Autologous

Use the table below to determine which forms can come due for an autologus infusion. First, identify reporting information in the navy blue columns (product type, track, genetically modified). Then, use that information to determine forms generated in the purple columns (F2003, F2004, F2005, F2006, F4003). A key question from F2400 to keep in mind when determining how forms come due for autologus infusions is “Is the product genetically modified?”

*On the Pre-TED (F2400), certain 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).

For each Autologous instance,

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