SEER Inquiry System - View

Question: 20130086 Status
Final

References
Source 1:   Heme & Lymph Manual & DB
pgs:  
Notes:  
Source 2:  
pgs:  
Notes:  


Question
Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when a patient is diagnosed in 2008 with chronic myeloid leukemia, chronic phase and is subsequently diagnosed with both accelerated phase (2010) and blast crisis of CML (2012)? See Discussion.

Discussion
Patient diagnosed in 1/2008 with CML, Chronic phase and had a complete remission following treatment.

In 3/2010 the patient was diagnosed with CML, Accelerated phase and again had a complete remission following treatment.

In 02/2012 the patient was diagnosed with CML, Blast crisis.

How do chronic and acute neoplasms (Rules M8 - M13) relate to histologies that are stated to have Chronic, Accelerated and Blast phases per the Heme DB? These histologies donít change, does this mean Rules M8 - M13 do not apply because there isnít a change in histology? How many primaries should be accessioned in this case?

Answer
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

This case is accessioned as a single primary, chronic myeloid leukemia, NOS [9863/3] diagnosed 01/2008 per Rule M2. The patient was diagnosed with CML, NOS [9863/3] in 2008 and again in 2010 and 2012. Abstract a single primary when there is a single histology.

CML, Chronic phase; CML, Accelerated phase; and CML, Blast phase (Blast crisis) are listed under the Alternate Names section for CML, NOS in the Heme DB.

Not all histologies have transformations. If a transformation is not listed in the Heme DB, Rules M8 - M13 do not apply.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

History
Assign 9863 for CML in 2008. The 2010 diagnosis is the same histology. Per the Hematopoietic database, chronic and accelerated phase are alternate names. This is the same primary per Rule M2.

Blast phase (crisis) is also an alternate name for CML, which makes the 2012 diagnosis the same primary per Rule M2.

As you noted, not all histologies have transformations. If a transformation is not listed, rules M8-M13 do not apply. For these types of cases, use M15 and use the multiple primaries calculator.



Last Updated
07/01/2014

Date Finalized
07/19/2013