1. please insert your own UPN number don‘t use initials max 25 characters study number will be given by ICIS please fill in all required fields please send it by fax or email date of splenectomy planned or performed User manual

2. The Patient Identification log (PIL) is your own key to identify PATIENT / UPN and has to be stored in your Investigator Site File

3. After registration of your patient you will receive the first sheet by email study number and UPN prefilled by ICIS please return the completed form within 3 months after splenectomy by email or fax study number, UPN and date of SE prefilled by ICIS to be returned yearly by email or fax and yearly Follow Ups

4. Thank you for registering your patient. Please contact us if you have questions. Study Coordinator Thomas Kühne University Children’s Hospital Haematology/Oncology PF CH-4031 Basel Switzerland Tel: +41-61- 704 12 12 Fax: +41-61-704 12 13 thomas.kuehne@ukbb.ch Datamanagement and Administration Monika Imbach University Children’s Hospital Haematology/Oncology PF CH-4031 Basel Switzerland Tel: +41-61-704 12 12 Fax: +41-61-704 12 41 splenectomy@ukbb.ch