Therapy-related myeloid neoplasms

Name
Therapy-related myeloid neoplasms
ICD-O-3 Morphology
9920/3
Effective 2001 and later
Reportable
for cases diagnosed 2001 and later
Primary Site(s)
C421

Help me code for dx year :

Grade
Code grade specified by pathologist. If no grade specified, code 9
Module Rule
Alternate Names
Alkylating agent related acute myeloid leukemia and myelodysplastic syndrome
t-AML
t-AML/t-MDS
t-MDS
t-MDS/MPN
Therapy-related acute myeloid leukemia, alkylating agent related
Therapy-related acute myeloid leukemia, epipodophyllotoxin-related
Therapy-related acute myeloid leukemia, NOS
Therapy-related acute promyelocytic leukemia (APL)
Therapy-related myelodysplastic syndrome
Therapy-related myelodysplastic/myeloproliferative neoplasm
Definition
Development of Acute myelogenous leukemia as a result of treatment for a previous malignancy with ionizing radiation or certain chemotherapy agents.

AML occurs after autologous bone marrow and stem cell transplantation; patients over 40 years at transplant who receive total body irradiation are at highest risk.

Therapy-related AML can result from chemotherapy or radiation therapy for benign or malignant diseases.
Abstractor Notes
For cases abstracted prior to 2010, this code was only used for therapy-related Acute myeloid leukemia (t-AML). In the 2008 WHO Manual, this code also includes therapy-related Myelodysplastic syndrome (t-MDS) and myelodysplastic/myeloproliferative neoplasms (t-MDS-MPN) occuring as late complications of prior cytotoxic chemotherapy and/or radiation therapy administered for a neoplastic or non-neoplastic disorder. PB and BM are the principle sites of involvement.

Although WHO groups therapy-related Myelodysplastic sydrome with the therapy-related AML MDS, MPN, and MDS-MPN, the ICD-O-3 has a separate code for therapy-related MDS 9987/3. WHO has grouped these therapy-related myeloid neoplasms into one category because current clinical practice recognizes these neoplasms as being similar in etiology (therapy-related) and groups them for the purpose of analysis. Therapy-related myeloid neoplasms represent coincidental disease and would be expected to behave like other de-novo disease.

For those cases diagnosed 2010 and later, Therapy-related myelodysplasic syndrome, NOS should be coded to the 9920/3 category.

DO NOT code therapy-related myeloid neoplasm simply because the patient has a history of radiation therapy or chemotherapy. There must be a physician's statement that says this is a therapy-related neoplasm (acute myeloid leukemia, MDS, MPN, or MDS/MPN.)
Definitive Diagnostic Methods
Bone marrow biopsy
Flow cytometry
Genetics testing
Immunohistochemistry
Genetics Data
Alk/RT: High incidence of clonal cytogenetic abnormalities
Alk/RT: Other chromosomes include 1, 4, 12, 14, and 18
Alk/RT: Unbalanced translocations or deletions involving chromosomes 5 and/or 7
del(13q), del (20q), del(11q)m dek*3o(m -17, -18, -21, +8
inv(16)
t(11;19)
t(3;21)
t(6;11)
t(6;9)
t(8;16)
t(8;21)
t(9;11)
Topo: 11q23 (MLL)
Immunophenotyping
CD7
CD13
CD33
CD34+
CD56
MDR-34+
Treatments
Chemotherapy
Radiation
Stem cell transplant
Transformations from
No Transformations
Corresponding ICD-9 Codes
205.0 Acute myeloid leukemia
Corresponding ICD-10 Codes
C92.0 Acute myeloid leukemia
Corresponding ICD-10-CM Codes (effective October 1, 2015 U.S. only)
C92.0 Acute myeloblastic leukemia
Signs and Symptoms
None
Diagnostic Exams
None
Recurrence and Metastases
None
Epidemiology and Mortality
None