Question 18: Is this the first time the recipient is being treated using a cellular therapy (non-HCT)?

This is defined as the first application of a cellular therapy the recipient ever receives, not the first application the recipient receives at your facility. The intent is to capture the full picture of the recipient’s treatment history.

If this is the first application of a cellular therapy the recipient has ever received or it is not known if this is the first cellular therapy, select Yes or Unknown, respectively and continue with question 27. If this is the not the first time the recipient has received a cellular therapy, select No and continue with question 19.

Question 19: Were all prior cellular therapies (non-HCT) reported to the CIBMTR?

This should include any / all infusions not performed at your center. If the recipient had a prior infusion, the past infusion dates can be found in the Recipient Information Grid in FormsNet3SM. Contact CIBMTR Center Support if there are questions.

If all prior cellular therapies were reported to the CIBMTR or it is not known if all cellular therapies were reported to the CIBMTR, select Yes or Unknown, respectively and continue to question 27. If all cellular therapies were not reported to the CIBMTR, report No and continue with question 20.

Question 20: Specify the number of prior cellular therapies:

Enter the number of prior cellular therapies for the recipient. A “cellular therapy event” is defined as the infusion or administration of a cellular therapy product for treatment of a specific indication(s). Each infusion or administration of a cellular product should be counted separately. Include all infusions the recipient received, even if they were not performed at your center. The intent is to capture the full picture of the recipient’s treatment history. It is not expected to complete forms for prior unreported infusions.

Question 21: Date of the prior cellular therapy:

Report the date (YYYY-MM-DD) of the prior cellular therapy for the reported instance. If the exact date is unknown and must be estimated, check the “date estimated” box.

For more information regarding reporting partial or unknown dates, see General Instructions, General Guidelines for Completing Forms.

Question 22: Was the cellular therapy performed at a different institution?

Indicate Yes or No if the prior cellular therapy reported in this instance was performed at another institution. If Yes, report the name and address of the institution in question 23.

Question 23: Specify the institution that performed the prior cellular therapy:

Report the name, city, state, and country of the institution where the recipient’s prior cellular therapy being reported in this instance was performed. These data are used to identify and link the recipient’s existence in the database and, if necessary, obtain data from the other institution where the previous treatment was administered.

Question 24 – 25: Specify the primary indication for the prior cellular therapy:

Select the indication for the prior cellular therapy reported in this instance. Any indication that is followed by “(post-HCT)” or “(with HCT)” requires a prior HCT also be reported to CIBMTR.

If the indication for the prior cellular therapy is not listed, select Other indication and specify the indication in question 25. If the indication for the prior cellular therapy is not documented, select Unknown.

Question 26: What was the cell source for the prior cellular therapy? (check all that apply)

Indicate the cell source(s) for the prior cellular therapy reported in this instance. If the product is “off the shelf” or a “third party donor” product obtained from pharmaceutical companies or other corporate entities, the donor type should still be identified.

An Autologous product has cells collected from the recipient for his / her own use.

An unrelated donor (Allogeneic, unrelated) is a donor who shares no known ancestry with the recipient. Include adoptive parents / children or stepparents / children.

A related donor (Allogeneic, related or syngeneic) is a blood-related relative. This includes monozygotic (identical twins), non-monozygotic (dizygotic, fraternal, non-identical) twins, siblings, parents, aunts, uncles, children, cousins, half-siblings, etc.

Question 27: Has the recipient ever had a prior HCT?

Include all HCTs in the recipient’s history, even if the transplants were not performed at your center. The intent is to capture the full picture of the recipient’s treatment history.

If the recipient has had a prior HCT, select Yes. If the recipient has not had a prior HCT, select No or Unknown, respectively and continue with question 33.

Question 28: Were all prior HCTs reported to the CIBMTR?

This should include any / all infusions not performed at your center. If the recipient had a prior infusion, the past infusion dates can be found in the Recipient Information Grid in FormsNet3SM. Contact CIBMTR Center Support if there are questions.

If all prior HCTs were reported to the CIBMTR or it is not known if all HCTs were reported to the CIBMTR, select Yes or Unknown, respectively and continue with question 33. If all HCTs were not reported to the CIBMTR, select No.

Question 29: Date of the prior HCT:

Report the date (YYYY-MM-DD) of the prior HCT reported in this instance.

If the exact date is unknown, please view General Instructions, General Guidelines for Completing Forms for more information on reporting partial and unknown dates.

Questions 30 – 31: Was the HCT performed at a different institution?

Indicate Yes or No if the prior HCT reported in this instance was performed at another institution. If Yes, report the name, city, state, and country of the institution where the recipient’s prior HCT reported in this instance was performed in question 31. These data are used to identify and link the recipient’s existence in the database and, if necessary, obtain data from the previous transplant center.

If the prior HCT was not performed at a different institution, select No and continue with question 32.

Question 32: Specify the HSC source(s) for the prior HCT: (check all that apply)

Indicate the applicable cell source(s) for the prior HCT being reported in this instance.

An Autologous product has cells collected from the recipient for his/her own use.

An unrelated donor (Allogeneic, unrelated) is a donor who shares no known ancestry with the recipient. Include adoptive parents / children or stepparents / children.

A related donor (Allogeneic, related) is a blood-related relative. This includes monozygotic (identical twins), non-monozygotic (dizygotic, fraternal, non-identical) twins, siblings, parents, aunts, uncles, children, cousins, half-siblings, etc.

Section Updates:

Question Number Date of Change Add/Remove/Modify Description Reasoning (If applicable)
. . . . .
Last modified: Jan 22, 2021

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