Q1 – 4: Donor Information

*Donor Information
This section is intended to collect specific details about the donor used for the current donor cellular infusion. This section will auto-populate after selecting the appropriate donor from the FormsNet3^SM pop-up.

!DLI and Allogeneic Boost Requirements
DLIs and allogeneic boosts must contain cells from a prior allogeneic donor.

Question 1: Donor ID

Report the donor’s ID for the current donor cellular infusion.

Question 2. Donor date of birth

Report the donor’s birth date for the current donor cellular infusion.

Question 3: Donor age

Report the donor’s age for the current donor cellular infusion.

Question 4: Donor sex assigned at birth

Report the donor’s sex assigned at birth for the current donor cellular infusion.

Section Updates:

Question Number	Date of Change	Add/Remove/Modify	Description	Reasoning (If applicable)

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CIBMTR® (Center for International Blood and Marrow Transplant Research) is a research collaboration between the Medical College of Wisconsin and NMDP.