If the indication for HCT is due to a combination of diseases or a transformation of one disease to another, it may be necessary to report multiple disease classifications. The tables below list how common examples of disease combinations and transformations should be reported using the Disease Classification questions.

Common Disease Combinations

Disease Combinations Report Primary Disease as: Report disease diagnosis date of: Complete multiple disease sections of the Disease Classification Form?
FAN or SAA and AML AML AML No
FAN or SAA and MDS MDS MDS No
MYE and AMY MYE MYE No

Common Disease Transformations

Disease Transformation Report primary disease as: Report disease diagnosis date of: Complete multiple disease sections of the Disease Classification Form?
MDS or MPN to AML AML AML Yes – AML and MDS or MPN
JMML to AML AML AML Yes – AML and MDS (select questions only)
NHL to another NHL Second NHL diagnosis Second NHL diagnosis No
HL to NHL* NHL NHL No
CLL to NHL (i.e., Richter’s Syndrome) NHL NHL No

AML=Acute Myelogenous Leukemia; AMY=Amyloidosis; CLL=Chronic Lymphocytic Leukemia; FAN=Fanconi Anemia; MDS=Myelodysplastic Syndrome; MPS=Myeloproliferative Disease; MYE=Multiple Myeloma; NHL=Non-Hodgkin Lymphoma; SAA=Severe Aplastic Anemia.
*Ensure that the disease process is a transformation from Hodgkin lymphoma to Non-Hodgkin lymphoma (typically diffuse large B-cell lymphoma), rather than the distinct entity “B-cell lymphoma, unclassifiable, with features indeterminate between DLBCL and classical Hodgkin Lymphoma.”

Question 1: Date of diagnosis for primary disease for HCT:

The date of diagnosis is important because the interval between diagnosis and HCT is often a significant indicator for the recipient’s prognosis post-HCT.

Report the date of the first pathological diagnosis (e.g., bone marrow or tissue biopsy) of the disease. Enter the date the sample was collected for examination. If the diagnosis was determined at an outside center, and no documentation of a pathological or laboratory assessment is available, the dictated date of diagnosis within a physician note may be reported. Do not report the date symptoms first appeared.

If the recipient was diagnosed prenatally (in utero) or was diagnosed with a congenital immunodeficiency, report the date of birth as the date of diagnosis.

If the exact pathological diagnosis date is not known, use the process described in General Instructions, Guidelines for Completing Forms.

If this is a subsequent HCT for a new malignancy (or other new indication), report the date of diagnosis of the new malignancy.

Question 2: What was the primary disease for which the HCT was performed?

Select the primary disease for which the recipient is receiving the HCT and continue with the appropriate disease classification questions.

Last modified: Aug 19, 2020

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