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9 - Grade/differentiation unknown, not stated, or not applicable
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.
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.