Refractory anemia with excess blasts

Name
Refractory anemia with excess blasts
ICD-O-3 Morphology
9983/3
Effective 2001 and later
Reportable
for cases diagnosed 2001 and later
Primary Site(s)
C421

Help me code for diagnosis year :

Grade
9 - Grade/differentiation unknown, not stated, or not applicable
Module Rule
None
Alternate Names
RAEB
RAEB I
RAEB II
RAEB-T
Definition
RAEB-1: 5-9% blasts in bone marrow, < 5% blasts in blood
RAEB-2: 10-19% blasts in bone marrow
(note if 5-19% blasts in blood and < 10% blasts in marrow, should be RAEB-2 OR RAEB with Auer rods). aka RAEB-T (RAEB in transformation which has ICD-O-3 code of 9984/3)

MDS is a group name for a number of specific diseases. As the MDS progresses, it may manifest as several subtypes. This is a part of the disease process. Abstracting each of the subtypes would result in over-counting these diseases. Code the first subtype that is diagnosed. Do not change the histology code or create a new abstract for any subsequent specific MDS subtypes.
Abstractor Notes
Blood and bone marrow are involved. Patients present with symptoms related to BM failure including anemia, thrombocytopenia, and neutropenia. Any one of the cell types can be low and look abnormal under the microscope. The number of blasts is increased; it is less than 10% in type 1 and ranges from 10% to 20% in type 2. This type accounts for 40% of all patients with MDS. The chance of transforming into acute myeloid leukemia is 25% with type 1 and 33% with type 2; this type has the worst outlook and most patients die within 2 years.

Note that RAEB-T has a separate code in ICD-O-3, 9984. That code is now obsolete.
Definitive Diagnostic Methods
Bone marrow biopsy
Immunophenotype
Genetics Data
-5
-7
8
del (5q)
del (7q)
del (20q)
Immunophenotyping
CD13
CD33
CD117
Treatments
Bone marrow transplant
Chemotherapy
Transformations from
No Transformations
Corresponding ICD-9 Codes
238.73 High grade myelodysplastic syndrome
Corresponding ICD-10 Codes
D46.2 Refractory anemia with excess of blasts
Corresponding ICD-10-CM Codes (effective October 1, 2015 U.S. only)
D46.20 Refractory anemia with excess of blasts, unspecified
D46.21 Refractory anemia with excess of blasts 1
D46.22 Refractory anemia with excess of blasts 2
Signs and Symptoms
None
Diagnostic Exams
None
Recurrence and Metastases
None
Epidemiology and Mortality
None