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
Primary site must be bone marrow (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
Refractory anemia with excess blasts in transformation
Definition
RAEB-1 (Type 1) and RAEB-2 (Type 2) are defined based on the number of blasts:
1. RAEB-1: 5-9% blasts in bone marrow, < 5% blasts in blood
2. 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)
Abstractor Notes
The principle sites of involvement are the peripheral blood and bone marrow. Any one of the cell types can be low and look abnormal under the microscope.

For MDS diseases (9980, 9982, 9983, 9985, 9986, 9989, 9991, 9992), abstracting each of the subtypes would result in over-counting of the diseases.
1. Code only the first subtype that is diagnosed.
2. Do not change the histology code or create a new abstract for any subsequent specific MDS subtypes

Code 9984/3 in ICD-O-3 is for: RAEB-T (Refractory anemia with excess blast in transformation). This code became obsolete effective 1/1/2010. Any cases noted to be RAEB-T for diagnosis dates 1/1/2010 and forward should be coded to 9983/3.
Definitive Diagnostic Methods
Bone marrow biopsy
Genetic testing
Immunophenotyping
Genetics Data
-5
-7
8
del (5q)
del (7q)
del (20q)
Immunophenotyping
CD13
CD33
CD117
Treatments
Bone marrow transplant
Chemotherapy
Immunotherapy
Stem cell transplant
Transformations from
None
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
Anemia
Easy bruising or bleeding
Petechiae (flat, pinpoint spots under the skin caused by bleeding)
Shortness of breath
Skin paler than usual
Weakness or feeling tired
Diagnostic Exams
Bone marrow and aspiration
Complete blood count (CBC)
Cytogenetic analysis
FISH (flourescence in situ hybridzation)
Recurrence and Metastases
~25% of RAEB-1 and 33% of RAEB-2 progress to AML
Epidemiology and Mortality
Age: > 50 years of age
Incidence: ~40% of all MDS
Sex: no male or female predominance
Survival: ~16 months for RAEB-1 and ~3-12 months for RAEB-2