Autologous

For each Autologous instance,

	Form 2003 (Gene Therapy)	Form 2004	Form 2005	Form 2006 or 4003
TED or CRF track Genetically modified = yes	X			X (F4003 only)
TED or CRF track Product Type = Cord Blood Units Genetically modified = no				X (for each product)
CRF track Genetically modified = no				X (for each product)
TED track Genetically modified = no

*On the Pre-TED (F2400), questions will determine the number of F2006 and/or F4003 generated.
A. ‘Specify number of products infused from this donor’
B. ‘Specify number of these product intended to achieve hematopoietic engraftment’
If A and B are equal, then FN3 will generate the number of F2006s reported in B.
If A and B are not equal, this indicates a co-infusion and data will be reported on both the F2006 (the number reported in B) and F4003 (the difference between A and B).

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