(R2) Karelian Registry of Unrelated Donors of Hematopoietic Stem Cells,(S) Tobias Registry of Swedish Bone Marrow Donors,(SG) Singapore Bone Marrow Donor Programme (BMDP),(SK) Slovak National Bone Marrow Donor Registry,(SKCB) Eurocord Slovakia / Slovak Pacental Stem Cell Registry,(SLCBB) St Louis Cord Blood Bank,(SLO) Slovenia Donor,(SM) San Marino Bone Marrow Donor Registry,(T1CB) TRAN - Cord Blood,(TACB) StemCyte, Inc. Taiwan,(TECB) Healthbanks Biotech, Co., Ltd,(TH) Thai Stem Cell Donor Registry (TSCDR),(TOCB) Tokyo Cord Blood Bank,(TPCB) BIONET / BabyBanks,(TRAN) TRAN - Adult Donors,(TRIS) Bone Marrow Bank of Istanbul Medical Faculty,(TW) Buddhist Tzu Chi Stem Cells Center - Adult Donors,(TWCB) Buddhist Tzu Chi Stem Cells Center - Cord Blood,(U1CB) National Marrow Donor Program - Cord Blood,(USA1) National Marrow Donor Program - Adult Donors,(USA2) America Bone Marrow Donor Registry,(UY) SINDOME,(VIAC) Viacord,(W3CB) Polish Central Bone Marrow Donor Registry - Cord Blood,(WACB) Unrelated Bone Marrow Donor Registry - Cord Blood,(ZA) South African Bone Marrow Registry		Registry or UCB Bank ID	(A) Austrian Bone Marrow Donors,(ACB) Austrian Cord Blood Registry,(ACCB) StemCyte, Inc,(AE) Emirates Bone Marrow Donor Registry,(AM) Armenian Bone Marrow Donor Registry Charitable Trust,(AOCB) University of Colorado Cord Blood Bank,(AR) Argentine CPH Donors Registry,(ARCB) BANCEL - Argentina Cord Blood Bank,(AUCB) Australian Cord Blood Registry,(AUS) Australian / New Zealand Bone Marrow Donor Registry,(B) Marrow Donor Program Belgium,(BCB) Belgium Cord Blood Registry,(BG) Bulgarian Bone Marrow Donor Registry,(BR) INCA/REDOMO,(BSCB) British Bone Marrow Registry - Cord Blood,(CB) Cord Blood Registry,(CH) Swiss BloodStem Cells - Adult Donors,(CHCB) Swiss Blood Stem Cells - Cord Blood,(CKCB) Celgene Cord Blood Bank,(CN) China Marrow Donor Program (CMDP),(CNCB) Shan Dong Cord Blood Bank,(CND) Canadian Blood Services Bone Marrow Donor Registry,(CS2) Czech National Marrow Donor Registry,(CSCR) Czech Stem Cells Registry,(CY) Cyprus Paraskevaidio Bone Marrow Donor Registry,(CY2) The Cyprus Bone Marrow Donor Registry,(D) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Adult Donors,(DCB) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Cord Blood,(DK) The Danish Bone Marrow Donor Registry,(DK2) Bone Marrow Donors Copenhagen (BMDC),(DUCB) German Branch of the European Cord Blood Bank,(E) REDMO,(ECB) Spanish Cord Blood Registry,(F) France Greffe de Moelle - Adult Donors,(FCB) France Greffe de Moelle - Cord Blood,(FI) Finnish Bone Marrow Donor Registry,(FICB) Finnish Cord Blood Registry,(GB) The Anthony Nolan Trust,(GB3) Welsh Bone Marrow Donor Registry,(GB4) British Bone Marrow Registry,(GR) Unrelated Hematopoietic Stem Cell Donor Registry Greece,(GRCB) Michigan Community Blood Centers Cord Blood Bank,(H) Hungarian Bone Marrow Donor Registry,(HEM) Hema-Quebec,(HK) Hong Kong Bone Marrow Donor Registry,(HR) Croatian Bone Marrow Donor Registry,(I) Italian Bone Marrow Donor Registry,(I3CB) Sheba Medical Centre Cord Blood Registry,(ICB) Italian Cord Blood Bank Network,(IL) Hadassah BMDR,(IL2) Ezer Mizion Bone Marrow Donor Registry,(IL3) Sheba Medical Center Donor Registry,(ILCB) Isreal Cord Blood Bank,(IN) Asian Indian Donor Marrow Registry,(IN2) Dept. of Transfusion Medicine,(IRL) The Irish Unrelated Bone Marrow Panel,(JP) Japan Marrow Donor Program,(KR) Korea Marrow Donor Program,(LT) Lithuanian National Bone Marrow Donor Registry,(LVCB) Leuven Cord Blood Bank,(MACB) Victoria Angel Registry of Hope,(MX) Mexican Bone Marrow Donor Registry,(N) The Norwegian Bone Marrow Donor Registry,(NL) Europdonor Foundation- Adult Donors,(NLCB) Europdonor Foundation - Cord Blood,(NYCB) National Cord Blood Program, New York Blood Center,(OTH) Other Registry,(P) Portuguese Bone Marrow Donors Registry,(PL) National Polish Bone Marrow Registry,(PL2) Unrelated Bone Marrow Donor Registry -Adult Donors,(PL3) Against Leukemia Foundation Marrow Donor Registry,(PL4) Ursula Jaworska Foundation - Bone Marrow Donor Registry,(PL5) Polish Central Bone Marrow Donor Registry - Adult Donors,(PMCB) Elie Katz Umbilical Cord Blood Program,(R) Russian Bone Marrow Donor Registry,(R2) Karelian Registry of Unrelated Donors of Hematopoietic Stem Cells,(S) Tobias Registry of Swedish Bone Marrow Donors,(SG) Singapore Bone Marrow Donor Programme (BMDP),(SK) Slovak National Bone Marrow Donor Registry,(SKCB) Eurocord Slovakia / Slovak Pacental Stem Cell Registry,(SLCBB) St Louis Cord Blood Bank,(SLO) Slovenia Donor,(SM) San Marino Bone Marrow Donor Registry,(T1CB) TRAN - Cord Blood,(TACB) StemCyte, Inc. Taiwan,(TECB) Healthbanks Biotech, Co., Ltd,(TH) Thai Stem Cell Donor Registry (TSCDR),(TOCB) Tokyo Cord Blood Bank,(TPCB) BIONET / BabyBanks,(TRAN) TRAN - Adult Donors,(TRIS) Bone Marrow Bank of Istanbul Medical Faculty,(TW) Buddhist Tzu Chi Stem Cells Center - Adult Donors,(TWCB) Buddhist Tzu Chi Stem Cells Center - Cord Blood,(U1CB) National Marrow Donor Program - Cord Blood,(USA1) National Marrow Donor Program - Adult Donors,(USA2) America Bone Marrow Donor Registry,(UY) SINDOME,(VIAC) Viacord,(W3CB) Polish Central Bone Marrow Donor Registry - Cord Blood,(WACB) Unrelated Bone Marrow Donor Registry - Cord Blood,(ZA) South African Bone Marrow Registry
PRO109	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Donor DOB:	YYYY/MM/DD		Donor DOB:	YYYY/MM/DD
PRO110	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Donor age:	open text, check "Months" or check "Years"		Donor age:	open text, check "Months" or check "Years"
PRO111	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Donor sex	open text, check "Months" or check "Years"		Donor sex	open text, check "Months" or check "Years"
PRO112	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Allogeneic Donors	yes	no	Did the donor receive growth and mobilizing factors, prior to any stem cell harvest, to enhance the product collection for this HCT?	No,Yes		Did the donor receive growth and mobilizing factors, prior to any stem cell harvest, to enhance the product collection for this HCT?	No,Yes
PRO113	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Allogeneic Donors	yes	no	Specify growth and mobilizing factor(s) (check all that apply)	G-CSF (filgrastim, Neupogen),Pegylated G-CSF(pegfilgrastim, Neulasta) , Plerixafor (Mozobil) Other growth or mobilizing factor(s)		Specify growth and mobilizing factor(s) (check all that apply)	G-CSF (filgrastim, Neupogen),Pegylated G-CSF(pegfilgrastim, Neulasta) , Plerixafor (Mozobil) Other growth or mobilizing factor(s)
PRO114	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Allogeneic Donors	yes	no	Specify other growth or mobilizing factor(s):	open text		Specify other growth or mobilizing factor(s):	open text
PRO115	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Date of first collection for this mobilization:	YYYY/MM/DD		Date of first collection for this mobilization:	YYYY/MM/DD
PRO116	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Were anticoagulants or other agents added to the product between collection and infusion?	No,Yes		Were anticoagulants or other agents added to the product between collection and infusion?	No,Yes
PRO117	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify anticoagulant(s) or other agents (check all that apply)	Acid citrate dextrose (ACD, ACD-A), Citrate phosphate dextrose (CPD, CPD-A), Ethylenediaminetetraacetic acid (EDTA), Heparin, Other agent		Specify anticoagulant(s) or other agents (check all that apply)	Acid citrate dextrose (ACD, ACD-A), Citrate phosphate dextrose (CPD, CPD-A), Ethylenediaminetetraacetic acid (EDTA), Heparin, Other agent
PRO118	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify other agent:	open text		Specify other agent:	open text
PRO119	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Was this product collected off-site and shipped to your facility?	no,yes		Was this product collected off-site and shipped to your facility?	no,yes
PRO120	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Date of receipt of product at your facility:	YYYY/MM/DD		Date of receipt of product at your facility:	YYYY/MM/DD
PRO121	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Time of receipt of product (24-hour clock):	Hour:Minute Check standard time or check daylight savings		Time of receipt of product (24-hour clock):	Hour:Minute Check standard time or check daylight savings
PRO122	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify the shipping environment of the product(s)	Room temperature, Cooled (refrigerator temperature, not frozen), Frozen (cyropreserved), Other shipping enfivronment		Specify the shipping environment of the product(s)	Room temperature, Cooled (refrigerated gel pack, refrigerator temperature, not frozen), Frozen (cyropreserved), Other shipping enfivronment
PRO123	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify other shipping environment:	open text		Specify other shipping environment:	open text
PRO124	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Was there any indication that the environment within the shipper was outside the expected temperature range for this product at any time during shipment?	no,yes		Was there any indication that the environment within the shipper was outside the expected temperature range for this product at any time during shipment?	no,yes
PRO125	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Were the secondary containers (e.g., insulated shipping containers and unit cassette) intact when they arrived at your center?	no,yes		Were the secondary containers (e.g., insulated shipping containers and unit cassette) intact when they arrived at your center?	no,yes
PRO126	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Cord Blood Product Infusion	yes	no	Was the cord blood unit stored at your center prior to thawing?	no,yes		Was the cord blood unit stored at your center prior to thawing?	no,yes
PRO127	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Cord Blood Product Infusion	yes	no	Specify the storage method used for the cord blood unit	Electric freezer,Liquid nitrogen,Vapor phase		Specify the storage method used for the cord blood unit	Electric freezer,Liquid nitrogen,Vapor phase
PRO128	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Cord Blood Product Infusion	yes	no	Temperature during storage	< -150 0C , > -150 0C to < -135 0C , > -135 0C to < -80 0C, > -80 0C		Temperature during storage	< -150 0C , > -150 0C to < -135 0C , > -135 0C to < -80 0C, > -80 0C
PRO129	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Date storage started:	YYYY/MM/DD		Date storage started:	YYYY/MM/DD
PRO130	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Cord Blood Product Infusion	yes	no	Total nucleated cells: (Includes nucleated red and nucleated white cells)	_ _ _ _ . __ __ x 10 __ __ (Includes nucleated red and nucleated white cells) (Cord blood units only)		Total nucleated cells: (Includes nucleated red and nucleated white cells)	_ _ _ _ . __ __ x 10 __ __ (Includes nucleated red and nucleated white cells) (Cord blood units only)
PRO131	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Cord Blood Product Infusion	yes	no	CD34+ cells	Done,Not done		CD34+ cells	Done,Not done
PRO132	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Cord Blood Product Infusion	yes	no	Total number of CD34+ cells:	_ _ _ _ . __ __ x 10 __ __		Total number of CD34+ cells:	_ _ _ _ . __ __ x 10 __ __
PRO133	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Was the product thawed from a cryopreserved state prior to infusion?	no,yes		Was the product thawed from a cryopreserved state prior to infusion?	no,yes
PRO134	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Was the entire product thawed?	no,yes		Was the entire product thawed?	no,yes
PRO135	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Cord Blood Product Infusion	yes	no	Specify the percent of the product that was thawed? (Cord Blood units only)	20%,80%,Other percent		Specify the percent of the product that was thawed? (Cord Blood units only)	20%,80%,Other percent
PRO136	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product	Cord Blood Product Infusion	yes	no	Specify other percent:	_ _%		Specify other percent:	_ _%
PRO137	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Date thawing process initiated:	YYYY/MM/DD		Date thawing process initiated:	YYYY/MM/DD
PRO138	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Time at initiation of thaw (24-hour clock):	Hour:Minute Check "standard time" or "check daylight savings time"		Time at initiation of thaw (24-hour clock):	Hour:Minute Check "standard time" or "check daylight savings time"
PRO139	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Time of thaw completion:	Hour:Minute Check "standard time" or "check daylight savings time"		Time of thaw completion:	Hour:Minute Check "standard time" or "check daylight savings time"
PRO140	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	What method was used to thaw the product?	Electric warmer,Other method,Waterbath		What method was used to thaw the product?	Electric warmer,Other method,Waterbath
PRO141	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify other method:	open text		Specify other method:	open text
PRO142	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Did any incidents or product complaints occur while preparing or thawing the product?	No,Yes		Did any incidents or product complaints occur while preparing or thawing the product?	No,Yes
PRO143	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Was the product processed prior to infusion?	No,Yes		Was the product processed prior to infusion?	No,Yes
PRO144	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify processing (check all that apply)	Buffy coat enriched (buffy coat preparation) ,Diluted,Plasma reduced,RBC reduced,Washed		Specify processing (check all that apply)	Buffy coat enriched (buffy coat preparation) ,Diluted,Plasma reduced,RBC reduced,Washed
PRO145	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Was the product manipulated prior to infusion?	no,yes		Was the product manipulated prior to infusion?	no,yes
PRO146	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify manipulations performed (check all that apply)	CD34 enriched (CD34+ selection), Ex-vivo expansion, Ex-vivo T-cell depetion, Genetic manipulation (gene transfer / transuction), Other cell manipulation		Specify manipulations performed (check all that apply)	CD34 enriched (CD34+ selection), Ex-vivo expansion, Ex-vivo T-cell depetion, Genetic manipulation (gene transfer / transuction), Other cell manipulation
PRO147	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify antibodies used (check all that apply)	Alpha/beta antibody,Anti CD19,Anti CD3,Anti CD4,Anti CD45RA,Anti CD52,Anti CD8,Other antibody		Specify antibodies used (check all that apply)	Alpha/beta antibody,Anti CD19,Anti CD3,Anti CD4,Anti CD45RA,Anti CD52,Anti CD8,Other antibody
PRO148	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify other antibody:	open text		Specify other antibody:	open text
PRO149	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify T-cell depletion method	Antibody affinity column,Immunomagnetic beads,Other Method		Specify T-cell depletion method	Antibody affinity column,Immunomagnetic beads,Other Method
PRO150	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify other method:	open text		Specify other method:	open text
PRO151	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	no	Specify other cell manipulation:	open text		Specify other cell manipulation:	open text
PRO152	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Specify the timepoint in the product preparation phase that the product was analyzed	Product arrival (cord blood only) , At infusion (final quantity infused)		Specify the timepoint in the product preparation phase that the product was analyzed	Product arrival (cord blood only) , At infusion (final quantity infused)
PRO153	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Date of product analysis:	YYYY/MM/DD		Date of product analysis:	YYYY/MM/DD
PRO154	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Total volume of product plus additives:	_ _ _ _ _ . _ ml		Total volume of product plus additives:	_ _ _ _ _ . _ ml
PRO155	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Total nucleated cells (TNC)	Done,Not done		Total nucleated cells (TNC)	Done,Not done
PRO156	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Total nucleated cells:	_ _ _ _ . __ __ x 10 __ __		Total nucleated cells:	_ _ _ _ . __ __ x 10 __ __
PRO157	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Viability of TNC	Done,Not done,Unknown		Viability of TNC	Done,Not done,Unknown
PRO158	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Viability of TNC:	_ _ _ %		Viability of TNC:	_ _ _ %
PRO159	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Method of testing TNC viability	Flow cytometry based,Other method,Trypan blue		Method of testing TNC viability	Flow cytometry based (7AAD, AOPI, AOEB),Other method,Trypan blue
PRO160	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Specify other method:	open text		Specify other method:	open text
PRO161	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Nucleated white blood cells	Done,Not done		Nucleated white blood cells	Done,Not done
PRO162	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Total number of nucleated white blood cells:	_ _ _ _ . __ __ x 10 __ __		Total number of nucleated white blood cells:	_ _ _ _ . __ __ x 10 __ __
PRO163	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Mononuclear cells	Done,Not done		Mononuclear cells	Done,Not done
PRO164	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Total number of mononuclear cells:	_ _ _ _ . __ __ x 10 __ __		Total number of mononuclear cells:	_ _ _ _ . __ __ x 10 __ __
PRO165	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Nucleated red blood cells	Done,Not done		Nucleated red blood cells	Done,Not done
PRO166	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Total number of nucleated red blood cells:	_ _ _ _ . __ __ x 10 __ __		Total number of nucleated red blood cells:	_ _ _ _ . __ __ x 10 __ __
PRO167	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	CD34+ cells	Done,Not done		CD34+ cells	Done,Not done
PRO168	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Total number of CD34+ cells:	_ _ _ _ . __ __ x 10 __ __		Total number of CD34+ cells:	_ _ _ _ . __ __ x 10 __ __
PRO169	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Viability of CD34+ cells	Done,Not done,Unknown		Viability of CD34+ cells	Done,Not done,Unknown
PRO170	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Viability of CD34+ cells:	_ _ _%		Viability of CD34+ cells:	_ _ _%
PRO171	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Method of testing CD34+ cell viability	Flow cytometry based,Other method,Trypan blue		Method of testing CD34+ cell viability	Flow cytometry based (7AAD, AOPI, AOEB), Other method,Trypan blue
PRO172	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Specify other method:	open text		Specify other method:	open text
PRO173	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	CD3+ cells	Done,Not done		CD3+ cells	Done,Not done
PRO174	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Viability of CD3+ cells	Done,Not done,Unknown		Viability of CD3+ cells	Done,Not done,Unknown
PRO175	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Total number of CD3+ cells:	_ _ _ _ . __ __ x 10 __ __		Total number of CD3+ cells:	_ _ _ _ . __ __ x 10 __ __
PRO176	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Viability of CD3+ cells:	_ _ _%		Viability of CD3+ cells:	_ _ _%
PRO177	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Method of testing CD3+ cell viability	Flow cytometry based,Other method,Trypan blue		Method of testing CD3+ cell viability	Flow cytometry based (7AAD, AOPI, AOEB), Other method,Trypan blue
PRO178	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Specify other method:	open text		Specify other method:	open text
PRO179	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	CD3+CD4+ cells	Done,Not done		CD3+CD4+ cells	Done,Not done
PRO180	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Total number of CD3+CD4+ cells:	_ _ _ _ . __ __ x 10 __ __		Total number of CD3+CD4+ cells:	_ _ _ _ . __ __ x 10 __ __
PRO181	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Viability of CD3+CD4+ cells	Done,Not done,Unknown		Viability of CD3+CD4+ cells	Done,Not done,Unknown
PRO182	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Viability of CD3+CD4+ cells:	_ _ _%		Viability of CD3+CD4+ cells:	_ _ _%
PRO183	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Method of testing CD3+CD4+ cell viability	Flow cytometry based,Other method,Trypan blue		Method of testing CD3+CD4+ cell viability	Flow cytometry based (7AAD, AOPI, AOEB), Other method,Trypan blue
PRO184	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Specify other method:	open text		Specify other method:	open text
PRO185	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	CD3+CD8+ cells	Done,Not done		CD3+CD8+ cells	Done,Not done
PRO186	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Total number of CD3+CD8+ cells:	_ _ _ _ *_ _ x 10 _ _		Total number of CD3+CD8+ cells:	_ _ _ _ *_ _ x 10 _ _
PRO187	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Viability of CD3+CD8+ cells	Done,Not done,Unknown		Viability of CD3+CD8+ cells	Done,Not done,Unknown
PRO188	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Viability of CD3+CD8+ cells:	_ _ _%		Viability of CD3+CD8+ cells:	_ _ _%
PRO189	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Method of testing CD3+CD8+ cell viability	Flow cytometry based,Other method,Trypan blue		Method of testing CD3+CD8+ cell viability	Flow cytometry based (7AAD, AOPI, AOEB), Other method,Trypan blue
PRO190	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Infusion Product		no	yes	Specify other method:	open text		Specify other method:	open text
PRO191	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	yes	Were the colony-forming units (CFU) assessed after thawing? (cord blood units only)	no,yes		Were the colony-forming units (CFU) assessed after thawing? (cord blood units only)	no,yes
PRO192	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	yes	Was there growth?	no,yes		Was there growth?	no,yes
PRO193	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	yes	Total CFU-GM	Done,Not done		Indicate which Assessments were Carried out (Check all that apply)	Total CFU-GM, Total CFU-GEMM, Total BFU-E
PRO194	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	yes	Total CFU-GM:	_ _ _ _ _.__x10__ __		Total CFU-GM:	_ _ _ _ _.__x10__ __
PRO195	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	yes	Total CFU-GEMM:	_ _ _ _ _.__x10__ __		Total CFU-GEMM:	_ _ _ _ _.__x10__ __
PRO196	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	yes	Total BFU-E:	_ _ _ _ _.__x10__ __		Total BFU-E:	_ _ _ _ _.__x10__ __
PRO197	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Were any positive cultures (for bacterial or fungal infections) obtained from the product at the transplant center? (complete for all cell products)	No,Pending,Unknown,Yes		Were any positive cultures (for bacterial or fungal infections) obtained from the product at the transplant center? (complete for all cell products)	No,Pending,Unknown,Yes
PRO198	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Product Analysis	yes	yes	Specify Organism Code(s):	Bacterial Infections: 121 inetobacter (all species), 125 Bordetella pertussis (whooping cough), 128 Campylobacter (all species), 129 Capnocytophaga (all species), 171 Chlamydia (pneumoniae), 130 Citrobacter (freundii, other species), 131 Clostridium (all species except difficile), 132 Clostridium difficile, 173 Corynebacterium jeikeium, 134 Enterobacter (all species), 135 Enterococcus (all species), 177 Enterococcus, vancomycin resistant (VRE), 136 Escherichia (also E. coli), 139 Fusobacterium (all species), 187 Haemophilus influenzae, 188 Haemophilus non-influenzae, 146 Klebsiella (all species), 147 Lactobacillus (bulgaricus, acidophilus, other species), 189 Legionella pneumophila, 190 Legionella non-pneumophila, 103 Leptospira (all species), 148 Leptotrichia buccalis, 149 Leuconostoc (all species), 104 Listeria monocytogenes, 151 Micrococcus, NOS, 118 Mycobacterium abscessus, 112 Mycobacterium avium - intracellulare (MAC, MAI), 108 Mycobacterium cheloneae, 109 Mycobacterium fortuitum, 114 Mycobacterium haemophilum, 115 Mycobacterium kansasii, 116 Mycobacterium marinum, 117 Mycobacterium mucogenicum, 110 Mycobacterium tuberculosis (tuberculosis, Koch bacillus), 105 Mycoplasma (all species), 183 Neisseria gonorrhoeae, 184 Neisseria meningitidis, 106 Nocardia (all species), 153 Pasteurella multocida, 155 Proteus (all species), 157 Pseudomonas or Burkholderia cepacia, 185 Pseudomonas aeruginosa, 186 Pseudomonas non-aeruginosa, 159 Rhodococcus (all species), 107 Rickettsia (all species), 160 Salmonella (all species), 161 Serratia marcescens,162 Shigella (all species), 180 Staphylococcus aureus (Methacillin Resistant), 179 Staphylococcus aureus (Methacillin Sensitive), 158 Stenotrophomonas maltophilia, 166 Stomatococcus mucilaginosis, 181 Streptococcus, alpha-hemolytic, 182 Streptococcus, Group B, 178 Streptococcus pneumoniae, 168 Treponema (syphilis), 169 Vibrio (all species) Fungal Infections: 210 Aspergillus, NOS, 211 Aspergillus flavus, 212 Aspergillus fumigatus, 213 Aspergillus niger, 215 Aspergillus terreus, 214 Aspergillus ustus, 270 Blastomyces (dermatitidis), 201 Candida albicans, 208 Candida non-albicans, 271 Coccidioides (all species), 222 Cryptococcus gattii, 221 Cryptococcus neoformans, 230 Fusarium (all species), 261 Histoplasma (capsulatum), 241 Mucorales (all species), 260 Pneumocystis (PCP / PJP), 242 Rhizopus (all species), 272 Scedosporium (all species), 240 Zygomycetes, NOS, 503 Suspected fungal infection, 777 Other organism		Specify Organism Code(s):	Bacterial Infections: 121 inetobacter (all species), 125 Bordetella pertussis (whooping cough), 128 Campylobacter (all species), 129 Capnocytophaga (all species), 171 Chlamydia (pneumoniae), 130 Citrobacter (freundii, other species), 131 Clostridium (all species except difficile), 132 Clostridium difficile, 173 Corynebacterium jeikeium, 134 Enterobacter (all species), 135 Enterococcus (all species), 177 Enterococcus, vancomycin resistant (VRE), 136 Escherichia (also E. coli), 139 Fusobacterium (all species), 187 Haemophilus influenzae, 188 Haemophilus non-influenzae, 146 Klebsiella (all species), 147 Lactobacillus (bulgaricus, acidophilus, other species), 189 Legionella pneumophila, 190 Legionella non-pneumophila, 103 Leptospira (all species), 148 Leptotrichia buccalis, 149 Leuconostoc (all species), 104 Listeria monocytogenes, 151 Micrococcus, NOS, 118 Mycobacterium abscessus, 112 Mycobacterium avium - intracellulare (MAC, MAI), 108 Mycobacterium cheloneae, 109 Mycobacterium fortuitum, 114 Mycobacterium haemophilum, 115 Mycobacterium kansasii, 116 Mycobacterium marinum, 117 Mycobacterium mucogenicum, 110 Mycobacterium tuberculosis (tuberculosis, Koch bacillus), 105 Mycoplasma (all species), 183 Neisseria gonorrhoeae, 184 Neisseria meningitidis, 106 Nocardia (all species), 153 Pasteurella multocida, 155 Proteus (all species), 157 Pseudomonas or Burkholderia cepacia, 185 Pseudomonas aeruginosa, 186 Pseudomonas non-aeruginosa, 159 Rhodococcus (all species), 107 Rickettsia (all species), 160 Salmonella (all species), 161 Serratia marcescens,162 Shigella (all species), 180 Staphylococcus aureus (Methicillin Resistant), 179 Staphylococcus aureus (Methicillin Sensitive), 158 Stenotrophomonas maltophilia, 166 Stomatococcus mucilaginosis, 181 Streptococcus, alpha-hemolytic, 182 Streptococcus, Group B, 178 Streptococcus pneumoniae, 168 Treponema (syphilis), 169 Vibrio (all species) Fungal Infections: 210 Aspergillus, NOS, 211 Aspergillus flavus, 212 Aspergillus fumigatus, 213 Aspergillus niger, 215 Aspergillus terreus, 214 Aspergillus ustus, 270 Blastomyces (dermatitidis), 201 Candida albicans, 208 Candida non-albicans, 271 Coccidioides (all species), 222 Cryptococcus gattii, 221 Cryptococcus neoformans, 230 Fusarium (all species), 261 Histoplasma (capsulatum), 241 Mucorales (all species), 260 Pneumocystis (PCP / PJP), 242 Rhizopus (all species), 272 Scedosporium (all species), 240 Zygomycetes, NOS, 503 Suspected fungal infection, 777 Other organism
PRO199	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Product Analysis	yes	yes	Specify Organism Code(s):	Bacterial Infections: 121 inetobacter (all species), 125 Bordetella pertussis (whooping cough), 128 Campylobacter (all species), 129 Capnocytophaga (all species), 171 Chlamydia (pneumoniae), 130 Citrobacter (freundii, other species), 131 Clostridium (all species except difficile), 132 Clostridium difficile, 173 Corynebacterium jeikeium, 134 Enterobacter (all species), 135 Enterococcus (all species), 177 Enterococcus, vancomycin resistant (VRE), 136 Escherichia (also E. coli), 139 Fusobacterium (all species), 187 Haemophilus influenzae, 188 Haemophilus non-influenzae, 146 Klebsiella (all species), 147 Lactobacillus (bulgaricus, acidophilus, other species), 189 Legionella pneumophila, 190 Legionella non-pneumophila, 103 Leptospira (all species), 148 Leptotrichia buccalis, 149 Leuconostoc (all species), 104 Listeria monocytogenes, 151 Micrococcus, NOS, 118 Mycobacterium abscessus, 112 Mycobacterium avium - intracellulare (MAC, MAI), 108 Mycobacterium cheloneae, 109 Mycobacterium fortuitum, 114 Mycobacterium haemophilum, 115 Mycobacterium kansasii, 116 Mycobacterium marinum, 117 Mycobacterium mucogenicum, 110 Mycobacterium tuberculosis (tuberculosis, Koch bacillus), 105 Mycoplasma (all species), 183 Neisseria gonorrhoeae, 184 Neisseria meningitidis, 106 Nocardia (all species), 153 Pasteurella multocida, 155 Proteus (all species), 157 Pseudomonas or Burkholderia cepacia, 185 Pseudomonas aeruginosa, 186 Pseudomonas non-aeruginosa, 159 Rhodococcus (all species), 107 Rickettsia (all species), 160 Salmonella (all species), 161 Serratia marcescens,162 Shigella (all species), 180 Staphylococcus aureus (Methacillin Resistant), 179 Staphylococcus aureus (Methacillin Sensitive), 158 Stenotrophomonas maltophilia, 166 Stomatococcus mucilaginosis, 181 Streptococcus, alpha-hemolytic, 182 Streptococcus, Group B, 178 Streptococcus pneumoniae, 168 Treponema (syphilis), 169 Vibrio (all species) Fungal Infections: 210 Aspergillus, NOS, 211 Aspergillus flavus, 212 Aspergillus fumigatus, 213 Aspergillus niger, 215 Aspergillus terreus, 214 Aspergillus ustus, 270 Blastomyces (dermatitidis), 201 Candida albicans, 208 Candida non-albicans, 271 Coccidioides (all species), 222 Cryptococcus gattii, 221 Cryptococcus neoformans, 230 Fusarium (all species), 261 Histoplasma (capsulatum), 241 Mucorales (all species), 260 Pneumocystis (PCP / PJP), 242 Rhizopus (all species), 272 Scedosporium (all species), 240 Zygomycetes, NOS, 503 Suspected fungal infection, 777 Other organism		Specify Organism Code(s):	Bacterial Infections: 121 inetobacter (all species), 125 Bordetella pertussis (whooping cough), 128 Campylobacter (all species), 129 Capnocytophaga (all species), 171 Chlamydia (pneumoniae), 130 Citrobacter (freundii, other species), 131 Clostridium (all species except difficile), 132 Clostridium difficile, 173 Corynebacterium jeikeium, 134 Enterobacter (all species), 135 Enterococcus (all species), 177 Enterococcus, vancomycin resistant (VRE), 136 Escherichia (also E. coli), 139 Fusobacterium (all species), 187 Haemophilus influenzae, 188 Haemophilus non-influenzae, 146 Klebsiella (all species), 147 Lactobacillus (bulgaricus, acidophilus, other species), 189 Legionella pneumophila, 190 Legionella non-pneumophila, 103 Leptospira (all species), 148 Leptotrichia buccalis, 149 Leuconostoc (all species), 104 Listeria monocytogenes, 151 Micrococcus, NOS, 118 Mycobacterium abscessus, 112 Mycobacterium avium - intracellulare (MAC, MAI), 108 Mycobacterium cheloneae, 109 Mycobacterium fortuitum, 114 Mycobacterium haemophilum, 115 Mycobacterium kansasii, 116 Mycobacterium marinum, 117 Mycobacterium mucogenicum, 110 Mycobacterium tuberculosis (tuberculosis, Koch bacillus), 105 Mycoplasma (all species), 183 Neisseria gonorrhoeae, 184 Neisseria meningitidis, 106 Nocardia (all species), 153 Pasteurella multocida, 155 Proteus (all species), 157 Pseudomonas or Burkholderia cepacia, 185 Pseudomonas aeruginosa, 186 Pseudomonas non-aeruginosa, 159 Rhodococcus (all species), 107 Rickettsia (all species), 160 Salmonella (all species), 161 Serratia marcescens,162 Shigella (all species), 180 Staphylococcus aureus (Methicillin Resistant), 179 Staphylococcus aureus (Methicillin Sensitive), 158 Stenotrophomonas maltophilia, 166 Stomatococcus mucilaginosis, 181 Streptococcus, alpha-hemolytic, 182 Streptococcus, Group B, 178 Streptococcus pneumoniae, 168 Treponema (syphilis), 169 Vibrio (all species) Fungal Infections: 210 Aspergillus, NOS, 211 Aspergillus flavus, 212 Aspergillus fumigatus, 213 Aspergillus niger, 215 Aspergillus terreus, 214 Aspergillus ustus, 270 Blastomyces (dermatitidis), 201 Candida albicans, 208 Candida non-albicans, 271 Coccidioides (all species), 222 Cryptococcus gattii, 221 Cryptococcus neoformans, 230 Fusarium (all species), 261 Histoplasma (capsulatum), 241 Mucorales (all species), 260 Pneumocystis (PCP / PJP), 242 Rhizopus (all species), 272 Scedosporium (all species), 240 Zygomycetes, NOS, 503 Suspected fungal infection, 777 Other organism
PRO200	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Product Analysis	yes	yes	Specify Organism Code(s):	Bacterial Infections: 121 inetobacter (all species), 125 Bordetella pertussis (whooping cough), 128 Campylobacter (all species), 129 Capnocytophaga (all species), 171 Chlamydia (pneumoniae), 130 Citrobacter (freundii, other species), 131 Clostridium (all species except difficile), 132 Clostridium difficile, 173 Corynebacterium jeikeium, 134 Enterobacter (all species), 135 Enterococcus (all species), 177 Enterococcus, vancomycin resistant (VRE), 136 Escherichia (also E. coli), 139 Fusobacterium (all species), 187 Haemophilus influenzae, 188 Haemophilus non-influenzae, 146 Klebsiella (all species), 147 Lactobacillus (bulgaricus, acidophilus, other species), 189 Legionella pneumophila, 190 Legionella non-pneumophila, 103 Leptospira (all species), 148 Leptotrichia buccalis, 149 Leuconostoc (all species), 104 Listeria monocytogenes, 151 Micrococcus, NOS, 118 Mycobacterium abscessus, 112 Mycobacterium avium - intracellulare (MAC, MAI), 108 Mycobacterium cheloneae, 109 Mycobacterium fortuitum, 114 Mycobacterium haemophilum, 115 Mycobacterium kansasii, 116 Mycobacterium marinum, 117 Mycobacterium mucogenicum, 110 Mycobacterium tuberculosis (tuberculosis, Koch bacillus), 105 Mycoplasma (all species), 183 Neisseria gonorrhoeae, 184 Neisseria meningitidis, 106 Nocardia (all species), 153 Pasteurella multocida, 155 Proteus (all species), 157 Pseudomonas or Burkholderia cepacia, 185 Pseudomonas aeruginosa, 186 Pseudomonas non-aeruginosa, 159 Rhodococcus (all species), 107 Rickettsia (all species), 160 Salmonella (all species), 161 Serratia marcescens,162 Shigella (all species), 180 Staphylococcus aureus (Methacillin Resistant), 179 Staphylococcus aureus (Methacillin Sensitive), 158 Stenotrophomonas maltophilia, 166 Stomatococcus mucilaginosis, 181 Streptococcus, alpha-hemolytic, 182 Streptococcus, Group B, 178 Streptococcus pneumoniae, 168 Treponema (syphilis), 169 Vibrio (all species) Fungal Infections: 210 Aspergillus, NOS, 211 Aspergillus flavus, 212 Aspergillus fumigatus, 213 Aspergillus niger, 215 Aspergillus terreus, 214 Aspergillus ustus, 270 Blastomyces (dermatitidis), 201 Candida albicans, 208 Candida non-albicans, 271 Coccidioides (all species), 222 Cryptococcus gattii, 221 Cryptococcus neoformans, 230 Fusarium (all species), 261 Histoplasma (capsulatum), 241 Mucorales (all species), 260 Pneumocystis (PCP / PJP), 242 Rhizopus (all species), 272 Scedosporium (all species), 240 Zygomycetes, NOS, 503 Suspected fungal infection, 777 Other organism		Specify Organism Code(s):	Bacterial Infections: 121 inetobacter (all species), 125 Bordetella pertussis (whooping cough), 128 Campylobacter (all species), 129 Capnocytophaga (all species), 171 Chlamydia (pneumoniae), 130 Citrobacter (freundii, other species), 131 Clostridium (all species except difficile), 132 Clostridium difficile, 173 Corynebacterium jeikeium, 134 Enterobacter (all species), 135 Enterococcus (all species), 177 Enterococcus, vancomycin resistant (VRE), 136 Escherichia (also E. coli), 139 Fusobacterium (all species), 187 Haemophilus influenzae, 188 Haemophilus non-influenzae, 146 Klebsiella (all species), 147 Lactobacillus (bulgaricus, acidophilus, other species), 189 Legionella pneumophila, 190 Legionella non-pneumophila, 103 Leptospira (all species), 148 Leptotrichia buccalis, 149 Leuconostoc (all species), 104 Listeria monocytogenes, 151 Micrococcus, NOS, 118 Mycobacterium abscessus, 112 Mycobacterium avium - intracellulare (MAC, MAI), 108 Mycobacterium cheloneae, 109 Mycobacterium fortuitum, 114 Mycobacterium haemophilum, 115 Mycobacterium kansasii, 116 Mycobacterium marinum, 117 Mycobacterium mucogenicum, 110 Mycobacterium tuberculosis (tuberculosis, Koch bacillus), 105 Mycoplasma (all species), 183 Neisseria gonorrhoeae, 184 Neisseria meningitidis, 106 Nocardia (all species), 153 Pasteurella multocida, 155 Proteus (all species), 157 Pseudomonas or Burkholderia cepacia, 185 Pseudomonas aeruginosa, 186 Pseudomonas non-aeruginosa, 159 Rhodococcus (all species), 107 Rickettsia (all species), 160 Salmonella (all species), 161 Serratia marcescens,162 Shigella (all species), 180 Staphylococcus aureus (Methicillin Resistant), 179 Staphylococcus aureus (Methicillin Sensitive), 158 Stenotrophomonas maltophilia, 166 Stomatococcus mucilaginosis, 181 Streptococcus, alpha-hemolytic, 182 Streptococcus, Group B, 178 Streptococcus pneumoniae, 168 Treponema (syphilis), 169 Vibrio (all species) Fungal Infections: 210 Aspergillus, NOS, 211 Aspergillus flavus, 212 Aspergillus fumigatus, 213 Aspergillus niger, 215 Aspergillus terreus, 214 Aspergillus ustus, 270 Blastomyces (dermatitidis), 201 Candida albicans, 208 Candida non-albicans, 271 Coccidioides (all species), 222 Cryptococcus gattii, 221 Cryptococcus neoformans, 230 Fusarium (all species), 261 Histoplasma (capsulatum), 241 Mucorales (all species), 260 Pneumocystis (PCP / PJP), 242 Rhizopus (all species), 272 Scedosporium (all species), 240 Zygomycetes, NOS, 503 Suspected fungal infection, 777 Other organism
PRO201	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Product Analysis	yes	yes	Specify Organism Code(s):	Bacterial Infections: 121 inetobacter (all species), 125 Bordetella pertussis (whooping cough), 128 Campylobacter (all species), 129 Capnocytophaga (all species), 171 Chlamydia (pneumoniae), 130 Citrobacter (freundii, other species), 131 Clostridium (all species except difficile), 132 Clostridium difficile, 173 Corynebacterium jeikeium, 134 Enterobacter (all species), 135 Enterococcus (all species), 177 Enterococcus, vancomycin resistant (VRE), 136 Escherichia (also E. coli), 139 Fusobacterium (all species), 187 Haemophilus influenzae, 188 Haemophilus non-influenzae, 146 Klebsiella (all species), 147 Lactobacillus (bulgaricus, acidophilus, other species), 189 Legionella pneumophila, 190 Legionella non-pneumophila, 103 Leptospira (all species), 148 Leptotrichia buccalis, 149 Leuconostoc (all species), 104 Listeria monocytogenes, 151 Micrococcus, NOS, 118 Mycobacterium abscessus, 112 Mycobacterium avium - intracellulare (MAC, MAI), 108 Mycobacterium cheloneae, 109 Mycobacterium fortuitum, 114 Mycobacterium haemophilum, 115 Mycobacterium kansasii, 116 Mycobacterium marinum, 117 Mycobacterium mucogenicum, 110 Mycobacterium tuberculosis (tuberculosis, Koch bacillus), 105 Mycoplasma (all species), 183 Neisseria gonorrhoeae, 184 Neisseria meningitidis, 106 Nocardia (all species), 153 Pasteurella multocida, 155 Proteus (all species), 157 Pseudomonas or Burkholderia cepacia, 185 Pseudomonas aeruginosa, 186 Pseudomonas non-aeruginosa, 159 Rhodococcus (all species), 107 Rickettsia (all species), 160 Salmonella (all species), 161 Serratia marcescens,162 Shigella (all species), 180 Staphylococcus aureus (Methacillin Resistant), 179 Staphylococcus aureus (Methacillin Sensitive), 158 Stenotrophomonas maltophilia, 166 Stomatococcus mucilaginosis, 181 Streptococcus, alpha-hemolytic, 182 Streptococcus, Group B, 178 Streptococcus pneumoniae, 168 Treponema (syphilis), 169 Vibrio (all species) Fungal Infections: 210 Aspergillus, NOS, 211 Aspergillus flavus, 212 Aspergillus fumigatus, 213 Aspergillus niger, 215 Aspergillus terreus, 214 Aspergillus ustus, 270 Blastomyces (dermatitidis), 201 Candida albicans, 208 Candida non-albicans, 271 Coccidioides (all species), 222 Cryptococcus gattii, 221 Cryptococcus neoformans, 230 Fusarium (all species), 261 Histoplasma (capsulatum), 241 Mucorales (all species), 260 Pneumocystis (PCP / PJP), 242 Rhizopus (all species), 272 Scedosporium (all species), 240 Zygomycetes, NOS, 503 Suspected fungal infection, 777 Other organism		Specify Organism Code(s):	Bacterial Infections: 121 inetobacter (all species), 125 Bordetella pertussis (whooping cough), 128 Campylobacter (all species), 129 Capnocytophaga (all species), 171 Chlamydia (pneumoniae), 130 Citrobacter (freundii, other species), 131 Clostridium (all species except difficile), 132 Clostridium difficile, 173 Corynebacterium jeikeium, 134 Enterobacter (all species), 135 Enterococcus (all species), 177 Enterococcus, vancomycin resistant (VRE), 136 Escherichia (also E. coli), 139 Fusobacterium (all species), 187 Haemophilus influenzae, 188 Haemophilus non-influenzae, 146 Klebsiella (all species), 147 Lactobacillus (bulgaricus, acidophilus, other species), 189 Legionella pneumophila, 190 Legionella non-pneumophila, 103 Leptospira (all species), 148 Leptotrichia buccalis, 149 Leuconostoc (all species), 104 Listeria monocytogenes, 151 Micrococcus, NOS, 118 Mycobacterium abscessus, 112 Mycobacterium avium - intracellulare (MAC, MAI), 108 Mycobacterium cheloneae, 109 Mycobacterium fortuitum, 114 Mycobacterium haemophilum, 115 Mycobacterium kansasii, 116 Mycobacterium marinum, 117 Mycobacterium mucogenicum, 110 Mycobacterium tuberculosis (tuberculosis, Koch bacillus), 105 Mycoplasma (all species), 183 Neisseria gonorrhoeae, 184 Neisseria meningitidis, 106 Nocardia (all species), 153 Pasteurella multocida, 155 Proteus (all species), 157 Pseudomonas or Burkholderia cepacia, 185 Pseudomonas aeruginosa, 186 Pseudomonas non-aeruginosa, 159 Rhodococcus (all species), 107 Rickettsia (all species), 160 Salmonella (all species), 161 Serratia marcescens,162 Shigella (all species), 180 Staphylococcus aureus (Methicillin Resistant), 179 Staphylococcus aureus (Methicillin Sensitive), 158 Stenotrophomonas maltophilia, 166 Stomatococcus mucilaginosis, 181 Streptococcus, alpha-hemolytic, 182 Streptococcus, Group B, 178 Streptococcus pneumoniae, 168 Treponema (syphilis), 169 Vibrio (all species) Fungal Infections: 210 Aspergillus, NOS, 211 Aspergillus flavus, 212 Aspergillus fumigatus, 213 Aspergillus niger, 215 Aspergillus terreus, 214 Aspergillus ustus, 270 Blastomyces (dermatitidis), 201 Candida albicans, 208 Candida non-albicans, 271 Coccidioides (all species), 222 Cryptococcus gattii, 221 Cryptococcus neoformans, 230 Fusarium (all species), 261 Histoplasma (capsulatum), 241 Mucorales (all species), 260 Pneumocystis (PCP / PJP), 242 Rhizopus (all species), 272 Scedosporium (all species), 240 Zygomycetes, NOS, 503 Suspected fungal infection, 777 Other organism
PRO202	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Specify organism:	open text		Specify organism:	open text
PRO203	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Date of this product infusion:	YYYY/MM/DD		Date of this product infusion:	YYYY/MM/DD
PRO204	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Was the entire volume of received product infused?	no,yes		Was the entire volume of received product infused?	no,yes
PRO205	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Specify what happened to the reserved portion	cryopreserved for future use,discarded,other fate		Specify what happened to the reserved portion	cryopreserved for future use,discarded,other fate
PRO206	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Specify other fate:	open text		Specify other fate:	open text
PRO207	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Time product infusion initiated (24-hour clock):	Hour:Minute Check "standard time" or "check daylight savings time"		Time product infusion initiated (24-hour clock):	Hour:Minute Check "standard time" or "check daylight savings time"
PRO208	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Date infusion stopped:	YYYY/MM/DD		Date infusion stopped:	YYYY/MM/DD
PRO209	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Time product infusion completed (24-hour clock):	Hour:Minute Check "standard time" or "check daylight savings time"		Time product infusion completed (24-hour clock):	Hour:Minute Check "standard time" or "check daylight savings time"
PRO210	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Specify the route of product infusion (24-hour clock);	Intramedullary,Intravenous,Other route of infusion		Specify the route of product infusion (24-hour clock);	Intramedullary,Intravenous,Other route of infusion
PRO211	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion		no	yes	Specify other route of infusion:	open text		Specify other route of infusion:	open text
PRO212	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Were there any adverse events or incidents associated with the stem cell infusion?	no,yes		Were there any adverse events or incidents associated with the stem cell infusion?	no,yes
PRO213	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Brachycardia	no,yes		Brachycardia	no,yes
PRO214	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO215	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Chest tightness / pain	no,yes		Chest tightness / pain	no,yes
PRO216	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO217	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Chills at time of infusion	no,yes		Chills at time of infusion	no,yes
PRO218	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO219	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Fever ≤ 103 °F within 24 hours of infusion	no,yes		Fever ≤ 103 °F within 24 hours of infusion	no,yes
PRO220	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO221	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Fever > 103° F within 24 hours of infusion	no,yes		Fever > 103° F within 24 hours of infusion	no,yes
PRO222	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO223	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Gross hemoglobinuria	no,yes		Gross hemoglobinuria	no,yes
PRO224	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO225	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Headache	no,yes		Headache	no,yes
PRO226	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO227	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Hives	no,yes		Hives	no,yes
PRO228	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO229	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Hypertension	no,yes		Hypertension	no,yes
PRO230	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO231	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Hypotension	no,yes		Hypotension	no,yes
PRO232	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO233	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Hypoxia requiring oxygen (O2) support	no,yes		Hypoxia requiring oxygen (O2) support	no,yes
PRO234	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO235	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Nausea	no,yes		Nausea	no,yes
PRO236	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO237	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Rigors, mild	no,yes		Rigors, mild	no,yes
PRO238	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO239	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Rigors, severe	no,yes		Rigors, severe	no,yes
PRO240	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO241	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Shortness of breath (SOB)	no,yes		Shortness of breath (SOB)	no,yes
PRO242	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO243	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Tachycardia	no,yes		Tachycardia	no,yes
PRO244	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO245	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Vomiting	no,yes		Vomiting	no,yes
PRO246	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO247	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Other expected AE	no,yes		Other expected AE	no,yes
PRO248	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Specify other expected AE:	open text		Specify other expected AE:	open text
PRO249	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO250	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Other unexpected AE	no,yes		Other unexpected AE	no,yes
PRO251	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	Specify other unexpected AE:	open text		Specify other unexpected AE:	open text
PRO252	Transplant Procedure and Product Information	Hematopoietic Cellular Transplant (HCT) Product Infusion	Cord Blood Product Infusion	yes	no	In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes		In the Medical Director's judgment, was the adverse event a direct result of the infusion?	no,yes
PRO253	Transplant Procedure and Product Information	Infectious Disease Markers			yes	Sequence Number:	Auto Filled Field		Sequence Number:	Auto Filled Field
PRO254	Transplant Procedure and Product Information	Infectious Disease Markers			yes	Date Received:	Auto Filled Field		Date Received:	Auto Filled Field
PRO255	Transplant Procedure and Product Information	Infectious Disease Markers			yes	CIBMTR Center Number:	Auto Filled Field		CIBMTR Center Number:	Auto Filled Field
PRO256	Transplant Procedure and Product Information	Infectious Disease Markers			yes	CIBMTR Research ID:	Auto Filled Field		CIBMTR Research ID:	Auto Filled Field
PRO257	Transplant Procedure and Product Information	Infectious Disease Markers				Event date:	Auto Filled Field created with CRID		Event date:	Auto Filled Field created with CRID
PRO258	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	HCT type (check all that apply)	Allogeneic, related,Allogeneic, unrelated		HCT type (check all that apply)	Allogeneic, related,Allogeneic, unrelated
PRO259	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	Product type (check all that apply)	Bone marrow,Other product,PBSC,Single cord blood unit		Product type (check all that apply)	Bone marrow,Other product,PBSC,Single cord blood unit
PRO260	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	Other product. Specify:	open text		Other product. Specify:	open text
PRO261	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	Registry donor ID:	open text		Registry donor ID:	open text
PRO262	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	Non-NMDP cord blood unit ID:	open text		Non-NMDP cord blood unit ID:	open text
PRO263	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	Global Registration Identifier for Donors (GRID)	open text		Global Registration Identifier for Donors (GRID)	open text
PRO264	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	ISBT DIN:	open text		ISBT DIN:	open text
PRO265	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	Registry or UCB Bank ID	(A) Austrian Bone Marrow Donors,(ACB) Austrian Cord Blood Registry,(ACCB) StemCyte, Inc,(AE) Emirates Bone Marrow Donor Registry,(AM) Armenian Bone Marrow Donor Registry Charitable Trust,(AOCB) University of Colorado Cord Blood Bank,(AR) Argentine CPH Donors Registry,(ARCB) BANCEL - Argentina Cord Blood Bank,(AUCB) Australian Cord Blood Registry,(AUS) Australian / New Zealand Bone Marrow Donor Registry,(B) Marrow Donor Program Belgium,(BCB) Belgium Cord Blood Registry,(BG) Bulgarian Bone Marrow Donor Registry,(BR) INCA/REDOMO,(BSCB) British Bone Marrow Registry - Cord Blood,(CB) Cord Blood Registry,(CH) Swiss BloodStem Cells - Adult Donors,(CHCB) Swiss Blood Stem Cells - Cord Blood,(CKCB) Celgene Cord Blood Bank,(CN) China Marrow Donor Program (CMDP),(CNCB) Shan Dong Cord Blood Bank,(CND) Canadian Blood Services Bone Marrow Donor Registry,(CS2) Czech National Marrow Donor Registry,(CSCR) Czech Stem Cells Registry,(CY) Cyprus Paraskevaidio Bone Marrow Donor Registry,(CY2) The Cyprus Bone Marrow Donor Registry,(D) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Adult Donors,(DCB) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Cord Blood,(DK) The Danish Bone Marrow Donor Registry,(DK2) Bone Marrow Donors Copenhagen (BMDC),(DUCB) German Branch of the European Cord Blood Bank,(E) REDMO,(ECB) Spanish Cord Blood Registry,(F) France Greffe de Moelle - Adult Donors,(FCB) France Greffe de Moelle - Cord Blood,(FI) Finnish Bone Marrow Donor Registry,(FICB) Finnish Cord Blood Registry,(GB) The Anthony Nolan Trust,(GB3) Welsh Bone Marrow Donor Registry,(GB4) British Bone Marrow Registry,(GR) Unrelated Hematopoietic Stem Cell Donor Registry Greece,(GRCB) Michigan Community Blood Centers Cord Blood Bank,(H) Hungarian Bone Marrow Donor Registry,(HEM) Hema-Quebec,(HK) Hong Kong Bone Marrow Donor Registry,(HR) Croatian Bone Marrow Donor Registry,(I) Italian Bone Marrow Donor Registry,(I3CB) Sheba Medical Centre Cord Blood Registry,(ICB) Italian Cord Blood Bank Network,(IL) Hadassah BMDR,(IL2) Ezer Mizion Bone Marrow Donor Registry,(IL3) Sheba Medical Center Donor Registry,(ILCB) Isreal Cord Blood Bank,(IN) Asian Indian Donor Marrow Registry,(IN2) Dept. of Transfusion Medicine,(IRL) The Irish Unrelated Bone Marrow Panel,(JP) Japan Marrow Donor Program,(KR) Korea Marrow Donor Program,(LT) Lithuanian National Bone Marrow Donor Registry,(LVCB) Leuven Cord Blood Bank,(MACB) Victoria Angel Registry of Hope,(MX) Mexican Bone Marrow Donor Registry,(N) The Norwegian Bone Marrow Donor Registry,(NL) Europdonor Foundation- Adult Donors,(NLCB) Europdonor Foundation - Cord Blood,(NYCB) National Cord Blood Program, New York Blood Center,(OTH) Other Registry,(P) Portuguese Bone Marrow Donors Registry,(PL) National Polish Bone Marrow Registry,(PL2) Unrelated Bone Marrow Donor Registry -Adult Donors,(PL3) Against Leukemia Foundation Marrow Donor Registry,(PL4) Ursula Jaworska Foundation - Bone Marrow Donor Registry,(PL5) Polish Central Bone Marrow Donor Registry - Adult Donors,(PMCB) Elie Katz Umbilical Cord Blood Program,(R) Russian Bone Marrow Donor Registry,(R2) Karelian Registry of Unrelated Donors of Hematopoietic Stem Cells,(S) Tobias Registry of Swedish Bone Marrow Donors,(SG) Singapore Bone Marrow Donor Programme (BMDP),(SK) Slovak National Bone Marrow Donor Registry,(SKCB) Eurocord Slovakia / Slovak Pacental Stem Cell Registry,(SLCBB) St Louis Cord Blood Bank,(SLO) Slovenia Donor,(SM) San Marino Bone Marrow Donor Registry,(T1CB) TRAN - Cord Blood,(TACB) StemCyte, Inc. Taiwan,(TECB) Healthbanks Biotech, Co., Ltd,(TH) Thai Stem Cell Donor Registry (TSCDR),(TOCB) Tokyo Cord Blood Bank,(TPCB) BIONET / BabyBanks,(TRAN) TRAN - Adult Donors,(TRIS) Bone Marrow Bank of Istanbul Medical Faculty,(TW) Buddhist Tzu Chi Stem Cells Center - Adult Donors,(TWCB) Buddhist Tzu Chi Stem Cells Center - Cord Blood,(U1CB) National Marrow Donor Program - Cord Blood,(USA1) National Marrow Donor Program - Adult Donors,(USA2) America Bone Marrow Donor Registry,(UY) SINDOME,(VIAC) Viacord,(W3CB) Polish Central Bone Marrow Donor Registry - Cord Blood,(WACB) Unrelated Bone Marrow Donor Registry - Cord Blood,(ZA) South African Bone Marrow Registry		Registry or UCB Bank ID	(A) Austrian Bone Marrow Donors,(ACB) Austrian Cord Blood Registry,(ACCB) StemCyte, Inc,(AE) Emirates Bone Marrow Donor Registry,(AM) Armenian Bone Marrow Donor Registry Charitable Trust,(AOCB) University of Colorado Cord Blood Bank,(AR) Argentine CPH Donors Registry,(ARCB) BANCEL - Argentina Cord Blood Bank,(AUCB) Australian Cord Blood Registry,(AUS) Australian / New Zealand Bone Marrow Donor Registry,(B) Marrow Donor Program Belgium,(BCB) Belgium Cord Blood Registry,(BG) Bulgarian Bone Marrow Donor Registry,(BR) INCA/REDOMO,(BSCB) British Bone Marrow Registry - Cord Blood,(CB) Cord Blood Registry,(CH) Swiss BloodStem Cells - Adult Donors,(CHCB) Swiss Blood Stem Cells - Cord Blood,(CKCB) Celgene Cord Blood Bank,(CN) China Marrow Donor Program (CMDP),(CNCB) Shan Dong Cord Blood Bank,(CND) Canadian Blood Services Bone Marrow Donor Registry,(CS2) Czech National Marrow Donor Registry,(CSCR) Czech Stem Cells Registry,(CY) Cyprus Paraskevaidio Bone Marrow Donor Registry,(CY2) The Cyprus Bone Marrow Donor Registry,(D) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Adult Donors,(DCB) ZKRD - Zentrales Knochenmarkspender - Register Deutschland Cord Blood,(DK) The Danish Bone Marrow Donor Registry,(DK2) Bone Marrow Donors Copenhagen (BMDC),(DUCB) German Branch of the European Cord Blood Bank,(E) REDMO,(ECB) Spanish Cord Blood Registry,(F) France Greffe de Moelle - Adult Donors,(FCB) France Greffe de Moelle - Cord Blood,(FI) Finnish Bone Marrow Donor Registry,(FICB) Finnish Cord Blood Registry,(GB) The Anthony Nolan Trust,(GB3) Welsh Bone Marrow Donor Registry,(GB4) British Bone Marrow Registry,(GR) Unrelated Hematopoietic Stem Cell Donor Registry Greece,(GRCB) Michigan Community Blood Centers Cord Blood Bank,(H) Hungarian Bone Marrow Donor Registry,(HEM) Hema-Quebec,(HK) Hong Kong Bone Marrow Donor Registry,(HR) Croatian Bone Marrow Donor Registry,(I) Italian Bone Marrow Donor Registry,(I3CB) Sheba Medical Centre Cord Blood Registry,(ICB) Italian Cord Blood Bank Network,(IL) Hadassah BMDR,(IL2) Ezer Mizion Bone Marrow Donor Registry,(IL3) Sheba Medical Center Donor Registry,(ILCB) Isreal Cord Blood Bank,(IN) Asian Indian Donor Marrow Registry,(IN2) Dept. of Transfusion Medicine,(IRL) The Irish Unrelated Bone Marrow Panel,(JP) Japan Marrow Donor Program,(KR) Korea Marrow Donor Program,(LT) Lithuanian National Bone Marrow Donor Registry,(LVCB) Leuven Cord Blood Bank,(MACB) Victoria Angel Registry of Hope,(MX) Mexican Bone Marrow Donor Registry,(N) The Norwegian Bone Marrow Donor Registry,(NL) Europdonor Foundation- Adult Donors,(NLCB) Europdonor Foundation - Cord Blood,(NYCB) National Cord Blood Program, New York Blood Center,(OTH) Other Registry,(P) Portuguese Bone Marrow Donors Registry,(PL) National Polish Bone Marrow Registry,(PL2) Unrelated Bone Marrow Donor Registry -Adult Donors,(PL3) Against Leukemia Foundation Marrow Donor Registry,(PL4) Ursula Jaworska Foundation - Bone Marrow Donor Registry,(PL5) Polish Central Bone Marrow Donor Registry - Adult Donors,(PMCB) Elie Katz Umbilical Cord Blood Program,(R) Russian Bone Marrow Donor Registry,(R2) Karelian Registry of Unrelated Donors of Hematopoietic Stem Cells,(S) Tobias Registry of Swedish Bone Marrow Donors,(SG) Singapore Bone Marrow Donor Programme (BMDP),(SK) Slovak National Bone Marrow Donor Registry,(SKCB) Eurocord Slovakia / Slovak Pacental Stem Cell Registry,(SLCBB) St Louis Cord Blood Bank,(SLO) Slovenia Donor,(SM) San Marino Bone Marrow Donor Registry,(T1CB) TRAN - Cord Blood,(TACB) StemCyte, Inc. Taiwan,(TECB) Healthbanks Biotech, Co., Ltd,(TH) Thai Stem Cell Donor Registry (TSCDR),(TOCB) Tokyo Cord Blood Bank,(TPCB) BIONET / BabyBanks,(TRAN) TRAN - Adult Donors,(TRIS) Bone Marrow Bank of Istanbul Medical Faculty,(TW) Buddhist Tzu Chi Stem Cells Center - Adult Donors,(TWCB) Buddhist Tzu Chi Stem Cells Center - Cord Blood,(U1CB) National Marrow Donor Program - Cord Blood,(USA1) National Marrow Donor Program - Adult Donors,(USA2) America Bone Marrow Donor Registry,(UY) SINDOME,(VIAC) Viacord,(W3CB) Polish Central Bone Marrow Donor Registry - Cord Blood,(WACB) Unrelated Bone Marrow Donor Registry - Cord Blood,(ZA) South African Bone Marrow Registry
PRO266	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	Donor DOB:	YYYY/MM/DD		Donor DOB:	YYYY/MM/DD
PRO267	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	Donor age:	open text, check "Months" or check "Years"		Donor age:	open text, check "Months" or check "Years"
PRO268	Transplant Procedure and Product Information	Infectious Disease Markers		no	no	Donor sex	female,male		Donor sex	female,male
PRO269	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Who is being tested for IDMs?	donor IDM (marrow or PBSC),cord blood unit IDM,maternal IDM (cord blood)		Who is being tested for IDMs?	donor IDM (marrow or PBSC),cord blood unit IDM,maternal IDM (cord blood)
PRO270	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	HBsAg: (hepatitis B surface antigen)	Non-reactive,Not done,Reactive		HBsAg: (hepatitis B surface antigen)	Non-reactive,Not done,Reactive
PRO271	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO272	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Anti HBc: (hepatitis B core antibody)	Non-reactive,Not done,Reactive		Anti HBc: (hepatitis B core antibody)	Non-reactive,Not done,Reactive
PRO273	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO274	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	FDA licensed NAAT testing for HBV	Negative,Not done,Positive		FDA licensed NAAT testing for HBV	Negative,Not done,Positive
PRO275	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO276	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Anti-HCV: (hepatitis C antibody)	Non-reactive,Not done,Reactive		Anti-HCV: (hepatitis C antibody)	Non-reactive,Not done,Reactive
PRO277	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO278	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	FDA licensed NAAT testing for HCV	Negative,Not done,Positive		FDA licensed NAAT testing for HCV	Negative,Not done,Positive
PRO279	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO280	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	HIV-1 p24 antigen	Non-reactive,Not done,Not reported,Reactive		HIV-1 p24 antigen	Non-reactive,Not done,Not reported,Reactive
PRO281	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO282	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	FDA licensed NAAT testing for HIV-1	Negative,Not done,Positive		FDA licensed NAAT testing for HIV-1	Negative,Not done,Positive
PRO283	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO284	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Anti-HIV 1 and anti-HIV 2*: (antibodies to Human Immunodeficiency Viruses)	Non-reactive,Not done,Not reported,Reactive		Anti-HIV 1 and anti-HIV 2*: (antibodies to Human Immunodeficiency Viruses)	Non-reactive,Not done,Not reported,Reactive
PRO285	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO286	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Chagas testing	Negative,Not Done,Positive		Chagas testing	Negative,Not Done,Positive
PRO287	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO288	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Anti-HSV (Herpes simplex virus antibody)	Negative,Not Done,Positive		Anti-HSV (Herpes simplex virus antibody)	Negative,Not Done,Positive
PRO289	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO290	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Anti-EBV (Epstein-Barr virus antibody)	Inconclusive,Negative,Not done,Positive		Anti-EBV (Epstein-Barr virus antibody)	Inconclusive,Negative,Not done,Positive
PRO291	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO292	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Anti-VZV (Varicella zoster virus antibody)	Negative,Not Done,Positive		Anti-VZV (Varicella zoster virus antibody)	Negative,Not Done,Positive
PRO293	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO294	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Other infectious disease marker, specify	no,yes		Other infectious disease marker, specify	no,yes
PRO295	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
PRO296	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Specify test and method:	open text		Specify test and method:	open text
PRO297	Transplant Procedure and Product Information	Infectious Disease Markers	Non NMDP Allogeneic or syngeneic Donor or Non NMDP Cord Blood Unit Information	yes	no	Specify test results:	open text		Specify test results:	open text

Sheet 5: Post-Transplant Periodic Inform

				Information Collection Domain: Post-Transplant Periodic Information Collection
Item ID	Time Point	Information Collection Domain Sub-Type	Information Collection Domain Additional Sub Domain	Response required if Additional Sub Domain applies	Information Collection may be requested multiple times	Current Information Collection Data Element (if applicable)	Current Information Collection Data Element Response Option(s)	Information Collection update:	Proposed Information Collection Data Element (if applicable)	Proposed Information Collection Data Element Response Option(s)	[Threaded comment] Your version of Excel allows you to read this threaded comment; however, any edits to it will get removed if the file is opened in a newer version of Excel. Learn more: https://go.microsoft.com/fwlink/?linkid=870924 Comment: Information in this column does not match the info in the table within the OMB letter - please revise. Rationale for Information Collection Update
POST001	Post-Transplant	Post-Transplant Essential Data		no	yes	Sequence Number:	Auto Filled Field		Sequence Number:	Auto Filled Field
POST002	Post-Transplant	Post-Transplant Essential Data		no	yes	Date Received:	Auto Filled Field		Date Received:	Auto Filled Field
POST003	Post-Transplant	Post-Transplant Essential Data		no	yes	CIBMTR Center Number:	Auto Filled Field		CIBMTR Center Number:	Auto Filled Field
POST004	Post-Transplant	Post-Transplant Essential Data		no	yes	CIBMTR Research ID:	Auto Filled Field		CIBMTR Research ID:	Auto Filled Field
POST005	Post-Transplant	Post-Transplant Essential Data		no	yes	Event date:	Auto Filled Field created with CRID		Event date:	Auto Filled Field created with CRID
POST006	Post-Transplant	Post-Transplant Essential Data		no	yes	Visit	100 day,1 year,2 years,> 2 years,6 months		Visit	100 day,1 year,2 years,> 2 years,6 months
POST007	Post-Transplant	Post-Transplant Essential Data		no	yes	Specify:	open text		Specify:	open text
POST008	Post-Transplant	Post-Transplant Essential Data		no	yes	Date of actual contact with the recipient to determine medical status for this follow-up report:	YYYY/MM/DD		Date of actual contact with the recipient to determine medical status for this follow-up report:	YYYY/MM/DD
POST009	Post-Transplant	Post-Transplant Essential Data		no	yes	Specify the recipient's survival status at the date of last contact	Alive,Dead		Specify the recipient's survival status at the date of last contact	Alive,Dead (Complete recipient death data)
POST010	Post-Transplant	Post-Transplant Essential Data		no	yes	Did the recipient receive a subsequent HCT?	no,yes		Did the recipient receive a subsequent HCT?	no,yes
POST011	Post-Transplant	Post-Transplant Essential Data	Subsequent Transplant	yes	yes	Date of subsequent HCT:	YYYY/MM/DD		Date of subsequent HCT:	YYYY/MM/DD
POST012	Post-Transplant	Post-Transplant Essential Data	Subsequent Transplant	yes	yes	What was the indication for subsequent HCT?	Graft failure / insufficient hematopoietic recovery,Insufficient chimerism,New malignancy (including PTLD and EBV lymphoma),Other,Persistent primary disease,Planned subsequent HCT, per protocol,Recurrent primary disease		What was the indication for subsequent HCT?	Graft failure / insufficient hematopoietic recovery,Insufficient chimerism,New malignancy (including PTLD and EBV lymphoma),Other,Persistent primary disease,Planned subsequent HCT, per protocol,Recurrent primary disease
POST013	Post-Transplant	Post-Transplant Essential Data	Subsequent Transplant	yes	yes	Specify other indication:	open text		Specify other indication:	open text
POST014	Post-Transplant	Post-Transplant Essential Data	Subsequent Transplant	yes	yes	Source of HSCs (check all that apply)	Allogeneic, related,Allogeneic, unrelated,Autologous		Source of HSCs (check all that apply)	Allogeneic, related,Allogeneic, unrelated,Autologous
POST015	Post-Transplant	Post-Transplant Essential Data		no	yes	Has the recipient received a cellular therapy? (e.g. CAR-T, DCI)	no,yes		Has the recipient received a cellular therapy? (e.g. CAR-T, DCI)	no,yes
POST016	Post-Transplant	Post-Transplant Essential Data	Subsequent Transplant	yes	yes				Was this infusion a donor lymphocyte infusion (DLI)?	no,yes
POST017	Post-Transplant	Post-Transplant Essential Data	Subsequent Transplant	yes	yes				Number of DLIs in this reporting period	__ __
POST018	Post-Transplant	Post-Transplant Essential Data	Subsequent Transplant	yes	yes				Are any of the products, associated with this course of cellular therapy, genetically modified?	no, yes
POST019	Post-Transplant	Post-Transplant Essential Data	Subsequent Transplant	yes	yes	Date of cellular therapy:	YYYY/MM/DD		Date of cellular therapy:	YYYY/MM/DD
POST020	Post-Transplant	Post-Transplant Essential Data		no	yes	Was there evidence of initial hematopoietic recovery?	No(ANC ≥ 500/mm3 was not achieved) ,Not applicable(ANC never dropped below 500/mm3 at any time after the start of the preparative regimen,Previously reported(recipient’s initial hematopoietic recovery was recorded on a previous report) ,Yes(ANC ≥ 500/mm3 achieved and sustained for 3 lab values)		Was there evidence of initial hematopoietic recovery?	No(ANC ≥ 500/mm3 was not achieved) ,Not applicable(ANC never dropped below 500/mm3 at any time after the start of the preparative regimen,Previously reported(recipient’s initial hematopoietic recovery was recorded on a previous report) ,Yes(ANC ≥ 500/mm3 achieved and sustained for 3 lab values)
POST021	Post-Transplant	Post-Transplant Essential Data		no	yes	Date ANC ≥ 500/mm³ (first of 3 lab values):	YYYY/MM/DD		Date ANC ≥ 500/mm³ (first of 3 lab values):	YYYY/MM/DD
POST022	Post-Transplant	Post-Transplant Essential Data		no	yes	Did late graft failure occur?	No,Yes		Did late graft failure occur?	No,Yes
POST023	Post-Transplant	Post-Transplant Essential Data		no	yes	Was an initial platelet count ≥ 20 x 109/L achieved?	No,Not applicable(Platelet count never dropped below 20 x 109/L) ,Previously reported(≥ 20 x 109/L was achieved and reported previously),Yes		Was an initial platelet count ≥ 20 x 109/L achieved?	No,Not applicable(Platelet count never dropped below 20 x 109/L) ,Previously reported(≥ 20 x 109/L was achieved and reported previously),Yes
POST024	Post-Transplant	Post-Transplant Essential Data		no	yes	Date platelets ≥ 20 x 109/L:	YYYY/MM/DD		Date platelets ≥ 20 x 109/L:	YYYY/MM/DD
POST025	Post-Transplant	Post-Transplant Essential Data		no	yes	Did acute GVHD develop?	No,Unknown,Yes		Did acute GVHD develop?	No,Unknown,Yes
POST026	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Date of acute GVHD diagnosis:	YYYY/MM/DD		Date of acute GVHD diagnosis:	YYYY/MM/DD
POST027	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Did acute GVHD persist?	No,Unknown,Yes		Did acute GVHD persist?	No,Unknown,Yes
POST028	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Overall grade of acute GVHD at diagnosis	I - Rash on ≤ 50% of skin, no liver or gut involvement II - Rash on > 50% of skin, bilirubin 2-3 mg/dL, or diarrhea 500 – 1000 mL/day or persistent nausea or vomiting III - Bilirubin 3-15 mg/dL, or gut stage 2-4 diarrhea > 1000 mL/day or severe abdominal pain with or without ileus IV - Generalized erythroderma with bullous formation, or bilirubin >15 mg/dL Not applicable (acute GVHD present but cannot be graded)		Overall grade of acute GVHD at diagnosis	I - Rash on ≤ 50% of skin, no liver or gut involvement II - Rash on > 50% of skin, bilirubin 2-3 mg/dL, or diarrhea 500 – 1000 mL/day or persistent nausea or vomiting III - Bilirubin 3-15 mg/dL, or gut stage 2-4 diarrhea > 1000 mL/day or severe abdominal pain with or without ileus IV - Generalized erythroderma with bullous formation, or bilirubin >15 mg/dL Not applicable (acute GVHD present but cannot be graded)
POST029	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Skin	Stage 0 – No rash, no rash attributable to acute GVHD Stage 1 – Maculopapular rash, < 25% of body surface Stage 2 – Maculopapular rash, 25–50% of body surface Stage 3 – Generalized erythroderma, > 50% of body surface Stage 4 – Generalized erythroderma with bullae formation and/or desquamation		Skin	Stage 0 – No rash, no rash attributable to acute GVHD Stage 1 – Maculopapular rash, < 25% of body surface Stage 2 – Maculopapular rash, 25–50% of body surface Stage 3 – Generalized erythroderma, > 50% of body surface Stage 4 – Generalized erythroderma with bullae formation and/or desquamation
POST030	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Lower intestinal tract (use mL/day for adult recipients and mL/kg/day for pediatric recipients)	Stage 0 – No diarrhea, no diarrhea attributable to acute GVHD / diarrhea < 500 mL/day (adult), or < 10 mL/kg/day (pediatric) Stage 1 – Diarrhea 500 - 1000 mL/day (adult), or 10 - 19.9 mL/kg/day (pediatric) Stage 2 – Diarrhea 1001 - 1500 mL/day (adult), or 20 - 30 mL/kg/day (pediatric) Stage 3 – Diarrhea > 1500 mL/day (adult), or > 30 mL/kg/day (pediatric) Stage 4 – Severe abdominal pain, with or without ileus, and/or grossly bloody stool		Lower intestinal tract (use mL/day for adult recipients and mL/kg/day for pediatric recipients)	Stage 0 – No diarrhea, no diarrhea attributable to acute GVHD / diarrhea < 500 mL/day (adult), or < 10 mL/kg/day (pediatric) Stage 1 – Diarrhea 500 - 1000 mL/day (adult), or 10 - 19.9 mL/kg/day (pediatric) Stage 2 – Diarrhea 1001 - 1500 mL/day (adult), or 20 - 30 mL/kg/day (pediatric) Stage 3 – Diarrhea > 1500 mL/day (adult), or > 30 mL/kg/day (pediatric) Stage 4 – Severe abdominal pain, with or without ileus, and/or grossly bloody stool
POST031	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Upper intestinal tract	Stage 0 – No persistent nausea or vomiting Stage 1 – Persistent nausea or vomiting		Upper intestinal tract	Stage 0 – No persistent nausea or vomiting Stage 1 – Persistent nausea or vomiting
POST032	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Liver	Stage 0 – No liver acute GVHD / bilirubin < 2.0 mg/dL (< 34 μmol/L) Stage 1 – Bilirubin 2.0–3.0 mg/dL (34–52 μmol/L) Stage 2 – Bilirubin 3.1–6.0 mg/dL (53–103 μmol/L) Stage 3 – Bilirubin 6.1–15.0 mg/dL (104–256 μmol/L) Stage 4 – Bilirubin > 15.0 mg/dL (> 256 μmol/L)		Liver	Stage 0 – No liver acute GVHD / bilirubin < 2.0 mg/dL (< 34 μmol/L) Stage 1 – Bilirubin 2.0–3.0 mg/dL (34–52 μmol/L) Stage 2 – Bilirubin 3.1–6.0 mg/dL (53–103 μmol/L) Stage 3 – Bilirubin 6.1–15.0 mg/dL (104–256 μmol/L) Stage 4 – Bilirubin > 15.0 mg/dL (> 256 μmol/L)
POST033	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Other site(s) involved with acute GVHD	No,Yes		Other site(s) involved with acute GVHD	No,Yes
POST034	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Specify other site(s):	open text		Specify other site(s):	open text
POST035	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Maximum overall grade of acute GVHD	I - Rash on ≤ 50% of skin, no liver or gut involvement II - Rash on > 50% of skin, bilirubin 2-3 mg/dL, or diarrhea 500 – 1000 mL/day or persistent nausea or vomiting III - Bilirubin 3-15 mg/dL, or gut stage 2-4 diarrhea > 1000 mL/day or severe abdominal pain with or without ileus IV - Generalized erythroderma with bullous formation, or bilirubin >15 mg/dL Not applicable (acute GVHD present but cannot be graded)		Maximum overall grade of acute GVHD	I - Rash on ≤ 50% of skin, no liver or gut involvement II - Rash on > 50% of skin, bilirubin 2-3 mg/dL, or diarrhea 500 – 1000 mL/day or persistent nausea or vomiting III - Bilirubin 3-15 mg/dL, or gut stage 2-4 diarrhea > 1000 mL/day or severe abdominal pain with or without ileus IV - Generalized erythroderma with bullous formation, or bilirubin >15 mg/dL Not applicable (acute GVHD present but cannot be graded)
POST036	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Date maximum overall grade of acute GVHD:	YYYY/MM/DD		First date maximum overall grade of acute GVHD:	YYYY/MM/DD
POST037	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Skin	Stage 0 – No rash, no rash attributable to acute GVHD Stage 1 – Maculopapular rash, < 25% of body surface Stage 2 – Maculopapular rash, 25–50% of body surface Stage 3 – Generalized erythroderma, > 50% of body surface Stage 4 – Generalized erythroderma with bullae formation and/or desquamation		Skin	Stage 0 – No rash, no rash attributable to acute GVHD Stage 1 – Maculopapular rash, < 25% of body surface Stage 2 – Maculopapular rash, 25–50% of body surface Stage 3 – Generalized erythroderma, > 50% of body surface Stage 4 – Generalized erythroderma with bullae formation and/or desquamation
POST038	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Lower intestinal tract (use mL/day for adult recipients and mL/kg/day for pediatric recipients)	Stage 0 – No diarrhea, no diarrhea attributable to acute GVHD / diarrhea < 500 mL/day (adult), or < 10 mL/kg/day (pediatric) Stage 1 – Diarrhea 500 - 1000 mL/day (adult), or 10 - 19.9 mL/kg/day (pediatric) Stage 2 – Diarrhea 1001 - 1500 mL/day (adult), or 20 - 30 mL/kg/day (pediatric) Stage 3 – Diarrhea > 1500 mL/day (adult), or > 30 mL/kg/day (pediatric) Stage 4 – Severe abdominal pain, with or without ileus, and/or grossly bloody stool		Lower intestinal tract (use mL/day for adult recipients and mL/kg/day for pediatric recipients)	Stage 0 – No diarrhea, no diarrhea attributable to acute GVHD / diarrhea < 500 mL/day (adult), or < 10 mL/kg/day (pediatric) Stage 1 – Diarrhea 500 - 1000 mL/day (adult), or 10 - 19.9 mL/kg/day (pediatric) Stage 2 – Diarrhea 1001 - 1500 mL/day (adult), or 20 - 30 mL/kg/day (pediatric) Stage 3 – Diarrhea > 1500 mL/day (adult), or > 30 mL/kg/day (pediatric) Stage 4 – Severe abdominal pain, with or without ileus, and/or grossly bloody stool
POST039	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Upper intestinal tract	Stage 0 – No persistent nausea or vomiting Stage 1 – Persistent nausea or vomiting		Upper intestinal tract	Stage 0 – No persistent nausea or vomiting Stage 1 – Persistent nausea or vomiting
POST040	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Liver	Stage 0 – No liver acute GVHD / bilirubin < 2.0 mg/dL (< 34 μmol/L) Stage 1 – Bilirubin 2.0–3.0 mg/dL (34–52 μmol/L) Stage 2 – Bilirubin 3.1–6.0 mg/dL (53–103 μmol/L) Stage 3 – Bilirubin 6.1–15.0 mg/dL (104–256 μmol/L) Stage 4 – Bilirubin > 15.0 mg/dL (> 256 μmol/L)		Liver	Stage 0 – No liver acute GVHD / bilirubin < 2.0 mg/dL (< 34 μmol/L) Stage 1 – Bilirubin 2.0–3.0 mg/dL (34–52 μmol/L) Stage 2 – Bilirubin 3.1–6.0 mg/dL (53–103 μmol/L) Stage 3 – Bilirubin 6.1–15.0 mg/dL (104–256 μmol/L) Stage 4 – Bilirubin > 15.0 mg/dL (> 256 μmol/L)
POST041	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Other site(s) involved with acute GVHD	No,Yes		Other site(s) involved with acute GVHD	No,Yes
POST042	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Specify other site(s):	open text		Specify other site(s):	open text
POST043	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Did chronic GVHD develop?	No,Unknown,Yes		Did chronic GVHD develop?	No,Unknown,Yes
POST044	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Date of chronic GVHD diagnosis:	YYYY/MM/DD		Date of chronic GVHD diagnosis:	YYYY/MM/DD
POST045	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Did chronic GVHD persist?	No,Unknown,Yes		Did chronic GVHD persist?	No,Unknown,Yes
POST046	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Maximum grade of chronic GVHD (according to best clinical judgment)	Mild,Moderate,Severe,Unknown		Maximum grade of chronic GVHD (according to best clinical judgment)	Mild,Moderate,Severe,Unknown
POST047	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Date of maximum grade of chronic GVHD:	YYYY/MM/DD		Date of maximum grade of chronic GVHD:	YYYY/MM/DD
POST048	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Specify if chronic GVHD was limited or extensive	Extensive – One or more of the following: – Generalized skin involvement; or, – Liver histology showing chronic aggressive hepatitis, bridging necrosis or cirrhosis; or, – Involvement of eye: Schirmer’s test with < 5 mm wetting; or – Involvement of minor salivary glands or oral mucosa demonstrated on labial biopsy; or – Involvement of any other target organ, Limited - Localized skin involvement and/or liver dysfunction		Specify if chronic GVHD was limited or extensive	Extensive – One or more of the following: – Generalized skin involvement; or, – Liver histology showing chronic aggressive hepatitis, bridging necrosis or cirrhosis; or, – Involvement of eye: Schirmer’s test with < 5 mm wetting; or – Involvement of minor salivary glands or oral mucosa demonstrated on labial biopsy; or – Involvement of any other target organ, Limited - Localized skin involvement and/or liver dysfunction
POST049	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Is the recipient still taking systemic steroids? (Do not report steroids for adrenal insufficiency, or steroid dose ≤10 mg/day for adults, <0.1 mg/kg/day for children)	No,Not Applicable,Unknown,Yes		Is the recipient still taking systemic steroids? (Do not report steroids for adrenal insufficiency, or steroid dose ≤10 mg/day for adults, <0.1 mg/kg/day for children)	No,Not Applicable,Unknown,Yes
POST050	Post-Transplant	Post-Transplant Essential Data	Graft vs. Host Disease	yes	yes	Is the recipient still taking (non-steroid) immunosuppressive agents (including PUVA) for GVHD?	No,Not Applicable,Unknown,Yes		Is the recipient still taking (non-steroid) immunosuppressive agents (including PUVA) for GVHD?	No,Not Applicable,Unknown,Yes
POST051	Post-Transplant	Post-Transplant Essential Data		no	yes	Was specific therapy used to prevent liver toxicity?	No,Yes		Was specific therapy used to prevent liver toxicity?	No,Yes
POST052	Post-Transplant	Post-Transplant Essential Data		no	yes	Specify therapy (check all that apply)	Defibrotide,N-acetylcysteine,Other therapy,Tissue plasminogen activator (TPA),Ursodiol		Specify therapy (check all that apply)	Defibrotide,N-acetylcysteine,Other therapy,Tissue plasminogen activator (TPA),Ursodiol, Enoxaparin (Lovenox), Heparin
POST053	Post-Transplant	Post-Transplant Essential Data		no	yes	Specify other therapy:	open text		Specify other therapy:	open text
POST054	Post-Transplant	Post-Transplant Essential Data		no	yes	Did veno-occlusive disease (VOD) / sinusoidal obstruction syndrome (SOS) develop?	No,Yes		Did veno-occlusive disease (VOD) / sinusoidal obstruction syndrome (SOS) develop?	No,Yes
POST055	Post-Transplant	Post-Transplant Essential Data		no	yes	Date of diagnosis:	YYYY/MM/DD		Date of diagnosis:	YYYY/MM/DD
POST056	Post-Transplant	Post-Transplant Essential Data		no	yes	Did the recipient develop COVID-19 (SARS-CoV-2)?	No,Yes		Did the recipient develop COVID-19 (SARS-CoV-2)?	No,Yes
POST057	Post-Transplant	Post-Transplant Essential Data		no	yes	Date of diagnosis:	YYYY/MM/DD		Date of diagnosis:	YYYY/MM/DD
POST058	Post-Transplant	Post-Transplant Essential Data		no	yes	Was a vaccine for COVID-19 (SARS-CoV-2) received?	No,Unknown,Yes		Was a vaccine for COVID-19 (SARS-CoV-2) received?	No,Unknown,Yes
POST059	Post-Transplant	Post-Transplant Essential Data	Covid-19 Vaccine	yes	yes	Specify vaccine brand	AstraZeneca,Johnson & Johnson,Moderna,Novavax,Other (specify),Pfizer-BioNTech		Specify vaccine brand	AstraZeneca,Johnson & Johnson,Moderna,Novavax,Other (specify),Pfizer-BioNTech
POST060	Post-Transplant	Post-Transplant Essential Data	Covid-19 Vaccine	yes	yes	Specify other type:	open text		Specify other type:	open text
POST061	Post-Transplant	Post-Transplant Essential Data	Covid-19 Vaccine	yes	yes	Select dose(s) received	Booster dose,First dose(with planned second dose) ,One dose(without planned second dose) ,Second dose,Third dose		Select dose(s) received	Booster dose,First dose(with planned second dose) ,One dose(without planned second dose) ,Second dose,Third dose
POST062	Post-Transplant	Post-Transplant Essential Data	Covid-19 Vaccine	yes	yes	Date received:	YYYY/MM/DD		Date received:	YYYY/MM/DD
POST063	Post-Transplant	Post-Transplant Essential Data	Covid-19 Vaccine	yes	yes	Date estimated	checked		Date estimated	checked
POST064	Post-Transplant	Post-Transplant Essential Data		no	yes	Did a new malignancy, myelodysplastic, myeloproliferative, or lymphoproliferative disease / disorder occur that is different from the disease / disorder for which the HCT or cellular therapy was performed?	No,Yes		Did a new malignancy, myelodysplastic, myeloproliferative, or lymphoproliferative disease / disorder occur that is different from the disease / disorder for which the HCT or cellular therapy was performed?	No,Yes (Also complete Subsequent Neoplasms) , previosly reported
POST065	Post-Transplant	Post-Transplant Essential Data	Allogenic Recipients of Cord Blood units, Beta Thalassemia, and/or Sickle Cell Disease	yes	yes	Were chimerism studies performed?	no,yes		Were chimerism studies performed?	no,yes
POST066	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Was documentation submitted to the CIBMTR? (e.g. chimerism laboratory reports)	No,Yes		Was documentation submitted to the CIBMTR? (e.g. chimerism laboratory reports)	No,Yes
POST067	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Were chimerism studies assessed for more than one donor / multiple donors?	No,Yes		Were chimerism studies assessed for more than one donor / multiple donors?	No,Yes
POST068	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Global Registration Identifier for Donors (GRID)	open text		Global Registration Identifier for Donors (GRID)	open text
POST069	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	NMDP cord blood unit ID:	open text		NMDP cord blood unit ID:	open text
POST070	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Registry donor ID:	open text		Registry donor ID:	open text
POST071	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Non-NMDP cord blood unit ID:	open text		Non-NMDP cord blood unit ID:	open text
POST072	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Date of birth:	YYYY/MM/DD		Donor Date of birth:	YYYY/MM/DD
POST073	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Age:	MM __ __ (if less than 1 year); YY __ __ __		Age:	MM __ __ (if less than 1 year); YY __ __ __
POST074	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Sex	female,male		Donor Sex	female,male
POST075	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Date sample collected:	YYYY/MM/DD		Date sample collected:	YYYY/MM/DD
POST076	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Method	Single nucleotide polymorphisms (SNPS) (includes quantitative PCR, real time PCR, sequencing, other), Fluorescent in situ hybridization (FISH) for XX/XY, Karyotyping for XX/XY,vOther, Restriction fragment-length polymorphisms (RFLP), VNTR or STR, micro or mini satellite		Method	Single nucleotide polymorphisms (SNPS) (includes quantitative PCR, real time PCR, sequencing, other), Fluorescent in situ hybridization (FISH) for XX/XY, Karyotyping for XX/XY,vOther, Restriction fragment-length polymorphisms (RFLP), VNTR or STR, micro or mini satellite
POST077	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Specify:	open text		Specify:	open text
POST078	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Cell source	Bone marrow,Peripheral blood		Cell source	Bone marrow,Peripheral blood
POST079	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Cell type	B-cells,Granulocytes,Hematopoietic progenitor cells,NK cells,Other,Red blood cells,T-cells,Total mononuclear cells,Unsorted / whole		Cell type	B-cells,Granulocytes,Hematopoietic progenitor cells,NK cells,Other,Red blood cells,T-cells,Total mononuclear cells,Unsorted / whole
POST080	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Specify:	open text		Specify:	open text
POST081	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Total cells examined:	open text		Total cells examined:	open text
POST082	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Number of donor cells:	open text		Number of donor cells:	open text
POST083	Post-Transplant	Post-Transplant Essential Data	Chimerism Study Performed	yes	yes	Percent donor cells:	__ __ __ %		Percent donor cells:	__ __ __ %
POST084	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Compared to the disease status prior to the preparative regimen, what was the best response to HCT?	Continued complete remission (CCR),Complete remission (CR),Not in complete remission,Not evaluated			Continued complete remission (CCR),Complete remission (CR),Not in complete remission,Not evaluated
POST085	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Specify disease status if not in complete remission	Disease detected,No disease detected but incomplete evaluation to establish CR		Specify disease status if not in complete remission	Disease detected,No disease detected but incomplete evaluation to establish CR
POST086	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was the date of best response previously reported?	no,yes		Was the date of best response previously reported?	no,yes
POST087	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
POST088	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was the disease status assessed by molecular testing?	No,Not Applicable,Yes		Was the disease status assessed by molecular testing?	No,Not Applicable,Yes
POST089	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
POST090	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was disease detected?	no,yes		Was disease detected?	no,yes
POST091	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was the disease status assessed via flow cytometry?	No,Not Applicable,Yes		Was the disease status assessed via flow cytometry?	No,Not Applicable,Yes
POST092	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
POST093	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was disease detected?	no,yes		Was disease detected?	no,yes
POST094	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was the disease status assessed by cytogenetic testing? (karyotyping or FISH)	No,Not Applicable,Yes		Was the disease status assessed by cytogenetic testing? (karyotyping or FISH)	No,Not Applicable,Yes
POST095	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was the disease status assessed via FISH?	No,Not Applicable,Yes		Was the disease status assessed via FISH?	No,Not Applicable,Yes
POST096	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
POST097	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was disease detected?	no,yes		Was disease detected?	no,yes
POST098	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was the disease status assessed via karyotyping?	No,Not Applicable,Yes		Was the disease status assessed via karyotyping?	No,Not Applicable,Yes
POST099	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
POST100	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was disease detected?	no,yes		Was disease detected?	no,yes
POST101	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was the disease status assessed by radiological assessment? (e.g. PET, MRI, CT)	No,Not Applicable,Yes		Was the disease status assessed by radiological assessment? (e.g. PET, MRI, CT)	No,Not Applicable,Yes
POST102	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
POST103	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was disease detected?	no,yes		Was disease detected?	no,yes
POST104	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was the disease status assessed by clinical / hematologic assessment?	no,yes		Was the disease status assessed by clinical / hematologic assessment?	no,yes
POST105	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Date assessed:	YYYY/MM/DD		Date assessed:	YYYY/MM/DD
POST106	Post-Transplant	Disease Assessment at the Time of Best Response to HCT		no	yes	Was disease detected?	no,yes		Was disease detected?	no,yes
POST107	Post-Transplant	Post-HCT Therapy		no	yes	Was therapy given for reasons other than relapse, persistent, or progressive disease? (Include any maintenance and consolidation therapy.)	no,yes		Was therapy given for reasons other than relapse, persistent, or progressive disease? (Include any maintenance and consolidation therapy.)	no,yes
POST108	Post-Transplant	Post-HCT Therapy		no	yes	Specify therapy (check all that apply)	Blinded randomized trial,Cellular therapy,Other therapy,Radiation,Systemic therapy		Specify therapy (check all that apply)	Blinded randomized trial,Cellular therapy,Other therapy,Radiation,Systemic therapy
POST109	Post-Transplant	Post-HCT Therapy		no	yes	Specify systemic therapy (check all that apply)	Alemtuzumab,Azacytidine,Blinatumomab,Bortezomib,Bosutinib,Carfilzomib,Chemotherapy,Dasatinib,Decitabine,Gemtuzumab,Gilteritinib,Ibrutinib,Imatinib mesylate,Ixazomib,Lenalidomide,Lestaurtinib,Midostaurin,Nilotinib,Nivolumab,Other systemic therapy,Pembrolizumab,Pomalidomide,Quizartinib,Rituximab,Sorafenib,Sunitinib,Thalidomide		Specify systemic therapy (check all that apply)	Alemtuzumab,Azacytidine,Blinatumomab,Bortezomib,Bosutinib,Carfilzomib,Dasatinib,Decitabine,Gemtuzumab,Gilteritinib,Ibrutinib,Imatinib mesylate,Ixazomib,Lenalidomide,Lestaurtinib,Midostaurin,Nilotinib,Nivolumab,Other systemic therapy,Pembrolizumab,Pomalidomide,Quizartinib,Rituximab,Sorafenib,Sunitinib,Thalidomide, Brentuximab vendotin, Daratumumab (Darzalex)
POST110	Post-Transplant	Post-HCT Therapy		no	yes	Specify other systemic therapy:	open text		Specify other systemic therapy:	open text
POST111	Post-Transplant	Post-HCT Therapy		no	yes	Specify other therapy:	open text		Specify other therapy:	open text
POST112	Post-Transplant	Post-HCT Therapy		no	yes	Did a fecal microbiota transplant (FMT) occur?	No, Yes		Did a fecal microbiota transplant (FMT) occur?	No, Yes
POST113	Post-Transplant	Post-HCT Therapy		no	yes				Date of FMT	DD/MM/YY
POST114	Post-Transplant	Post-HCT Therapy		no	yes				Specify the indication for the FMT	Graft versus host disease (GVHD), Clostridium difficle, Other
POST115	Post-Transplant	Post-HCT Therapy		no	yes				Specify other indication:	open text
POST116	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Did the recipient experience a clinical/hematologic relapse or progression post-HCT?	No,Yes		Did the recipient experience a clinical/hematologic relapse or progression post-HCT?	No,Yes
POST117	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Was the date of the first clinical / hematologic relapse or progression previously reported?	No,Yes (only valid >day 100)		Was the date of the first clinical / hematologic relapse or progression previously reported?	No,Yes (only valid >day 100)
POST118	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Date first seen:	YYYY/MM/DD		Date first seen:	YYYY/MM/DD
POST119	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Was intervention given for relapsed, persistent or progressive disease?	No,Yes		Was intervention given for relapsed, persistent or progressive disease?	No,Yes
POST120	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Specify reason for which intervention was given	Persistent disease,Relapsed / progressive disease		Specify reason for which intervention was given	Persistent disease,Relapsed / progressive disease
POST121	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Specify the method(s) of detection for which intervention was given (check all that apply)	Clinical and/or hematologic analysis,Cytogenetic Analysis,Disease specific molecular marker,Flow Cytometry,Radiological		Specify the method(s) of detection for which intervention was given (check all that apply)	Clinical and/or hematologic analysis,Cytogenetic Analysis,Disease specific molecular marker,Flow Cytometry,Radiological
POST122	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Date intervention started:	YYYY/MM/DD		Date intervention started:	YYYY/MM/DD
POST123	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Specify therapy (check all that apply)	Blinded randomized trial,Cellular therapy,Other therapy,Radiation,Systemic therapy		Specify therapy (check all that apply)	Blinded randomized trial,Cellular therapy,Other therapy,Radiation,Systemic therapy
POST124	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Specify systemic therapy (check all that apply)	Alemtuzumab,Azacytidine,Blinatumomab,Bortezomib,Bosutinib,Carfilzomib,Chemotherapy,Dasatinib,Decitabine,Gemtuzumab,Gilteritinib,Ibrutinib,Imatinib mesylate,Ixazomib,Lenalidomide,Lestaurtinib,Midostaurin,Nilotinib,Nivolumab,Other systemic therapy,Pembrolizumab,Pomalidomide,Quizartinib,Rituximab,Sorafenib,Sunitinib,Thalidomide		Specify systemic therapy (check all that apply)	Alemtuzumab,Azacytidine,Blinatumomab,Bortezomib,Bosutinib,Carfilzomib,Chemotherapy,Dasatinib,Decitabine,Gemtuzumab,Gilteritinib,Ibrutinib,Imatinib mesylate,Ixazomib,Lenalidomide,Lestaurtinib,Midostaurin,Nilotinib,Nivolumab,Other systemic therapy,Pembrolizumab,Pomalidomide,Quizartinib,Rituximab,Sorafenib,Sunitinib,Thalidomide, Daratumumb (Darzalex), Venetoclax
POST125	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Specify other systemic therapy:	open text		Specify other systemic therapy:	open text
POST126	Post-Transplant	Relapse or Progression Post-HCT		no	yes	Specify other therapy:	open text		Specify other therapy:	open text
POST127	Post-Transplant	Current Disease Status		no	yes	What is the current disease status?	Complete remission (CR),Not in complete remission,Not evaluated		What is the current disease status?	Complete remission (CR),Not in complete remission,Not evaluated
POST128	Post-Transplant	Current Disease Status		no	yes	Specify disease status if not in complete remission	Disease detected,No disease detected but incomplete evaluation to establish CR		Specify disease status if not in complete remission	Disease detected,No disease detected but incomplete evaluation to establish CR
POST129	Post-Transplant	Current Disease Status		no	yes	Date of most recent disease assessment:	YYYY/MM/DD		Date of assesment of current disease status	YYYY/MM/DD
POST130	Post-Transplant	Recipient Death Data	Recipient Death	yes	no				Date of death:	YYYY/MM/DD
POST131	Post-Transplant	Recipient Death Data	Recipient Death	yes	no				Date estimated	checked
POST132	Post-Transplant	Recipient Death Data	Recipient Death	yes	no				Was cause of death confirmed by autopsy?	Autopsy pending,No,Unknown,Yes
POST133	Post-Transplant	Recipient Death Data	Recipient Death	yes	no				Was documentation submitted to the CIBMTR?	No,Yes
POST134	Post-Transplant	Recipient Death Data	Recipient Death	yes	no	Primary cause of death	Accidental death,Acute GVHD,Adult respiratory distress syndrome (ARDS) (other than IPS),Bacterial infection,Cardiac failure,Chronic GVHD,Central nervous system (CNS) failure,COVID-19 (SARS-CoV-2),Cytokine release syndrome,Diffuse alveolar damage (without hemorrhage), Disseminated intravascular coagulation (DIC),Fungal infection, Gastrointestinal (GI) failure (not liver),Graft rejection or failure, Thrombotic microangiopathy (TMA) (Thrombotic thrombocytopenic purpura (TTP)/Hemolytic Uremic Syndrome (HUS)),Idiopathic pneumonia syndrome (IPS), Liver failure (not VOD),Multiple organ failure,New malignancy,Infection, organism not identified,Other cause, Other infection,Other organ failure,Other pulmonary syndrome (excluding pulmonary hemorrhage),Other vascular,Prior malignancy,Protozoal infection, Pulmonary failure,Recurrence / persistence / progression of disease,Renal failure,Suicide,Thromboembolic, Pneumonitis due to Cytomegalovirus (CMV),Viral infection,Pneumonitis due to other virus,Veno-occlusive disease (VOD) / sinusoidal obstruction syndrome (SOS)		Primary cause of death	Accidental death,Acute GVHD,Adult respiratory distress syndrome (ARDS) (other than IPS),Bacterial infection,Cardiac failure,Chronic GVHD,Central nervous system (CNS) failure,COVID-19 (SARS-CoV-2),Cytokine release syndrome,Diffuse alveolar damage (without hemorrhage),Diffuse alveolar hemorrhage (DAH),Disseminated intravascular coagulation (DIC),Fungal infection,Gastrointestinal hemorrhage,Gastrointestinal (GI) failure (not liver),Graft rejection or failure,Hemorrhagic cystitis,Thrombotic microangiopathy (TMA) (Thrombotic thrombocytopenic purpura (TTP)/Hemolytic Uremic Syndrome (HUS)),Idiopathic pneumonia syndrome (IPS),Intracranial hemorrhage,Liver failure (not VOD),Multiple organ failure,New malignancy,Infection, organism not identified,Other cause,Other hemorrhage neurotoxicity (ICANS), Other infection,Other organ failure,Other pulmonary syndrome (excluding pulmonary hemorrhage),Other vascular,Prior malignancy,Protozoal infection,Pulmonary hemorrhage,Pulmonary failure,Recurrence / persistence / progression of disease,Renal failure,Suicide,Thromboembolic, Tumor lysis syndrome, Pneumonitis due to Cytomegalovirus (CMV),Viral infection,Pneumonitis due to other virus,Veno-occlusive disease (VOD) / sinusoidal obstruction syndrome (SOS)
POST135	Post-Transplant	Recipient Death Data	Recipient Death	yes	no	Specify:	open text		Specify:	open text
POST136	Post-Transplant	Recipient Death Data	Recipient Death	yes	no	Contributing cause of death	Accidental death,Acute GVHD,Adult respiratory distress syndrome (ARDS) (other than IPS),Bacterial infection,Cardiac failure,Chronic GVHD,Central nervous system (CNS) failure,COVID-19 (SARS-CoV-2),Cytokine release syndrome,Diffuse alveolar damage (without hemorrhage), Disseminated intravascular coagulation (DIC),Fungal infection, Gastrointestinal (GI) failure (not liver),Graft rejection or failure, Thrombotic microangiopathy (TMA) (Thrombotic thrombocytopenic purpura (TTP)/Hemolytic Uremic Syndrome (HUS)),Idiopathic pneumonia syndrome (IPS), Liver failure (not VOD),Multiple organ failure,New malignancy,Infection, organism not identified,Other cause, Other infection,Other organ failure,Other pulmonary syndrome (excluding pulmonary hemorrhage),Other vascular,Prior malignancy,Protozoal infection, Pulmonary failure,Recurrence / persistence / progression of disease,Renal failure,Suicide,Thromboembolic, Pneumonitis due to Cytomegalovirus (CMV),Viral infection,Pneumonitis due to other virus,Veno-occlusive disease (VOD) / sinusoidal obstruction syndrome (SOS)		Contributing cause of death	Accidental death,Acute GVHD,Adult respiratory distress syndrome (ARDS) (other than IPS),Bacterial infection,Cardiac failure,Chronic GVHD,Central nervous system (CNS) failure,COVID-19 (SARS-CoV-2),Cytokine release syndrome,Diffuse alveolar damage (without hemorrhage),Diffuse alveolar hemorrhage (DAH),Disseminated intravascular coagulation (DIC),Fungal infection,Gastrointestinal hemorrhage,Gastrointestinal (GI) failure (not liver),Graft rejection or failure,Hemorrhagic cystitis,Thrombotic microangiopathy (TMA) (Thrombotic thrombocytopenic purpura (TTP)/Hemolytic Uremic Syndrome (HUS)),Idiopathic pneumonia syndrome (IPS),Intracranial hemorrhage,Liver failure (not VOD),Multiple organ failure,New malignancy,Infection, organism not identified,Other cause,Other hemorrhage neurotoxicity (ICANS), Other infection,Other organ failure,Other pulmonary syndrome (excluding pulmonary hemorrhage),Other vascular,Prior malignancy,Protozoal infection,Pulmonary hemorrhage,Pulmonary failure,Recurrence / persistence / progression of disease,Renal failure,Suicide,Thromboembolic, Tumor lysis syndrome, Pneumonitis due to Cytomegalovirus (CMV),Viral infection,Pneumonitis due to other virus,Veno-occlusive disease (VOD) / sinusoidal obstruction syndrome (SOS)
POST137	Post-Transplant	Recipient Death Data	Recipient Death	yes	no	Specify:	open text		Specify:	open text
POST138	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes	Specify the new malignancy	Hematologic Malignancy: Acute myeloid leukemia (AML / ANLL), Other leukemia, Myelodysplastic syndrome (MDS), Myeloproliferative neoplasm (MPN), Overlapping myelodysplasia / myeloproliferative neoplasm (MDS / MPN), Hodgkin lymphoma, Non-Hodgkin lymphoma, Clonal cytogenetic abnormality without leukemia or MDS, Uncontrolled proliferation of donor cells without malignant transformation Solid Tumors: Oropharyngeal cancer (e.g. tongue, mouth, throat), Gastrointestinal malignancy (e.g. esophagus, stomach, small intestine, colon, rectum, anus, liver, pancreas), Lung cancer, Melanoma, Squamous cell skin malignancy, Basal cell skin malignancy, Breast cancer, Genitourinary malignancy (e.g. kidney, bladder, cervix, uterus, ovary, prostate, testis), Central nervous system (CNS) malignancy (e.g. meningioma, glioma), Thyroid cancer		Specify the new malignancy	Hematologic Malignancy: Acute myeloid leukemia (AML / ANLL), Acute lymphoblastic leukemia (ALL), Other leukemia, Myelodysplastic syndrome (MDS), Myeloproliferative neoplasm (MPN), Overlapping myelodysplasia / myeloproliferative neoplasm (MDS / MPN), Hodgkin lymphoma, Non-Hodgkin lymphoma, Multiple myeloma / plasma cell neoplasms, Clonal cytogenetic abnormality without leukemia or MDS, Uncontrolled proliferation of donor cells without malignant transformation. Solid Tumors: Bone sarcoma (regardless of site), Soft tissue sarcoma (regardless of site), Oropharyngeal cancer (e.g. tongue, mouth, throat), Gastrointestinal malignancy (e.g. esophagus, stomach, small intestine, colon, rectum, anus, liver, pancreas), Lung cancer, Melanoma, Squamous cell skin malignancy, Basal cell skin malignancy, Breast cancer, Genitourinary malignancy (e.g. kidney, bladder, cervix, uterus, ovary, prostate, testis), Central nervous system (CNS) malignancy (e.g. meningioma, glioma), Thyroid cancer
POST139	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Was post-transplant lymphoproliferative disorder (PTLD) diagnosed?	No,Yes
POST140	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Specify type of PTLD	Monomorphic,Polymorphic,Unknown
POST141	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Specify oropharyngeal cancer	Mouth,Throat,Tongue, Other oropharyngeal cancer
POST142	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Specify gastrointestinal malignancy	Anus,Colon,Esophagus,Liver ,Pancreas,Rectum,Small intestine (DUODENUM, JEJUNUM, ILEUM),Stomach, Other gastrointestinall cancer
POST143	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Specify genitourinary malignancy	Bladder,Cervix,Kidney,Ovary,Prostate,Testicle,Uterus, Other genitourary malignancy
POST144	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Specify CNS malignancy	Glioma,Meningioma,Other CNS malignancy
POST145	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes	Specify other new malignancy:	open text		Specify other new malignancy:	open text
POST146	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes	Date of diagnosis:	YYYY/MM/DD		Date of diagnosis:	YYYY/MM/DD
POST147	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes	Was documentation submitted to the CIBMTR?	No,Yes		Was documentation submitted to the CIBMTR?	No,Yes
POST148	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes	Was the new malignancy donor / cell product derived?	No,Not Done,Yes		Was the new malignancy donor / cell product derived?	No,Not Done,Yes
POST149	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes	Was documentation submitted to the CIBMTR?	no,yes		Was documentation submitted to the CIBMTR?	no,yes
POST150	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Was PTLD confirmed by biopsy?	No,Yes
POST151	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes	Was the pathology of the tumor EBV positive?	no,yes		Was the pathology of the tumor EBV positive?	no,yes
POST152	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Was documentation submitted to the CIBMTR? (e.g. pathology report)	No,Yes
POST153	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Was there EBV reactivation in the blood?	No,Not Done,Yes
POST154	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				How was EBV reactivation diagnosed?	Other method,Qualitative PCR of blood,Quantitative PCR of blood
POST155	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Specify other method:	open text
POST156	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Quantitative EBV viral load of blood: At diagnosis	_____ copies/ml
POST157	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Was a quantitative PCR of blood performed again after diagnosis?	No,Yes
POST158	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Highest EBV viral load of blood:	______copies/ml
POST159	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Was there lymphomatous involvement?	No,Yes
POST160	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Specify sites of PTLD involvement (check all that apply)	Bone marrow,Central nervous system (brain or cerebrospinal fluid),Liver,Lung,Lymph node(s),Other,Spleen
POST161	Post-Transplant	Subsequent Neoplasms	New Malignancy, Lymphoproliferative or Myeloproliferative Disease / Disorder	yes	yes				Specify other site:	open text
POST162	Post-Transplant	Subsequent Neoplasms		no	yes	First Name (person completing form):	open text		First Name (person completing form):	open text
POST163	Post-Transplant	Subsequent Neoplasms		no	yes	Last Name:	open text		Last Name:	open text
POST164	Post-Transplant	Subsequent Neoplasms		no	yes	E-mail address:	open text		E-mail address:	open text
POST165	Post-Transplant	Subsequent Neoplasms		no	yes	Date:	YYYY/MM/DD		Date:	YYYY/MM/DD

Sheet 6: pull down menus

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