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SummaryFunction="0" TopMargin="0" LeftMargin="15" BottomMargin="0" RightMargin="0" FontName="굴림" FontSize="10" FontBold="0" FontUnderline="0" FontItalic="0" FontStrike="0" ForeColor="0" FieldID="-1" FieldIndex="-1" StyleIndex="0"><FieldReferences/><SummaryCondition/><HyperLinkInfo LinkType="0" LinkText="" ToolTipType="0" ToolTipText="" LinkFieldID="-1" LinkFieldIndex="-1" ToolTipFieldID="-1" ToolTipFieldIndex="-1"/><ConditionalStyles/><FieldReferences/></Cell></Row><Row Size="450"><Cell CellType="0" BackStyle="0" BackColor="16777215" FillStyle="0" FillColor="0" Alignment="0" VerticalAlignment="1" CanGrow="0" CanShrink="0" DataType="0" Text="※ 신청서 기재방법 및 구비서류 (모두 반드시 기재토록 하며 관련 검사결과지 첨부)
- 1. 연령 : 조혈모세포이식 시술일 기준
- 2. 의사소견서, 병리소견, 골수검사 등을 반드시 첨부 - CBC 최근 1달 이내
- 3. 급성골수성백혈병 및 급성림프모구백혈병의 경우 7, 8항을 상세히 기록
- 4. 부분반응 확인과 관련하여 9항에 항암요법 전ㆍ후 종양크기 및 기타소견을 반드시 기재
- 5. 악성림프종 등 고형암의 경우 해당되는 인정기준 각호의 내용을 9항 및 소견서 등에 별도기재
- (신경모세포종의 경우 Bone Scan 등 뼈 소견을 반드시 포함하여야 함)
- 6. 다발성골수종의 경우 6항에 ① BM/Bone Bx, ② M단백(PEP/IEP), ③ 뼈소견(X-ray 등), ④ 기타 혈액학적
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