Acute myelomonocytic leukemia

Name
Acute myelomonocytic leukemia
ICD-O-1 Morphology
9867/3
Effective 1978 - 1991
ICD-O-2 Morphology
9867/3
Effective 1992 - 2000
ICD-O-3 Morphology
9867/3
Effective 2001 and later
Reportable
for cases diagnosed 1978 and later
Primary Site(s)
C421

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Grade
Code grade specified by pathologist. If no grade specified, code 9
Module Rule
See abstractor notes
Alternate Names
Acute myeloid leukemia, M4
AMML
AMMoL
FAB M4
Definition
AMML is an acute leukemia characterized by the proliferation of both neutrophil and monocyte precursors. A high number of circulating blood monocytic cells may be present.

Form of acute myeloid leukemia which involves a proliferation of CFU-GM myeloblasts and monoblasts.
Abstractor Notes
The peripheral blood (PB) and bone marrow (BM) have more than 20% blasts, neutrophils and their precursors, plus monocytes and their precursors. The monocyte component may be more evident in the PB than in the BM.

The preliminary diagnosis may include
1. Acute myeloid leukemia (AML), NOS
2. AML with maturation
3. AML without maturation

The diagnosis of AML is proven by BM biopsy.

If the leukemia occurs before or simultaneously with Myeloid Sarcoma (9930/3), see M3 and Module 5:PH10.
Definitive Diagnostic Methods
Bone marrow biopsy
Immunophenotyping
Peripheral blood smear
Genetics Data
None
Immunophenotyping
CD4+
CD7+ (approximately 30% of cases)
CD11b+
CD11c+
CD13+
CD14+
CD15+
CD33+
CD34+
CD36+
CD64+
CD65+
CD117+
CD163+
HLA-DR
Macrophage-restricted CD68 (PGM1)
Treatments
Bone marrow transplant
Chemotherapy
Transformations to
None
Corresponding ICD-9 Codes
205.0 Acute myeloid leukemia
Corresponding ICD-10 Codes
C92.5 Acute myelomonocytic leukemia
Corresponding ICD-10-CM Codes (effective October 1, 2015 U.S. only)
C92.5 Acute myelomonocytic leukemia
Signs and Symptoms
Anemia
Easy bruising or bleeding
High white blood cell count with numerous blasts and promonocytes
Shortness of breath
Weakness
Weight loss or loss of appetite
Diagnostic Exams
Progression and Transformation
None
Epidemiology and Mortality
Age: 50 years median age
Incidence: 5-10% of all AML cases
Sex: female predominance