Summary - Form 2018 (R3) 1 of 12 Form Question Number (r3) Type Description New Text Previous Text Today's date was removed 2018 N/A Today's Date Removed from Key Fields 2018 N/A HCT Type 2018 N/A Product Type Option Value Option Value Syngeneic (identical twin) removed Question text changed Bone marrow PBSC Single cord blood unit Multiple cord blood units Other product Marrow PBSC Cord blood Other product Previous Question Number (r2) N/A N/A N/A 2018 1 What was the date of diagnosis? "What was the date of diagnosis of lymphoma?" was changed to "What was the date of diagnosis?" What was the date of diagnosis? What was the date of diagnosis of lymphoma? 1 Hodgkin Lymphoma Codes: 01 Nodular lymphocyte predominant Hodgkin lymphoma 02 Lymphocyte-rich 03 Nodular sclerosis 04 Mixed cellularity 05 Lymphocyte depleted 06 Hodgkin lymphoma, not otherwise specified Classical Hodgkin Lymphoma Codes: 01 Nodular lymphocyte predominant Hodgkin lymphoma 02 Lymphocyte-rich 03 Nodular sclerosis 04 Mixed cellularity 05 Lymphocyte depleted 06 Hodgkin lymphoma, not otherwise specified 2018 2 What was the lymphoma histology at diagnosis? Option Value Option values changed Non-Hodgkin Lymphoma Codes: B-cell Neoplasms 07 Splenic marginal zone B-cell lymphoma 08 Extranodal marginal zone B-cell lymphoma of mucosal associated lymphoid tissue type (MALT) 09 Nodal marginal zone B-cell lymphoma (± monocytoid B-cells) 10 Follicular, predominantly small cleaved cell (Grade I follicle center lymphoma) Non-Hodgkin Codes: 07 Lymphoplasmacytic lymphoma 08 Splenic marginal zone B-cell lymphoma 09 Extranodal marginal zone B-cell lymphoma of mucosal associated lymphoid tissue type (MALT) 10 Nodal marginal zone B-cell lymphoma (± monocytoid B-cells) 11 Follicular, predominantly small cleaved cell (Grade I follicle center lymphoma) 11 Follicular, mixed, small cleaved and large cell (Grade II follicle center lymphoma) 12 Follicular, mixed, small cleaved and large cell (Grade II follicle center lymphoma) 12 Follicular, predominantly large cell (Grade IIIA follicle center lymphoma) 13 Follicular, predominantly large cell (Grade IIIB follicle center lymphoma) 14 Follicular (grade unknown) 15 Mantle cell lymphoma 16 Intravascular large B-cell lymphoma 17 Primary mediastinal (thymic) large B-cell lymphoma 18 Primary effusion lymphoma 19 Diffuse, large B-cell lymphoma NOS 20 Primary diffuse, large B-cell lymphoma of the CNS 13 Follicular, predominantly large cell (Grade III follicle center lymphoma) 14 Follicular (grade unknown) 15 Mantle cell lymphoma 16 Diffuse, large B-cell lymphoma intravascular large B-cell lymphoma subtype 17 Diffuse, large B-cell lymphoma mediastinal large B-cell lymphoma subtype 18 Diffuse, large B-cell lymphoma primary effusion lymphoma subtype 19 Diffuse, large B-cell lymphoma subtype unknown 20 Burkitt lymphoma / Burkitt cell leukemia 21 High grade B-cell lymphoma, Burkitt-like (provisional entity) 2
Summary - Form 2018 (R3) 2 of 12 21 Burkitt lymphoma 22 B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and Burkitt lymphoma 23 B-cell lymphoma, unclassifiable, with features intermediate between DLBCL and classical Hodgkin Lymphoma 24 T-cell / histiocytic rich large B-cell lymphoma 25 Other B-cell lymphoma T-cell and NK-cell Neoplasms 26 Extranodal NK / T-cell lymphoma, nasal type 27 Enteropathy-type T-cell lymphoma 28 Hepatosplenic T-cell lymphoma 29 Subcutaneous panniculitis-like T-cell lymphoma 30 Mycosis fungoides 31 Sezary syndrome 32 Primary cutaneous CD30+ T-cell lymphoproliferative disorders [Primary cutaneous anaplastic large-cell lymphoma (C-ALCL), lymphoid papulosis] 33 Peripheral T-cell lymphoma (PTCL), NOS 34 Angioimmunoblastic T-cell lymphoma 35 Anaplastic large-cell lymphoma (ALCL), ALK positive 36 Anaplastic large-cell lymphoma (ALCL), ALK negative 37 T-cell large granular lymphocytic leukemia 38 Aggressive NK-cell leukemia 39 Adult T-cell lymphoma / leukemia (HTLV1 associated) 40 Other T-cell / NK-cell lymphoma 22 Primary CNS lymphoma 23 Other B-cell lymphoma 24 Extranodal NK / T-cell lymphoma, nasal type 25 Enteropathy-type T-cell lymphoma 26 Hepatosplenic gamma-delta T-cell lymphoma 27 Subcutaneous panniculitis-like T-cell lymphoma 28 Mycosis fungoides 29 Sezary syndrome 30 Anaplastic large-cell lymphoma, T / null cell, primary cutaneous type 31 Angioimmunoblastic T-cell lymphoma 32 Anaplastic large-cell lymphoma, T / null cell, primary systemic type 33 Other T-cell / NK-cell lymphoma 34 Large T-cell granular lymphocytic leukemia 35 Aggressive NK-cell leukemia 36 Adult T-cell lymphoma / leukemia (HTLV1 associated) 37 Waldenstrom macroglobulinemia 2018 3 Specify other lymphoma: "Specify:" was changed to "Specify other lymphoma:" Specify other lymphoma: Specify: 3 2018 4 Were immunohistochemical stains obtained? New Question N/A 2018 5 ALK-1 (Anaplastic Lymphoma Kinase 1) New Question N/A 2018 6 BCL-2 New Question N/A 2018 7 BCL-6 New Question N/A 2018 8 CD5 New Question N/A 2018 9 CD10 New Question N/A 2018 10 CD20 New Question N/A 2018 11 CD23 New Question N/A 2018 12 CD30 New Question N/A 2018 13 CD43 New Question N/A 2018 14 CD103 New Question N/A 2018 15 Cyclin D1 New Question N/A 2018 16 Ki-67 New Question N/A 2018 17 MUM1 New Question N/A 2018 18 Pax-5 New Question N/A 2018 19 Was flow cytometry (immunophenotyping) performed? New Question N/A 2018 20 CD1 New Question N/A 2018 21 CD2 New Question N/A 2018 22 CD3 New Question N/A 2018 23 CD4 New Question N/A 2018 24 CD5 New Question N/A 2018 25 CD7 New Question N/A 2018 26 CD8 New Question N/A 2018 27 CD10 New Question N/A 2018 28 CD20 New Question N/A 2018 29 CD19 New Question N/A 2018 30 CD22 New Question N/A 2018 31 CD23 New Question N/A
Summary - Form 2018 (R3) 3 of 12 2018 32 CD103 New Question N/A 2018 33 Cytoplasmic CD3 New Question N/A 2018 34 Cytoplasmic kappa New Question N/A 2018 35 Cytoplasmic lambda New Question N/A 2018 36 Kappa New Question N/A 2018 37 Lambda New Question N/A 2018 38 TCR α-β New Question N/A 2018 39 TCR γ-δ New Question N/A 2018 40 Were cytogenetics tested (conventional or FISH)? New Question N/A 2018 41 t(1;14) New Question N/A 2018 42 t(2;5) New Question N/A 2018 43 t(2;8) New Question N/A 2018 44 t(8;14) New Question N/A 2018 45 t(8;22) New Question N/A 2018 46 t(11;14) New Question N/A 2018 47 t(11;18) New Question N/A 2018 48 t(14;18) New Question N/A 2018 49 i(7q)(q10) New Question N/A 2018 50 Was documentation submitted to the CIBMTR? New Question N/A 2018 51 Were tests for molecular markers performed (e.g. PCR)? New Question N/A 2018 52 BCL-1/Cyclin D1, t(11;14) New Question N/A 2018 53 BCL-2, t(14;18) New Question N/A 2018 54 BCL-6 New Question N/A 2018 55 B-cell, Immunoglobulin Heavy (IgH) chain rearrangement New Question N/A 2018 56 T-cell receptor (TCR) gene rearrangement New Question N/A 2018 57 Other molecular marker(s) New Question N/A 2018 58 Specify other molecular marker(s): New Question N/A 2018 59 Was documentation submitted to the CIBMTR? New Question N/A 2018 60 WBC: New Question N/A 2018 61 WBC value New Question N/A 2018 62 Hemoglobin: New Question N/A 2018 63 Hemoglobin value New Question N/A 2018 67 Serum β2 microglobulin: New Question N/A 2018 68 Serum beta 2 value New Question N/A 2018 69 Upper limit of normal for serum β2 microglobulin New Question N/A 2018 70 2018 71 Was a gene expression profile performed? New Question N/A Were results considered high risk lymphoma? New Question N/A
Summary - Form 2018 (R3) 4 of 12 2018 72 2018 73 2018 74 2018 75 2018 76 Was a PET (or PET/CT) scan performed? New Question N/A Was the PET (or PET/CT) scan positive for lymphoma involvement at any disease site? New Question N/A Did the recipient have known nodal involvement? New Question N/A Specify the total number of nodal regions involved: New Question N/A Specify the size of the largest nodal mass: New Question N/A 2018 77 Was there any known extranodal or splenic involvement? "Was there any known extranodal or splenic involvement at diagnosis?" was changed to "Was there any known extranodal or splenic involvement?" Was there any known extranodal or splenic involvement? Was there any known extranodal or splenic involvement at diagnosis? 12 2018 91 Specify other site(s): "Specify site:" was changed to "Specify other site(s):" Specify other site(s): Specify site: 26 2018 92 Stage of organ involvement: "Did the recipient have any known organ involvement at diagnosis:" was changed to "Stage of organ involvement:" Stage of organ involvement: Did the recipient have any known organ involvement at diagnosis: 9 2018 92 Stage of organ involvement: Option Value Option values changed I Involvement of a single lymph node region or of a single extralymphatic organ or site II Involvement of two or more lymph node regions on same side of diaphragm or localized involvement of extralymphatic organ or site and one or more lymph node regions on same side of diaphragm. III Involvement of lymph node regions on both sides of diaphragm, which may also be accompanied by localized involvement of extralymphatic organ or site, or the spleen, or both IV Diffuse or disseminated involvement of one or more extralymphatic organs in tissues with or without associated lymph node enlargement Unknown I Involvement of a single lymph node region or of a single extralymphatic organ or site II Involvement of two or more lymph node regions on same side of diaphragm or localized involvement of extralymphatic organ or site and one or more lymph node regions on same side of diaphragm. III Involvement of lymph node regions on both sides of diaphragm, which may also be accompanied by localized involvement of extralymphatic organ or site, or the spleen, or both IV Diffuse or disseminated involvement of one or more extralymphatic organs in tissues with or without associated lymph node enlargement Other organ involvement Unknown 9 2018 93 Were systemic symptoms (B symptoms) present? (unexplained fever > 38 C; or night sweats; unexplained weight loss > 10% body weight in six months before diagnosis) "Did the recipient show any systemic symptoms at diagnosis:" was changed to "Were systemic symptoms (B symptoms) present? (unexplained fever > 38 C; or night sweats; unexplained weight loss > 10% body weight in six months before diagnosis)" Were systemic symptoms (B symptoms) present? (unexplained fever > 38 C; or night sweats; unexplained weight loss > 10% body weight in six months before diagnosis) Did the recipient show any systemic symptoms at diagnosis: 11
Summary - Form 2018 (R3) 5 of 12 2018 94-96 2018 97 2018 98 2018 99 What scale was used to determine the recipients functional status? Is the non-hodgkin lymphoma histology reported at diagnosis (question 2) a transformation from CLL? Was histologic transformation (not from CLL) detected at the same time or at any time after the lymphoma diagnosis (question 2)? What was the lymphoma histology at transformation? Was the date of transformation the same as the date of Other Karnofsky/Lansky scale questions were reformatted 30 "Is the current histology a transformation from CLL?" was changed to "Is the non- Hodgkin lymphoma histology reported at diagnosis (question 2) a transformation Is the non-hodgkin lymphoma histology reported at diagnosis (question 2) a from CLL?" transformation from CLL? Is the current histology a transformation from CLL? 4 "Did histologic transformation occur after diagnosis?" was changed to "Was histologic transformation (not from CLL) detected at the same time or at any time after the lymphoma diagnosis Was histologic transformation (not from CLL) detected at the same time or (question 2)?" at any time after the lymphoma diagnosis (question 2)? Did histologic transformation occur after diagnosis? 5 "Latest histology:" was changed to "What was the lymphoma histology at transformation?" What was the lymphoma histology at transformation? Latest histology: 7 2018 101 diagnosis? New Question N/A Were immunohistochemical 2018 103 stains obtained? New Question N/A ALK-1 (Anaplastic 2018 104 Lymphoma Kinase 1) New Question N/A 2018 105 BCL-2 New Question N/A 2018 106 BCL-6 New Question N/A 2018 107 CD5 New Question N/A 2018 108 CD10 New Question N/A 2018 109 CD20 New Question N/A 2018 110 CD23 New Question N/A 2018 111 CD30 New Question N/A 2018 112 CD43 New Question N/A 2018 113 CD103 New Question N/A 2018 114 Cyclin D1 New Question N/A 2018 115 Ki-67 New Question N/A 2018 116 MUM1 New Question N/A 2018 117 Pax-5 New Question N/A Was flow cytometry (immunophenotyping) 2018 118 performed? New Question N/A 2018 119 CD1 New Question N/A 2018 120 CD2 New Question N/A 2018 121 CD3 New Question N/A 2018 122 CD4 New Question N/A 2018 123 CD5 New Question N/A 2018 124 CD7 New Question N/A 2018 125 CD8 New Question N/A 2018 126 CD10 New Question N/A 2018 127 CD19 New Question N/A 2018 128 CD20 New Question N/A 2018 129 CD22 New Question N/A
Summary - Form 2018 (R3) 6 of 12 2018 130 CD23 New Question N/A 2018 131 CD103 New Question N/A 2018 132 Cytoplasmic CD3 New Question N/A 2018 133 Cytoplasmic kappa New Question N/A 2018 134 Cytoplasmic lambda New Question N/A 2018 135 Kappa New Question N/A 2018 136 Lambda New Question N/A 2018 137 TCR α-β New Question N/A 2018 138 TCR γ-δ New Question N/A 2018 139 Were cytogenetics tested (conventional or FISH)? New Question N/A 2018 140 t(1;14) New Question N/A 2018 141 t(2;5) New Question N/A 2018 142 t(2;8) New Question N/A 2018 143 t(8;14) New Question N/A 2018 144 t(8;22) New Question N/A 2018 145 t(11;14) New Question N/A 2018 146 t(11;18) New Question N/A 2018 147 t(14;18) New Question N/A 2018 148 i(7q)(q10) New Question N/A 2018 149 Was documentation submitted to the CIBMTR? New Question N/A 2018 150 Were tests for molecular markers performed (e.g. PCR)? New Question N/A 2018 151 BCL-1/Cyclin D1, t(11;14) New Question N/A 2018 152 BCL-2, t(14;18) New Question N/A 2018 153 BCL-6 New Question N/A 2018 154 B-cell, Immunoglobulin Heavy (IgH) chain rearrangement New Question N/A 2018 155 T-cell receptor (TCR) gene rearrangement New Question N/A 2018 156 Other molecular marker(s) New Question N/A 2018 157 Specify other molecular marker(s): New Question N/A 2018 158 Was documentation submitted to the CIBMTR? New Question N/A 2018 159 WBC: New Question N/A 2018 160 WBC value New Question N/A 2018 161 Hemoglobin: New Question N/A 2018 162 Hemoglobin value New Question N/A 2018 163 LDH: New Question N/A 2018 164 LDH value New Question N/A 2018 165 Upper limit of normal for LDH: New Question N/A 2018 166 Serum β2 microglobulin: New Question N/A 2018 167 Serum beta 2 value New Question N/A 2018 168 Upper limit of normal for serum β2 microglobulin New Question N/A
Summary - Form 2018 (R3) 7 of 12 2018 169 2018 170 2018 171 2018 172 Was a gene expression profile performed? New Question N/A Were results considered high risk lymphoma? New Question N/A Was a PET (or PET/CT) scan performed? New Question N/A Was the PET (or PET/CT) scan positive for lymphoma involvement at any disease site? New Question N/A 2018 173 Was there any known extranodal or splenic involvement? New Question N/A 2018 174 Bone New Question N/A 2018 175 Bone marrow New Question N/A 2018 176 Brain New Question N/A 2018 177 Cerebrospinal fluid (CSF) New Question N/A 2018 178 Epidural space New Question N/A 2018 179 Gastrointestinal (GI) tract New Question N/A 2018 180 Kidney New Question N/A 2018 181 Liver New Question N/A 2018 182 Lung New Question N/A 2018 183 Pleura New Question N/A 2018 184 Skin New Question N/A 2018 185 Spleen New Question N/A 2018 186 Other site(s) New Question N/A 2018 187 Specify other site(s): New Question N/A 2018 188 Stage of organ involvement at transformation: New Question N/A 2018 189 Were systemic symptoms (B symptoms) present? New Question N/A 2018 190 What scale was used to determine the recipient s functional status: New Question N/A 2018 191 Karnofsky Scale (recipient age 16 years): New Question N/A 2018 192 Lansky Scale (recipient age < 16 years): New Question N/A 2018 193 Was therapy given? "Was therapy given between diagnosis and the start of the preparative regimen?" was changed to "Was therapy given?" Was therapy given? Was therapy given between diagnosis and the start of the preparative regimen? 31 2018 194 Systemic therapy: "Chemotherapy:" was changed to "Systemic therapy: Systemic therapy: Chemotherapy: 32
Summary - Form 2018 (R3) 8 of 12 2018 195 Date therapy started New Question N/A 2018 196 Date started: "Date therapy started:" was changed to "Date started" Date started: Date therapy started 33 2018 197 Date therapy stopped New Question N/A "Date therapy stopped:" was 2018 198 Date stopped: changed to "Date stopped:" Date stopped: Date therapy stopped 34 2018 199 Number of cycles: New Question N/A 2018 200 Number of cycles: Other "Unknown/not applicable" check box was removed 35 2018 201 ABVD (Doxorubicin, Bleomycin, Vinblastine, Dacarbazine) New Question N/A 2018 202 2018 203 2018 204 2018 205 2018 206 2018 207 2018 208 2018 209 BEACOPP (Bleomycin, Etoposide, Doxorubicin, Cyclophosphamide, Vincristine, Procarbazine, Prednisone) New Question N/A CHOP (Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) New Question N/A R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) New Question N/A ESHAP (Etoposide, Methylprednisolone, Cytarabine, Cisplatin) New Question N/A DHAP (Dexamethasone, Cytarabine, Cisplatin) New Question N/A ICE (Ifosfamide, Mesna, Carboplatin, Etoposide) New Question N/A R-ICE (Rituximab, Ifosfamide, Mesna, Carboplatin, Etoposide) New Question N/A MOPP (Mechlorethamine, Vincristine, Procarbazine, Prednisone) New Question N/A
Summary - Form 2018 (R3) 9 of 12 2018 210 Stanford V (Doxorubicin, Vinblastine, Mechlorethamine, Vincristine, Bleomycin, Etoposide, Prednisone) New Question N/A 2018 212 Bendamustine New Question N/A 2018 214 Bortezomib (Velcade) New Question N/A 2018 215 Brentuximab New Question N/A 2018 225 Doxorubicin liposomal (Doxil) New Question N/A 2018 227 Everolimus (RAD-001) New Question N/A 2018 232 Interferon New Question N/A 2018 233 Lenalidomide (Revlimid) New Question N/A 2018 237 Ofatumumab (Arzerra, HuMAX-CD20) New Question N/A 2018 239 Photopheresis New Question N/A 2018 240 Pralatrexate New Question N/A 2018 243 Romidepsin New Question N/A 2018 244 Targretin New Question N/A 2018 245 Temsirolimus (Torisel) New Question N/A 2018 249 Vinorelbine (Navelbine) New Question N/A 2018 250 Vorinostat New Question N/A 2018 N/A Other monoclonal antibody Removed 40 2018 N/A Specify other antibody Removed 41 "Other treatment" was 2018 251 Other systemic therapy changed to "Other systemic therapy" Other systemic therapy Other treatment 63 2018 252 Specify other systemic therapy: "Specify other treatment:" was changed to "Specify other systemic therapy:" Specify other systemic therapy: Specify other treatment: 64 "Was this line of therapy given for stem cell priming?" 2018 253 Was this line of therapy given for stem cell mobilization (priming)? was changed to "Was this line of therapy given for stem cell mobilization (priming)?" Was this line of therapy given for stem cell mobilization (priming)? Was this line of therapy given for stem cell priming? 76 2018 255 Date therapy started New Question N/A 2018 256 Date started: "Date therapy started:" was changed to "Date started" Date started: Date therapy started 66 2018 257 Date therapy stopped New Question N/A 2018 258 Date stopped: "Date therapy stopped:" was changed to "Date stopped:" Date stopped: Date therapy stopped 67 2018 259 What was the extent of the radiation field? New Question N/A
Summary - Form 2018 (R3) 10 of 12 2018 260 Abdominopelvic New Question N/A 2018 261 Cervical spine New Question N/A 2018 262 Inguinal New Question N/A 2018 263 Mediastinum / chest "Mediastinum" was changed to "Mediastinum / chest" Mediastinum / chest Mediastinum 68 2018 265 Specify other site(s) "Specify other site(s)" was changed to "Specify other site:" Specify other site: Specify other site(s): 70 2018 266 Dose per fraction: New Question N/A 2018 267 Total number of fractions: New Question N/A 2018 268 Total dose: New Question N/A 2018 269 Specify technique: New Question N/A 2018 270 Specify other technique: New Question N/A 2018 272 Date of surgery: New Question N/A "Specify other site(s)" was 2018 276 Specify other site(s) changed to "Specify other site:" Specify other site: Specify other site(s): 75 2018 277 Best response to line of therapy: Option Value Option values changed Complete remission (CR) Partial remission (PR) Stable disease (SD) Progressive disease (PD) Unknown Not assessed "Date response established:" was changed to "Date assessed:" Date assessed: Date response established: CR - Complete remission (CR) CRU - CR Undetermined (CRU) PR - Partial remission (PR) NR/SD - Stable disease (SD) Prog - Progressive disease (PD) Unknown 77 2018 278 Date assessed: Serum β2 2018 281 microglobulin: New Question N/A 2018 282 Serum beta 2 value New Question N/A Upper limit of normal for serumβ2 2018 283 microglobulin New Question N/A 2018 284 Was a PET (or PET/CT) scan performed after the most recent line of therapy or at the time of pre-hct evaluation? "Was a PET scan performed at any time between diagnosis and the start of the preparative regimen?" was changed to "Was a PET (or PET/CT) scan performed after the most recent line of therapy or at the time of pre- HCT evaluation?" Was a PET (or PET/CT) scan performed after the most recent line of therapy or at the time of pre-hct evaluation? Was a PET scan performed at any time between diagnosis and the start of the preparative regimen? 81 Was the PET (or PET/CT) scan positive for lymphoma involvement at any disease site? "Was a PET scan positive for lymphoma involvement at any disease site?" was changed to "Was the PET (or PET/CT) scan positive for lymphoma involvement at any disease site?" Was the PET (or PET/CT) scan positive for lymphoma involvement at any disease site? Was a PET scan positive for lymphoma involvement at any disease site? 82 2018 285 Were cytogenetics tested (conventional or 2018 286 FISH)? New Question N/A 2018 287 t(1;14) New Question N/A
Summary - Form 2018 (R3) 11 of 12 2018 288 t(2;5) New Question N/A 2018 289 t(2;8) New Question N/A 2018 290 t(8;14) New Question N/A 2018 291 t(8;22) New Question N/A 2018 292 t(11;14) New Question N/A 2018 293 t(11;18) New Question N/A 2018 294 t(14;18) New Question N/A 2018 295 i(7q)(q10) New Question N/A 2018 296 Were tests for molecular markers performed (e.g. PCR)? New Question N/A 2018 297 BCL-1/Cyclin D1, t(11;14) New Question N/A 2018 298 BCL-2, t(14;18) New Question N/A 2018 299 BCL-6 New Question N/A 2018 300 2018 301 2018 302 2018 303 B-cell, Immunoglobulin Heavy (IgH) chain rearrangement New Question N/A T-cell receptor (TCR) gene rearrangement New Question N/A Other molecular marker(s) New Question N/A Specify other molecular marker(s): New Question N/A 2018 304 Did the recipient have known nodal involvement? "Did the recipient have known nodal involvement at the time of the pre-hsct disease status assessment?" was changed to "Did the recipient have known nodal involvement?" "Did the recipient have known extranodal involvement at the time of the pre-hsct disease status assessment?" was changed to "Was there any known extranodal or splenic involvement?" Did the recipient have known nodal involvement? Did the recipient have known nodal involvement at the time of the pre-hsct disease status assessment? 83 2018 307 Was there any known extranodal or splenic involvement? Was there any known extranodal or splenic involvement? Did the recipient have known extranodal involvement at the time of the pre- HSCT disease status assessment? 86 2018 319 Spleen New Question N/A 2018 321 Specify other site: "Specify site:" was changed to "Specify other site:" Specify other site: Specify site: 99 2018 N/A 2018 N/A Was molecular testing performed at the time of the pre-hsct disease status determination? Removed Question was removed 100 Specify the date molecular testing was performed: Removed Question was removed 101 2018 N/A Was disease detected? Removed Question was removed 102
Summary - Form 2018 (R3) 12 of 12 2018 N/A 2018 322 2018 322 What was the sensitivity of the lymphoma to chemotherapy prior to the preparative regimen? (Report the response to the last chemotherapy given prior to HSCT; treatment must be given 6 months prior to HSCT.) (see disease state definitions at question 104) Removed Question was removed 103 What was the disease status? What was the disease status? Option Value "What was the disease remission state immediately prior to the preparative regimen?" was changed to "What was the disease status?" Option values changed What was the disease status? Disease Untreated PIF res - Primary induction failure resistant: NEVER in COMPLETE remission but with stable or progressive disease on treatment. PIF sen / PR1 - Primary induction failure sensitive: NEVER in COMPLETE remission but with partial remission on treatment. PIF unk - Primary induction failure sensitivity unknown CR1-1st complete remission: no bone marrow or extramedullary relapse prior to transplant CR2-2nd complete remission CR3+ - 3rd or subsequent complete remission REL1 unt - 1st relapse untreated; includes either bone marrow or extramedullary relapse REL1 res - 1st relapse resistant: stable or progressive disease with treatment REL1 sen - 1st relapse sensitive: partial remission (if complete remission was achieved, classify as CR2) What was the disease remission state immediately prior to the preparative regimen? 104 Disease Untreated PIF res..primary induction failure resistant: NEVER in COMPLETE remission but with stable or progressive disease on treatment. PIF sen / PR1 Primary induction failure sensitive: NEVER in COMPLETE remission but with partial remission on treatment. PIF unk..primary induction failure sensitivity unknown CR1 1st complete remission: no bone marrow or extramedullary relapse prior to transplant CR2..2nd complete remission CR3+.3rd or subsequent complete remission CRU1.1st complete remission undetermined: as above with the exception of persistent scan abnormalities of unknown significance CRU2 2nd complete remission undetermined CRU3+.3rd or subsequent complete remission undetermined REL1 unt..1st relapse untreated; includes either bone marrow or extramedullary relapse 104 REL1 unk - 1st relapse sensitivity unknown REL1 res..1st relapse resistant: stable or progressive disease with treatment REL2 unt - 2nd relapse untreated: includes either bone marrow or extramedullary REL1 sen.1st relapse sensitive: partial remission (if complete remission was relapse achieved, classify as CR2) REL2 res - 2nd relapse resistant: stable or progressive disease with treatment REL1 unk.1st relapse sensitivity unknown REL2 sen - 2nd relapse sensitive: partial remission (if complete remission REL2 unt..2nd relapse untreated: includes either bone marrow or achieved, classify as CR3+) extramedullary relapse REL2 unk - 2nd relapse sensitivity unknown REL2 res..2nd relapse resistant: stable or progressive disease with treatment REL3+ unt - 3rd or subsequent relapse untreated; includes either bone marrow or REL2 sen.2nd relapse sensitive: partial remission (if complete remission extramedullary relapse achieved, classify as CR3+) REL3+ res - 3rd or subsequent relapse resistant: stable or progressive disease with REL2 unk..2nd relapse sensitivity unknown treatment REL3+ unt..3rd or subsequent relapse untreated; includes wither bone marrow REL3+ sen - 3rd or subsequent relapse sensitive: partial remission (if complete or extramedullary relapse remission achieved, classify as CR3+) REL3+ res..3rd or subsequent relapse resistant: stable or progressive disease REL3+ unk - 3rd relapse or greater sensitivity unknown with treatment REL3+ sen.3rd or subsequent relapse sensitive: partial remission (if complete remission achieved, classify as CR3+) REL3+ unk.3rd relapse or greater sensitivity unknown 2018 323 Date assessed: Signature 2018 section Date: New Question "Date assessed:" was changed to "Date of the most recent assessment for disease status prior to the preparative regimen:" "Date:" added to signature section Date assessed: Date of the most recent assessment for disease status prior to the preparative regimen: 105 N/A