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Q131 – 200: Chronic Graft vs. Host Disease (GVHD)

Comprehensive Baseline & Follow-up Manuals » 2100: Post-Infusion Follow-Up » Q131 – 200: Chronic Graft vs. Host Disease (GVHD)

*Autologous Transplants If this was an autologous or syngeneic HCT, continue with the Infection Prophylaxis section of the form starting with question 208. Chimerism testing and graft-versus-host disease sections should only be completed for allogeneic HCTs. Report…

Q224-233: Disease Assessment at the Failure of the 1st Line of Therapy (DLBCL only)

Comprehensive Disease-Specific Manuals » 2018/2118: Hodgkin and Non-Hodgkin Lymphoma » 2018: LYM Pre-Infusion » Q224-233: Disease Assessment at the Failure of the 1st Line of Therapy (DLBCL only)

*Disease Assessments at the Failure of the 1st Line of Therapy (DLBCL only) The Disease Assessment at the Failure of the 1st Line of Therapy (DLBCL only) section will only be completed if the primary disease for infusion is de novo diffuse large b-cell lymphoma (DLBCL)…

2553: VOD/SOS

Infection & Miscellaneous Manuals » 2553: VOD/SOS

The Veno-occlusive Disease (VOD) / Sinusoidal Obstruction Syndrome (SOS) Form, Form 2553, must be completed when VOD / SOS has been reported to have developed on the 100 Day Post-HCT Data Form (F2100) or the 100 Day Post-TED Form (Form 2450). Additionally, a Six Month…

Q83-88: Data from Post-HSCT Follow-Up Form (2100)

Infection & Miscellaneous Manuals » 2540: Tepadina® Supplemental Data » Q83-88: Data from Post-HSCT Follow-Up Form (2100)

Questions 83-88 refer to data reported on form 2100, Q441-615, please ensure data reported here matches with form 2100. Questions 83-85: In the transplant physician’s judgment, were any of the disorders / impairments reported on the form 2100 a direct result of…

2018: LYM Pre-Infusion

Comprehensive Disease-Specific Manuals » 2018/2118: Hodgkin and Non-Hodgkin Lymphoma » 2018: LYM Pre-Infusion

Complete this form for recipients whose primary disease, reported on the Disease Classification Form (Form 2402), is Hodgkin Lymphoma (HL) or non-Hodgkin Lymphoma (NHL). One exception is Waldenstrom’s macroglobulinemia / lymphoplasmacytic lymphoma, for which, a…

Q36-82: Organ Function

Infection & Miscellaneous Manuals » 2540: Tepadina® Supplemental Data » Q36-82: Organ Function

Questions 36 – 82: Organ Function This section of the form compliments the organ function section of the Post-HCT Follow Up Data Form, F2100. Hypersensitivity !Questions 36-40 can only be complete on the 100 day follow-up form. These questions will be skipped…

Q213-254: Laboratory Studies at Last Evaluation Prior to the Start of the Preparative Regimen / Infusion

Comprehensive Disease-Specific Manuals » 2057/2157 Myeloproliferative Neoplasms (MPN) » 2057: Myeloproliferative Neoplasm (MPN) Pre-Infusion » Q213-254: Laboratory Studies at Last Evaluation Prior to the Start of the Preparative Regimen / Infusion

Question 213: Date CBC with differential drawn Report the date of the CBC with differential was drawn at the last evaluation prior to the start of the preparative regimen / infusion and continue with question 214. If multiple assessments were performed, report the…

2100: Post-Infusion Follow-Up

Comprehensive Baseline & Follow-up Manuals » 2100: Post-Infusion Follow-Up

A transplant center designated as a Comprehensive Report Form center will submit data on the Pre-TED and Pre-TED Disease Classification Forms, followed by either the Post-TED Form or the Comprehensive Report Forms. The type of follow-up forms required for a specific…

Q172-236: Disease Status at the Time of Evaluation for this Reporting Period

Comprehensive Disease-Specific Manuals » 2014/2114: Myelodysplastic Syndrome (MDS) » 2114: Myelodysplastic Syndrome (MDS) Post-Infusion » Q172-236: Disease Status at the Time of Evaluation for this Reporting Period

Question 172: Does the current disease status reflect the disease detected in this reporting period section (as captured in questions 89-152), without subsequent therapy? This section of the form is intended to capture the most recent disease assessments performed in…

2114: Myelodysplastic Syndrome (MDS) Post-Infusion

Comprehensive Disease-Specific Manuals » 2014/2114: Myelodysplastic Syndrome (MDS) » 2114: Myelodysplastic Syndrome (MDS) Post-Infusion

This form must be completed for all recipients who are randomized to the Comprehensive Report Form (CRF) track and whose primary disease is reported on the Pre-TED Disease Classification Form (Form 2402) as “Myelodysplastic Syndrome (MDS) (50)” The Myelodysplastic…

Q233 – 271: Disease Status Immediately Prior to Preparative Regimen

Comprehensive Disease-Specific Manuals » 2026/2126: Neuroblastoma » 2026: Neuroblastoma Pre-Infusion » Q233 – 271: Disease Status Immediately Prior to Preparative Regimen

Questions 233 – 248: Were tumor marker analyses performed immediately prior to the preparative regimen? Tumor markers, also known as biomarkers, are substances produced by cancer tissue or by the body in response to cancer at higher than normal levels. In…

Q1-28: Diagnosis

Infection & Miscellaneous Manuals » 2553: VOD/SOS » Q1-28: Diagnosis

Veno-occlusive disease (VOD) or sinusoidal obstruction syndrome (SOS) may occur have HCT as a conditioning regimen injury to the hepatic venous endothelium, resulting in hepatic venous outflow obstruction due to occlusion of the hepatic venules and sinusoids. This…

Q224 – 247: Infection

Comprehensive Baseline & Follow-up Manuals » 2100: Post-Infusion Follow-Up » Q224 – 247: Infection

Infections occur frequently in transplant patients. The following questions are intended to capture detailed information on clinically significant infections diagnosed during the reporting period. A single infection may be found on multiple cultures or at multiple…

Getting Started

Getting Started

Welcome to the CIBMTR Forms Instruction Manual. The Table of Contents on the left side of the screen is for navigational purposes; if you are on a mobile device you may find the Table on Contents on the top of the page. General Instructions provides useful general…

Q166-223: Pre-HCT Therapy

Comprehensive Disease-Specific Manuals » 2018/2118: Hodgkin and Non-Hodgkin Lymphoma » 2018: LYM Pre-Infusion » Q166-223: Pre-HCT Therapy

The FormsNet3SM application allows questions 167-233 to be reported multiple times. Complete these questions for each line of therapy administered on or after the date of diagnosis of lymphoma and prior to the start of the preparative regimen (or prior to infusion if…

Q211-252: Disease Status at the Time of Evaluation for this Reporting Period

Comprehensive Disease-Specific Manuals » 2016/2116: Plasma Cell Disorders (PCD) » 2116: PCD Post-Infusion » Q211-252: Disease Status at the Time of Evaluation for this Reporting Period

For questions 211-252, report values obtained at the last evaluation for this reporting period. If testing is performed multiple times during the reporting period, report the values obtained at the last evaluation in the reporting period. Questions 211 – 213: Serum…

2017 Manual Updates

Getting Started » Historical Manual Updates » 2017 Manual Updates

December 2017 November 2017 October 2017 September 2017 August 2017 July 2017 June 2017 May 2017 April 2017 March 2017 February 2017 January 2017 !Hyperlinks Please note, hyperlinks on this page will not work for any manual sections which have been retired and / or…

2020 Manual Updates

Getting Started » Historical Manual Updates » 2020 Manual Updates

January 2020 February 2020 March 2020 April 2020 May 2020 June 2020 July 2020 August 2020 October 2020 December 2020 Updates made during the current calendar year are included below. For updates prior to 2020, click on the subtopic corresponding to the year of…

Q179-258: Myelodysplastic Diseases

Transplant Essential Data (TED) Manuals » 2402: Disease Classification » Q179-258: Myelodysplastic Diseases

*Transformation to AML If the recipient is being transplanted for AML that has transformed from MDS, the primary disease for HCT must be reported as AML. Disease Classification questions must be completed for both AML and MDS. The myelodysplastic syndromes (MDS) are a…

Q203-287: Disease Status at the Time of Evaluation for this Reporting Period

Comprehensive Disease-Specific Manuals » 2057/2157 Myeloproliferative Neoplasms (MPN) » 2157: Myeloproliferative Neoplasm (MPN) Post-Infusion » Q203-287: Disease Status at the Time of Evaluation for this Reporting Period

Question 203: Does the current disease status reflect the disease detected in this reporting period section (as captured in questions 105-202), without subsequent therapy? This section of the form is intended to capture the most recent disease assessments performed in…

2019 Manual Updates

Getting Started » Historical Manual Updates » 2019 Manual Updates

January 2019 February 2019 March 2019 April 2019 May 2019 June 2019 July 2019 August 2019 October 2019 December 2019 Updates made during the current calendar year are included below. For updates prior to 2019, click on the subtopic corresponding to the year of…

Q188-254:Laboratory Studies at Last Evaluation Prior to the Start of the Preparative Regimen / Infusion

Comprehensive Disease-Specific Manuals » 2016/2116: Plasma Cell Disorders (PCD) » 2016: PCD Pre-Infusion » Q188-254:Laboratory Studies at Last Evaluation Prior to the Start of the Preparative Regimen / Infusion

For questions 188 – 254, report values obtained at the last evaluation prior to the start of the preparative regimen / infusion. If testing is performed multiple times prior to the start of the preparative regimen, report the last test before the start of the…

2018 Manual Updates

Getting Started » Historical Manual Updates » 2018 Manual Updates

December 2018 November 2018 October 2018 September 2018 August 2018 July 2018 June 2018 May 2018 April 2018 March 2018 February 2018 January 2018 Updates made during the current calendar year are included below. For updates prior to 2018, click on the subtopic…