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Retired Forms Manuals

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Retired Forms Manuals

For reference purposes, CIBMTR provides online access to manuals for retired CIBMTR and NMDP/Be The Match forms, Appendices and General Instruction documents.  See the sections below for all retired content.   

Retired Forms Manuals​
Form Number​Form NameForm Version ​Retired Date
​2000Baseline Form Instructions (PDF)​4.0​March 2015
2000​ Baseline Form Instructions (PDF)​​3.0​October 2013
​2004Infectious Disease Markers Form Instructions (PDF)​4.0March 2015
2004​Infectious Disease Markers Form Instructions (PDF) ​3.0​October 2013
​2005Confirmation of HLA Typing Form Instructions (PDF)​5.0January 2017
2005​Confirmation of HLA Typing Form Instructions (PDF)​4.0​October 2013
​2006Infusion Form Instructions (PDF)​4.0​March 2015
2006​Infusion Form Instructions (PDF)​2.0​October 2013
2006​ Infusion Form FAQ (PDF)1.0​​February 2010
​2010Acute Myelogenous Leukemia (AML) Pre-HCT Data Form Instructions (PDF)​3.0​July 2017
2010​Acute Myelogenous Leukemia (AML) Pre-HSCT Data Form Instructions (PDF)​2.0​October 2013
​2011Acute Lymphoblastic Leukemia (ALL) Pre-HCT Data Form Instructions (PDF)​4.0July 2017
2013Chronic Lymphocytic Leukemia (CLL) Pre-HCT Data Form Instructions (PDF)​2.0March 2015
​2014Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Pre-HCT Data Form Instructions (PDF)​3.0March 2015
​2015Juvenile Myelomonocytic Leukemia (JMML) Pre-HCT Data Form Instructions (PDF)​3.0​March 2015
​2016 ​Multiple Myeloma / Plasma Cell Disorders (PCD) Pre-HCT Data Form Instructions (PDF)​3.0​March 2015
2016​Multiple Myeloma / Plasma Cell Leukemia Pre-HSCT Data Form Instructions (PDF)​2.0​October 2013
​2018Hodgkin and Non-Hodgkin Lymphoma Pre-HCT Data Form Instructions (PDF)​4.0​January 2019
​2018Hodgkin and Non-Hodgkin Lymphoma Pre-HCT Data Form Instructions (PDF)​3.0January 2018
2018​Hodgkin and Non-Hodgkin Lymphoma Pre-HSCT Data Form Instructions (PDF)​2.1​October 2013
​2019Waldenstrom's Macroglobulinemia / Lymphoplasmacytic Lymphoma (MAC) Pre-HCT Data Form Instructions (PDF)​3.0​March 2015
​2028Aplastic Anemia Pre-HCT Data Form Instructions (PDF)​2.0​March 2015
​2034 ​X-Linked Lymphoproliferative Syndrome (XLP) Pre-HCT Data Form Instructions​3.0​March 2015
​2039Hemophagocytic Lymphohistiocytosis (HLH) Pre-HCT Data Form Instructions (PDF)​3.0​March 2015
​2046Fungal Infection Pre-Infusion Data (PDF)​4.0​May 2018
​2100100 Day Post-HCT Data Form Instructions (PDF)​4.0​July 2018
​2100100 Days Post-HCT Data Form Instructions (PDF)​3.0January 2017
​2110Acute Myelogeneous Leukemia (AML) Post-HCT Data Form Instructions (PDF)​3.0​July 2017
2110​Acute Myelogenous Leukemia (AML) Post-HSCT Data Form Instructions (PDF)​2.0​October 2013
​2111Acute Lymphoblastic Leukemia (ALL) Post-HCT Data Form Instructions (PDF)​3.0​July 2017
​2113Chronic Lymphocytic Leukemia (CLL) Post-HCT Data Form Instructions (PDF)​2.0​March 2015
​2114Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Post-HCT Data Form Instructions (PDF)​3.0​March 2015
​2115 ​Juvenile Myelomonocytic Leukemia (JMML) Post-HCT Data Form Instructions (PDF)​3.0​March 2015
​2116 ​Multiple Myeloma / Plasma Cell Disorders (PCD) Post-HCT Data Form Instructions (PDF)​3.0​March 2015
2116​Multiple Myeloma / Plasma Cell Leukemia Post-HSCT Data Form Instructions (PDF)​2.0​October 2013
​2118Hodgkin and Non-Hodgkin Lymphoma Post-HCT Data Form Instructions (PDF)​3.0​January 2018
2118​Hodgkin and Non-Hodgkin Lymphoma Post-HSCT Data Form Instructions (PDF)​2.0​October 2013
​2119Waldenstrom's Macroglobulinemia / Lymphoplasmacytic Lymphoma (MAC) Post-HCT Data Form Instructions (PDF)​3.0​March 2015
​2128 ​Aplastic Anemia Post-HCT Data Form Instructions (PDF)​2.0​March 2015
​2134 ​X-Linked Lymphoproliferative Syndrome (XLP) Post-HCT Data Form Instructions (PDF)​3.0​March 2015
​2139 ​Hemophagocytic Lymphohistiocytosis (HLH) Post-HCT Data Form Instructions (PDF)​3.0​March 2015
​2146Fungal Infection Post-Infusion Data (PDF)​3.0​May 2018
​2200 ​Six Months to Two Years Post-HCT Data Form Instructions (PDF)​3.0​January 2017
​2300Greater Than Two Years Post-HCT Data Form Instructions (PDF)​3.0January 2017
​2400Pre-TED Form Instructions (PDF)​4.0January 2017
2400​Pre-TED Form Instructions (PDF)​3.0​October 2013
​2402Pre-TED Disease Classification Form Instructions (PDF)​2.0​January 2018
​2402Pre-TED Disease Classification Form Instructions (PDF)​1.0​July 2017
​2450Post-TED Form Instructions (PDF)​3.0​January 2017
​2800Log of Appended Documents Form Instructions (PDF)​2.0​March 2015
​General Instructions Section 11Log of Appended Documents​N/A​August 2014
​2804CIBMTR Recipient ID Assignment Form Instructions (PDF)​4.0​March 2015
​2900Recipient Death Data Form Instructions (PDF)​3.0​January 2019
​2900Recipient Death Data Form Instructions (PDF)​2.0​January 2017
​2900 ​Recipient Death Data Form Instructions (PDF)​1.0​March 2015
​4000Cellular Therapy Essential Data Pre-Infusion Form Instructions (PDF)​4.0​January 2018
​4000Cellular Therapy Essential Data Pre-Infusion Form Instructions (PDF)​3.0​July 2017
​4003Cellular Therapy Product Form Instructions (PDF)​1.0​January 2019
​4006Cellular Therapy Infusion Data Form Instructions (PDF)​2.0​January 2018
​4006Cellular Therapy Infusion Data Form Instructions (PDF)​1.0​July 2017
​4100Cellular Therapy Essential Data Follow-Up Form Instructions (PDF)​3.0​October 2018
​4100Cellular Therapy Essential Data Follow-Up Form Instructions (PDF)​2.0​January 2018
​4100Cellular Therapy Essential Data Follow-Up Form Instructions (PDF)​1.0​July 2017
N/A​ Supplemental Report Form ManualsN/A​​September 2013
N/A​ TED Manual (PDF)N/A​​January 2008
N/A NMDP Forms Instruction Manual (PDF)N/A​​December 2007
​N/ACIBMTR Data Management Manual (PDF)​N/A​December 2007
​N/ACIBMT Registration Instruction Manual (PDF)​N/A​December 2007

  

Appendices
Table of Contents (PDF)Appendices Table of Contents
Appendix A (PDF)Abbreviations and Definitions
Appendix B (PDF)Glossary of Terms
Appendix C (PDF)​Cytogenetic Assessments
Appendix C (PDF)CIBMTR Data Collection Forms
Appendix D (PDF)Unique ID Assignment Form (CRID), Form 2804
Appendix E (PDF)Public Health Authority (PHA) Status
Appendix F (PDF)Validation Ranges
Appendix G (PDF)Continuous Process Improvement (CPI) and Procedures for Non-Compliance
Appendix H (PDF)Summary of CIBMTR On-Site Data Audit Program
Appendix I (PDF)Ethnicity and Race
Appendix J (PDF)CIBMTR Contact Information
Appendix K (PDF)Key Fields
Appendix L (PDF)Karnofsky/Lansky Performance Status
Appendix M (PDF)The Hematopoietic Cell Transplant-Co-morbidity Index (HCT-CI)
Appendix N (PDF)Response Evaluation Criteria in Solid Tumors (RECIST)
Appendix O (PDF)How to Distinguish Infusion Types
Appendix P (PDF)Definition of Product
Appendix Q (PDF)United States Abbreviations
​Appendix R (PDF)​Cytogenetic Abbreviations and Terminology
Appendix S (PDF)
​Multiple Donor Chimerism
Appendix T (PDF)​Pre-HCT Treatment for Lymphoma
Appendix U (PDF)Helpful Hints for Reporting Co-Existing Diseases​
Appendix V (PDF)Multiple Myeloma - Defining What Baseline to Use When Determining the Best Response to HSCT
Appendix W (DOC)Tracking Disease Status for Multiple Myeloma
Appendix Y (PDF)​Critical Fields
Appendix Z (PDF)​Primary Disease and Disease Inserts Due

 

 

General Instructions
Table of Contents (PDF)General Instructions
Section 1 (PDF)Introduction
Section 2 (PDF)Stem Cell Therapeutic Outcomes Database (SCTOD)
Section 3 (PDF)Center Type and Data Collection Forms
Section 4 (PDF)Autologous Hematopoietic Stem Cell Transplant
Section 5 (PDF)EBMT Centers
Section 6 (PDF)Protocols and Consent Forms
Section 7 (PDF)Unique ID Assignment (CRID) & Protected Health Information, Form 2804
Section 8 (PDF)FormsNet
Section 9 (PDF)Forms Due Report
Section 10 (PDF)CIBMTR Campus & CRC Assignment
Section 12 (PDF)Declaring Recipients Lost to Follow-Up
Section 13 (PDF)Recipient Transfers
Section 14 (PDF)General Guidelines for Completing Forms
Section 15 (PDF)How to Avoid Errors
Section 16 (PDF)Reimbursement for Forms Completion
Section 17 (PDF)Continuous Process Improvement (CPI)
Section 18 (PDF)On-Site Data Audits
Section 19 (PDF)Helpful Web sites and CIBMTR Contact Information

 

 

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Last Updated: 2/5/2019 1:29 PM
CIBMTR