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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 Name​Form Version ​Retired Date
​2000
​Baseline Form Instructions (PDF)
​5.0
​October 2020
​2000​Baseline Form Instructions (PDF)​4.0​January 2020
​2000​Baseline Form Instructions (PDF)​4.0​March 2015
2000​ Baseline Form Instructions (PDF)​​3.0​October 2013
​2004​Infectious Disease Markers Form Instructions (PDF)​4.0​January 2020
​2004​Infectious Disease Markers Form Instructions (PDF)​4.0March 2015
2004​​Infectious Disease Markers Form Instructions (PDF) ​3.0​October 2013
​2005​Confirmation of HLA Typing Form Instructions (PDF)​6.0​January 2020
​2005​Confirmation of HLA Typing Form Instructions (PDF)​5.0January 2017
2005​​Confirmation of HLA Typing Form Instructions (PDF)​4.0​October 2013
​2006​Infusion Form Instructions (PDF)​4.0​January 2020
​2006​Infusion 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
​2010​Acute 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
​2011​Acute Lymphoblastic Leukemia (ALL) Pre-HCT Data Form Instructions (PDF)​4.0July 2017
2013​Chronic Lymphocytic Leukemia (CLL) Pre-HCT Data Form Instructions (PDF)​2.0March 2015
​2014​Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Pre-HCT Data Form Instructions (PDF)​3.0​May 2020
​2014​Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Pre-HCT Data Form Instructions (PDF)2.0March 2015
​2015
​Juvenile Myelomonocytic Leukemia (JMML) Pre-HCT Data Form Instructions (PDF)​3.0​March 2015
​2016

​Multiple Myleoma / Plasma Cell Disorders (PCD) Pre-HCT Data Form Instructions (PDF)

​3.0
​April 2021
​2016 ​Multiple Myleoma / Plasma Cell Disorders (PCD) Pre-HCT Data Form Instructions (PDF)​3.0​January 2020
​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
​2018​Hodgkin and Non-Hodgkin Lymphoma Pre-HCT Data Form Instructions (PDF)​4.0​January 2019
​2018
​Hodgkin and Non-Hodgkin Lymphoma Pre-HCT Data Form Instructions (PDF)
​5.0
​October 2020
​2018
 Hodgkin 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)​2.0​October 2013
​2019​Waldenstrom's Macroglobulinemia / Lymphoplasmacytic Lymphoma (MAC) Pre-HCT Data Form Instructions (PDF)​3.0​March 2015
​2028
​Aplastic Anemia Pre-HCT Data Form Instructions (PDF)
​2.0
​October 2020
​2028
​Aplastic Anemia Pre-HCT Data Form Instructions (PDF)
1.0​March 2015
​2034 ​X-Linked Lymphoproliferative Syndrome (XLP) Pre-HCT Data Form Instructions​3.0​March 2015
​2039​Hemophagocytic Lymphohistiocytosis (HLH) Pre-HCT Data Form Instructions (PDF)​3.0​March 2015
​2046​Fungal Infection Pre-Infusion Data (PDF)​4.0​May 2018
​2100
Post-HCT Follow-Up (PDF)
​6.0
​July 2021
​2100
100 Day Post-HCT Data Form Instructions (PDF)​
​5.0
​October 2020
​2100
​100 Day Post-HCT Data Form Instructions (PDF)​4.0​July 2018
​2100​100 Days Post-HCT Data Form Instructions (PDF)​3.0January 2017
​2110​Acute 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
​2111​Acute Lymphoblastic Leukemia (ALL) Post-HCT Data Form Instructions (PDF)​3.0​July 2017
​2113​Chronic Lymphocytic Leukemia (CLL) Post-HCT Data Form Instructions (PDF)​2.0​March 2015
​2114​Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Post-HCT Data Form Instructions (PDF)​3.0​May 2020
​2114​Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Post-HCT Data Form Instructions (PDF)2.0​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
​April 2021
​2116​Multiple Myeloma / Plasma Cell Disorders (PCD) Post-HCT Data Form Instructions (PDF)​3.0​January 2020
​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
​2118 Hodgkin 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
​2119​Waldenstrom'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
​October 2020
​2128
 ​Aplastic Anemia Post-HCT Data Form Instructions (PDF)1.0​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
​2146​Fungal 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
​2300​Greater Than Two Years Post-HCT Data Form Instructions (PDF)​3.0January 2017
​2400
​Pre-TED Form Instructions (PDF)
​7.0
​January 2021
​2400​Pre-TED Form Instructions (PDF)​6.0​May 2020
2400​​Pre-TED Form Instructions (PDF)​5.0​January 2020
​2400​Pre-TED Form Instructions (PDF)​4.0January 2017
2400​​Pre-TED Form Instructions (PDF)​3.0​October 2013
​2402
​Pre-TED Disease Classification Form Instructions (PDF)
​5.0
​October 2020
​2402​Pre-TED Disease Classification Form Instructions (PDF)​4.0​May 2020
​2402​Post-TED Disease Classification Form Instructions (PDF)3.0​January 2020
​2402 Pre-TED Disease Classification Form Instructions (PDF)​2.0​January 2018
​2402​Pre-TED Disease Classification Form Instructions (PDF)​1.0​July 2017
​2450​Post-TED Form Instructions (PDF)​4.0​January 2020
​2450​Post-TED Form Instructions (PDF)​3.0​January 2017
​2540
​Tepadina® Supplemental Data Collection Form Instructions (PDF)
​1.0
​April 2019
​2556 ​Myelofibrosis Pre-HCT Data​1.0​May 2020
​2557​Myelofibrosis Post-HCT Data​1.0​May 2020
​2800​Log of Appended Documents Form Instructions (PDF)​2.0​March 2015
​General Instructions Section 11​Log of Appended Documents​N/A​August 2014
​2804​CIBMTR Recipient ID Assignment Form Instructions (PDF)​5.0​October 2019
​2804​CIBMTR Recipient ID Assignment Form Instructions (PDF)​4.0​March 2015
​2814
​Indication Form Instructions (PDF)
​2.0
​April 2019
​2900

​Recipient Death Data Form Instructions (PDF)​3.0​January 2019
​2900​Recipient Death Data Form Instructions (PDF)​2.0​January 2017
​2900 ​Recipient Death Data Form Instructions (PDF)​1.0​March 2015
​3500
​Subsequent Neoplasms (PDF)
​1.0
​July 2021
​4000
​Cellular Therapy Essential Data Pre-Infusion Form Instructions (PDF)
​7.0
​July 2021
​4000
​Cellular Therapy Essential Data Pre-Infusion Form Instructions (PDF)
​6.0
​January 2021
​4000 ​Cellular Therapy Essential Data Pre-Infusion Form Instructions (PDF)​5.0​January 2020
​4000
 Cellular Therapy Essential Data Pre-Infusion Form Instructions (PDF)​4.0​January 2018
​4000
​Cellular Therapy Essential Data Pre-Infusion Form Instructions (PDF)​3.0​July 2017
​4003
​Cellular Therapy Product Form Instructions (PDF)
​3.0
​January 2021
​4003​Cellular Therapy Product Form Instructions (PDF)​2.0​January 2020
​4003​Cellular Therapy Product Form Instructions (PDF)​1.0​January 2019
​4006
​Cellular Therapy Infusion Data Form Instructions (PDF)
​4.0
​January 2021
​4006​Cellular Therapy Infusion Data Form Instructions (PDF)​3.0​January 2020
​4006 Cellular Therapy Infusion Data Form Instructions (PDF)​2.0​January 2018
​4006​Cellular Therapy Infusion Data Form Instructions (PDF)​1.0​July 2017
​4100
​Cellular Therapy Essential Data Follow-Up Form Instructions (PDF)
​6.0
​July 2021
​4100
​Cellular Therapy Essential Data Follow-Up Form Instructions (PDF)
​5.0
​January 2021
​4100​Cellular Therapy Essential Data Follow-Up Form Instructions (PDF)​4.0​January 2020
​4100​Cellular Therapy Essential Data Follow-Up Form Instructions (PDF)​3.0​October 2018
​4100 Cellular Therapy Essential Data Follow-Up Form Instructions (PDF)​2.0​January 2018
​4100​Cellular 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/A​CIBMTR Data Management Manual (PDF)​N/A​December 2007
​N/A​CIBMT Registration Instruction Manual (PDF)​N/A​December 2007

  

Retired Response Criteria
Disease Response Criteria ​Retired Date
Acute Lymphoblastic Leukemia (ALL) Response Criteria July 2017
Acute Monoblastic Leukemia (AML) Response CriteriaJuly 2017
Hodgkin and Non-Hodgkin Lymphoma (LYM) Response Criteria January 2018
Multiple Myeloma (MM) / Plasma Cell Disorders (PCD) Response CriteriaJanuary 2020
​Myelodysplastic Syndrome (MDS) / Myeloproliferative Neoplasm (MPN) Response CriteriaMay 2020


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: 7/27/2021 10:01 AM
CIBMTR