This form must be completed for all recipients randomized to the Comprehensive Report Form (CRF) track whose primary disease is reported on the Pre-TED Disease Classification Form (Form 2402) as Non-Hodgkin lymphoma and the subtype is reported as Waldenström’s Macroglobulinemia/Lymphoplasmacytic Lymphoma. The Waldenström’s Macroglobulinemia/Lymphoplasmacytic Lymphoma Post-HCT Data (Form 2119) must be completed in conjunction with each Post-HCT follow-up form (Forms 2100, 2200, 2300) completed. The form is designed to capture specific data occurring within the timeframe of each reporting period (i.e., between day 0 and day 100 for Form 2100, between day 100 and the six-month date of contact for Form 2200, between the date of contact for the six-month follow-up and the date of contact for the one-year follow-up for Form 2200, etc.).

Q1-17: Disease Assessment at the Time of Best Response to HCT
Q18-58: Post-HCT Therapy
Q59-77: Laboratory Studies at the Time of Evaluation for this Reporting Period
Q78-79: Disease Status at the Time of Evaluation for this Reporting Period

Manual Updates:
Sections of the Forms Instruction Manual are frequently updated. The most recent updates to the manual can be found below. For additional information, select the manual section and review the updated text.

Date Manual Section Add/Remove/Modify Description
3/19/18 Comprehensive Disease Specific Manuals Add Added the following instruction for applicable post-infusion disease-specific forms where current disease status is asked (2110, 2111, 2112, 2113, 2114, 2115, 2116, 2118, 2119).
The center does not need to repeat all disease-specific assessments (biopsies, scans, labs) each reporting period in order to complete current disease status data fields. Once a particular disease status is achieved, the center can continue reporting that disease status (based on labs / clinical assessments) until there is evidence of relapse / progression.
2/24/17 Comprehensive Disease-Specific Manuals Modify Updated explanations of triggers for disease inserts to refer to the primary disease reported on the Pre-TED Disease Classification Form (Form 2402) instead of the Pre-TED Form (Form 2400)
5/29/15 2119: WM Post-HCT Modify Clarified explanatory text for questions 22-23:
Indicate if the number of cycles is “known” or “unknown.” If the number of cycles is known, continue with question 23 and specify the number of cycles of chemotherapy administered. If the patient received a single administration or one line of chemotherapy, indicate a single cycle. If the patient received long-term maintenance therapy consisting of a single agent, indicate “known” for question 82; leave question 83 blank and override the error as “not applicable.” Indicate if the number of cycles is “known” or “unknown.” If known, report the number of cycles the recipient received during the reporting period for the line of therapy reported in question 23. If the therapy is not given in cycles or the number of cycles is not known, select “unknown” and continue with question 24.
If the number of cycles is unknown, continue with question 24.
Last modified: Mar 19, 2018

Need more help with this?
Don’t hesitate to contact us here.

Was this helpful?

Yes No
You indicated this topic was not helpful to you ...
Could you please leave a comment telling us why? Thank you!
Thanks for your feedback.