2130: SCD Post-Infusion

The Sickle Cell Disease Post-Infusion (2130) Form is one of the Comprehensive Report Forms. This form captures Sickle Cell Disease (SCD) post-HCT data for the reporting period.

This form must be completed for all recipients whose primary disease, as reported on the Disease Classification (2402) Form, is Sickle Cell Disease (SCD). The Sickle Cell Disease Post-Infusion (2130) Form must be completed in conjunction with each Post-Infusion Follow-up (2100) Form. This form is designed to capture specific data occurring within the timeframe of each reporting period (i.e., between day 0 and day 100; between day 100 and the six-month date of contact for six-month follow-up; and between the date of contact for the six-month follow-up and the date of contact for the one-year follow-up, etc.).

Links to Sections of the Form
Q1 – 5: Physical Assessments
Q6 – 8: Transfusion Therapy
Q9 – 22: Therapy for Iron Overload
Q23 – 28: Pulmonary Assessments
Q29 – 53: Cardiovascular Assessments
Q54 – 63: Hepatic Assessments
Q64 – 72: Renal Assessments
Q73 – 77: Splenic Assessments
Q78 – 81: Acute Chest Syndrome
Q82 – 87: Pain
Q88 – 93: Avascular Necrosis
Q94 – 102: Central Nervous System
Q103 – 114: Other Symptoms
Q115 – 126: Existing Organ Impairments
Q127 – 133: Disease Modifying Therapies
Q134 – 159: Other Laboratory Studies
Q160: Disease Status
Q161: Marrow Evaluation

Manual Updates:
Sections of the Forms Instruction Manual are frequently updated. The most recent updates to the manual can be found below. For additional information, select the manual section and review the updated text.

If you need to reference the historical Manual Change History for this form, please click here or reference the retired manual section on the Retired Forms Manuals webpage.

Date	Manual Section	Add/Remove/Modify	Description
10/25/2024	2130 SCD Post-Infusion	Add	Version 3 of the 2130: Sickle Cell Disease (SCD) Post-Infusion Data section of the Forms Instruction Manual released. Version 3 corresponds to revision 5 of the Form 2130.

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