Chronic myeloid leukemia, NOS

Name
Chronic myeloid leukemia, NOS
ICD-O-1 Morphology
9863/3
Effective 1978 - 1991
ICD-O-2 Morphology
9863/3
Effective 1992 - 2000
ICD-O-3 Morphology
9863/3
Effective 2001 and later
Reportable
for cases diagnosed 1978 and later
Primary Site(s)
C421

Help me code for dx year :

Grade
Code grade specified by pathologist. If no grade specified, code 9
Module Rule
None
Alternate Names
Chronic myelocytic leukemia, NOS
Chronic myelogenous leukemia, BCR-ABL1 status unknown
Chronic myelogenous leukemia, NOS
Chronic myeloid leukemia, BCR-ABL1 status unknown, Accelerated phase (AP)
Chronic myeloid leukemia, BCR-ABL1 status unknown, Blast phase (BP)
Chronic myeloid leukemia, BCR-ABL1 status unknown, Chronic phase (CP)
CML, BCR-ABL1 status unknown, Accelerated phase (AP)
CML, BCR-ABL1 status unknown, Blastic phase (BP)
CML, BCR-ABL1 status unknown, Chronic phase (BP)
CML, NOS
Definition
No delineation of translocation, BCR-ABL1, or Phil chromosome noted to qualify for ICD-O-3 9863.

Specific term as defined by WHO, codes as 9875/3 and indicates the process has Ph+, BCR-ABL1 fusion and/or t(9;22)(q34;q11) demonstrated, as defined by ICD-O-3 for 9875 as well. Presumably myelogenous leukemia without genetic studies done would be coded to 9863.
Abstractor Notes
Chronic myeloid leukemia, NOS is a generic disease description. DCO cases or path report only cases may stay in this classification. In most cases, NOS histology is only the provisional diagnosis; the physician will run further diagnostic procedures and look for various clinical presentations to identify a more specific disease. Further review of the medical record should be done to look for the tests listed as definitive diagnosis. The more specific chronic myeloid leukemias are: Chronic myelogenous leukemia, BCR-ABL1 positive; Atypical chronic myeloid leukemia, BCR-ABL1 negative; Chronic myelomonocytic leukemia; and Juvenile myelomonocytic leukemia. If the characteristics of a specific subtype of chronic myeloid leukemia develop later in the course of the disease, change the histology code to the more specific diagnosis.

Treatment:

Chronic phase: Tyrosine kinase inhibitor. High-dose chemotherapy with donor stem cell transplant; BRM (interferon). OR Chemotherapy; splenectomy; clinical trial of lower-dose chemotherapy with donor stem cell transplant.

Accelerated phase: Donor stem cell transplant;; tyrosine kinase inhibitor; BRM, (interferon (with or without chemotherapy). Chemotherapy may be a single or multi-drug regimen.

Blast phase: Tyrosine kinase inhibitor; chemotherapy (single or multi-drug); bi=BRM (interferon); Donor stem cell transplant
Definitive Diagnostic Methods
Bone Marrow biopsy
Peripheral blood
Genetics Data
None
Immunophenotyping
None
Treatments
Treatment differs depending upon the phase (chronic, accelerated, blastic). See Abstractor Notes for treatment information.
Transformations to
No Transformations
Transformations from
No Transformations
Corresponding ICD-9 Codes
205.1 Chronic myeloid leukemia
Corresponding ICD-10 Codes
C92.1 Chronic myeloid leukemia
Corresponding ICD-10-CM Codes (effective October 1, 2015 U.S. only)
C92.1 Chronic myeloid leukemia, BCR/ABL-positive
Signs and Symptoms
None
Diagnostic Exams
None
Recurrence and Metastases
None
Epidemiology and Mortality
None