CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Genetics
CRF: HLA Form - 1507

14 results.
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type Source Form Set Form Field Domain CDASH Variable CDASH Definition CDASH Label Controlled Terminology Prompt Essentiality Question Text CDASH imp guidance SDTM IG target csDSR PhenX Data Type CRF Completion Inst SDTMIG Target Var SDTMIG Target Map Codelist Name PVs Pre Pop Value Query Display List Style
C59125 Match score calculated recipient to donor HLA locus A text MtchScrCalcRecipDonrHLALocATxt Text field for recording the recipient-to-donor calculated match score for HLA (Human Leukocyte Antigen) locus A. Text field for recording the recipient-to-donor calculated match score for HLA (Human Leukocyte Antigen) locus A. Recipient-to-Donor Locus A calculated HLA Match Score Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-22 11:42:41.0 HLA Form - 1507 Genetics Genotype 5

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BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXSCRA
C59126 Match score calculated recipient to donor HLA locus B text MtchScrCalcRecipDonrHLALocBTxt Text field for recording the recipient-to-donor calculated match score for HLA (Human Leukocyte Antigen) locus B. Text field for recording the recipient-to-donor calculated match score for HLA (Human Leukocyte Antigen) locus B. Recipient-to-Donor Locus B calculated HLA Match Score Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-22 11:42:41.0 HLA Form - 1507 Genetics Genotype 5

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BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXSCRB
C59127 Match score calculated recipient to donor HLA locus C text MtchScrCalcRecipDonrHLALocCTxt Text field for recording the recipient-to-donor calculated match score for HLA (Human Leukocyte Antigen) locus C. Text field for recording the recipient-to-donor calculated match score for HLA (Human Leukocyte Antigen) locus C. Recipient-to-Donor Locus C calculated HLA Match Score Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-22 11:42:41.0 HLA Form - 1507 Genetics Genotype 5

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BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXSCRC
C59128 Match score calculated recipient to donor HLA locus DRB1 text MtchScrCalRecDonrHLALocDRB1Txt Text field for recording the recipient-to-donor calculated match score for HLA (Human Leukocyte Antigen) locus DRB1. Text field for recording the recipient-to-donor calculated match score for HLA (Human Leukocyte Antigen) locus DRB1. Recipient-to-Donor Locus DRB1 calculated HLA Match Score Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-22 11:42:41.0 HLA Form - 1507 Genetics Genotype 5

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BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXSCRD
C18027 Comment text CmmntTxt Provide any additional information that pertains to the question. Provide any additional information that pertains to the question. Comments Alphanumeric Adult;Pediatric Proposed 3.00 2013-07-16 14:01:43.01 HLA Form - 1507 Genetics Genotype 4000

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DeBaun Forms
C59129 Match score calculated recipient to donor HLA locus DQB1 text MtchScrCalRecDonrHLALocDQB1Txt Text field for recording the recipient-to-donor calculated match score for HLA (Human Leukocyte Antigen) locus DQB1. Text field for recording the recipient-to-donor calculated match score for HLA (Human Leukocyte Antigen) locus DQB1. Recipient-to-Donor Locus DQB1 calculated HLA Match Score Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-22 11:42:41.0 HLA Form - 1507 Genetics Genotype 5

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BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXSCRQ
C58580 Transplant role type TransplantRoleTyp Type of role in the transplant that is occupied by the person for whom data are being recorded. Type of role in the transplant that is occupied by the person for whom data are being recorded. Recipient or Donor? Recipient;Donor Recipient;Donor Alphanumeric Adult;Pediatric Proposed 1.00 2018-10-23 11:12:47.0 HLA Form - 1507 Genetics Genotype

Single Pre-Defined Value Selected

BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) n/a
C59130 Match score total calculated recipient to donor HLA text MtchScrTotlCalRecDonrHLATxt Text field for recording the recipient-to-donor total calculated match score for HLA (Human Leukocyte Antigen). Text field for recording the recipient-to-donor total calculated match score for HLA (Human Leukocyte Antigen). Recipient-to-Donor total calculated HLA Match Score Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-22 11:42:41.0 HLA Form - 1507 Genetics Genotype 7

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BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXHLA
C58581 Human leukocyte antigen typing gene locus code HLATypngGeneLocusCode Code identifying the gene locus for the human leukocyte antigen (HLA) being typed. Code identifying the gene locus for the human leukocyte antigen (HLA) being typed. HLA locus HLA-A;HLA-B;HLA-C;HLA-DQB1;HLA-DRB1 HLA-A;HLA-B;HLA-C;HLA-DQB1;HLA-DRB1 Alphanumeric Adult;Pediatric Proposed 1.00 2018-10-23 11:25:56.0 HLA Form - 1507 Genetics Genotype

Single Pre-Defined Value Selected

BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) n/a
C59131 Institutional HLA match score recipient to donor category InstlHLAMtchScrRecipToDonrCat Category of institution's HLA (Human Leukocyte Antigen) match score for recipient to donor. Category of institution's HLA (Human Leukocyte Antigen) match score for recipient to donor. Indicate your institution's HLA Match Score for Recipient-to-Donor 0/6;1/6;2/6;3/6;4/6;5/6;6/6;0/8;1/8;2/8;3/8;4/8;5/8;6/8;7/8;8/8 0/6;1/6;2/6;3/6;4/6;5/6;6/6;0/8;1/8;2/8;3/8;4/8;5/8;6/8;7/8;8/8 Alphanumeric Adult;Pediatric Proposed 1.00 2019-01-22 11:55:41.0 HLA Form - 1507 Genetics Genotype

Single Pre-Defined Value Selected

BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXSISC
C58582 Genetic typing method code GeneticTypingMethodCode Code for the type of method used for genetic typing. Code for the type of method used for genetic typing. Typing method 1;2 DNA Technology;Serology Numeric Values

DNA based typing: DNA typing is allele level typing and determines HLA alleles by looking at the sequence of the DNA. Serologic typing: Serologic typing is antigen level typing and determines an HLA group of alleles by looking at the proteins expressed on the cell surface. If you are unsure whether the typing method used is DNA based or Serologic, follow up with your HLA lab.

Adult;Pediatric Proposed 1.00 2018-10-23 11:52:51.0 HLA Form - 1507 Genetics Genotype

Single Pre-Defined Value Selected

BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXRAMET
C58583 Human leukocyte antigen typing allele 1 code HLATypingAllele1Code Code for the first allele reported for the specified gene locus using the specified human leukocyte antigen (HLA) typing method. Code for the first allele reported for the specified gene locus using the specified human leukocyte antigen (HLA) typing method. 1st allele Alphanumeric

DNA based typing: Laboratories may use '/', '-' or a combination of numbers and letters on the typing report as a shorthand notation for the results. The letters, called allele codes, will be 1 or more characters in length and represent a combination of possible alleles at a locus. The same allele combination may be reported several different ways (e.g., DRB*01:01 or 01:02, DRB1*01:01/01:02, DRB1*01:01/02, or DRB1*01:AB). Transcribe the information onto the form as directly as possible. If 2 digits are reported for DNA based typing (e.g., HLA-A*02), enter the two digits followed by 'xx' (e.g., 02:xx). Serologic typing: Serologic typing is antigen level typing and determines an HLA group of alleles by looking at the proteins expressed on the cell surface. Serologic typing is reported as either 1 or 2 digits (e.g., 18 or 2). Leading zeros should not be entered for serologic typing; otherwise serologic typing results should be entered exactly as they appear on the report.

Adult;Pediatric Proposed 1.00 2018-10-23 12:00:40.0 HLA Form - 1507 Genetics Genotype 100

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BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXA1REC
C58584 Human leukocyte antigen typing allele 2 code HLATypingAllele2Code Code for the second allele reported for the specified gene locus using the specified human leukocyte antigen (HLA) typing method. Code for the second allele reported for the specified gene locus using the specified human leukocyte antigen (HLA) typing method. 2nd allele Alphanumeric

If only one allele is reported for a locus (homozygous), the value should be entered for both the 1st and 2nd alleles.

Adult;Pediatric Proposed 1.00 2018-10-23 12:00:40.0 HLA Form - 1507 Genetics Genotype 100

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BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXA2REC
C58585 Blood marrow transplant donor type code BloodMarowTrnsplntDonorTypCode Code for the type of donor being considered for blood or marrow transplant. Code for the type of donor being considered for blood or marrow transplant. Donor type 1;2 Unrelated Cord Blood;Related Haploidentical Numeric Values Adult;Pediatric Proposed 1.00 2018-10-23 12:07:12.0 HLA Form - 1507 Genetics Genotype

Single Pre-Defined Value Selected

BMTCTN 15070 Release 5.10 HLA Form - 1507 (H05) HXXDNTYP
14 results.
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