Acute myeloid leukemia with myelodysplasia-related changes

Name
Acute myeloid leukemia with myelodysplasia-related changes
ICD-O-3 Morphology
9895/3
Effective 2001 and later
Reportable
for cases diagnosed 2001 and later
Primary Site(s)
C421
Primary site must be bone marrow (C421)

Help me code for diagnosis year :

Grade
Code grade specified by pathologist. If no grade specified, code 9
Module Rule
See abstractor notes
Alternate Names
Acute myeloid leukemia with multilineage dysplasia
Acute myeloid leukemia with prior myelodysplastic syndrome
Acute myeloid leukemia without prior myelodysplastic syndrome
Definition
An acute leukemia with 20% or more blasts in blood or marrow, and dysplasia in 2 or more myeloid cell lines, generally including megakaryocytes.

Dysplasia must be present in at least 50% of the cells of at least 2 lines. May occur de novo OR following myelodysplastic/myeloproliferative disorder.
Abstractor Notes
This is an AML with myelodysplasia-related changes. It is an acute leukemia with 20% or more PB or BM blasts with morphologic features of
1. Myelodysplasia OR
2. Prior history of MDS OR
3. Myelodysplastic/myeloproliferative neoplasm OR
4. MDS-related cytopenic abnormalities and without the specific genetic abnormalities of AML with recurrent genetic abnormalities.

These patients DO NOT have a history of prior cytotoxic or radiation therapy for an unrelated disease. The provisional diagnoses during work-up may include refractory anemia with excess blasts; acute erythroid leukemia, acute megakaryoblastic leukemia and AML, NOS.

If the leukemia occurs before or simultaneously with Myeloid Sarcoma (9930/3), see M3 and Module 5:PH10.
Definitive Diagnostic Methods
Bone marrow biopsy
Genetic testing
Immunophenotyping
Peripheral blood smear
Genetics Data
-5/del(5q)
-7/del(7q)
-18
8
9
11
19
21
del(11q)
del(12p)
del(20q)
inv (3;3)
inv(3)(q21q26)
t 3q21
t 3q26
t(1;7)
t(2;11)
t(3;21)(q21;26)
t(3;5)(q25;q34)
Immunophenotyping
CD7
CD13
CD33
CD34+
CD38
CD56
Treatments
Chemotherapy
Transformations to
None
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.A Acute myeloid leukemia with multilineage dysplasia
Signs and Symptoms
Easy bruising or bleeding
Fatigue
Fever
Petechiae
Severe pancytopenia
Shortness of breath
Weakness
Weight loss or loss of appetite
Diagnostic Exams
Bone marrow aspiration and biopsy
Complete blood count (CBC)
CT (CAT) scan
Reverse transcription-polymerase chain reaction test (RT-PCR)
Progression and Transformation
Lower rate of achieving complete remission than other AML types
Epidemiology and Mortality
Age: elderly, rare in children
Incidence: 24-35% of all AML cases (variable based on definition)
Survival: generally poor, lower rate of achieving remission than other types of AML