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SEER Inquiry System - Report
Produced: 07/09/2025 7:11 AM
Question 20100046
Inquiry Details
References:
Heme & Lymph Manual & DB
Question:
Heme & Lymphoid Neoplasms: Is a clinical remission sufficient to change the tumor status to "disease free" for a patient on long-term chemotherapy for a diagnosis of either a chronic hematologic disease, such as CML, or a myeloproliferative disorder, such as essential thrombocythemia? See Discussion.
Discussion:
For some patients with chronic hematologic diseases, the disease/recurrence status could change frequently as chemotherapy is started and stopped over an extended period of time. Should the tumor status for these cases always be "not disease free"? When the physician documents the patient is in clinical remission, does their status change to "NED or disease free?" There seems to be a lot of variation across the US in how registrars are coding this field. Clarification would be appreciated.
Answer:
The term "disease free" is not used in a standard fashion for hematopoietic and lymphoid neoplasms.
Code the cancer status to free of disease when the physician indicates NED. For hematopoietic and lymphoid neoplasms, a physician's statement of NED, disease-free, clinical remission or no evidence of disease at this time, should be recorded with cancer status to disease free. The term "disease free" or NED means that there is no clinical evidence of disease.
History:
This SINQ question has been updated to the Hematopoietic & Lymphoid Neoplasm Manual & Database published January 2014.
The original answer below was written based on the rules in 2010
You are correct, the term "disease free" is not used in a standard fashion for hematopoietic and lymphoid neoplasms.
Code as free of disease when physician states NED. For hematopoietic and lymphoid neoplasms, a physician's statement of NED, disease-free, or no evidence of disease at this time, should be recorded as cancer status: disease free. The term "disease free" or NED means that there is no clinical evidence of disease.
The answers for SINQ questions with 2010 ID numbers were written using the 2010 Heme & Lymph Manual & DB. The instructions for using the 2010 Hematopoietic Database were written for the version of the software in use as of 5/24/2011. The user interface of the web-based 2010 Hematopoietic Database available from the SEER website varies slightly from the 5/24/2011 version in that the web-based version provides all the disease information in one scrollable window.
For cases diagnosed 2010-2011, access the 2010 Hematopoietic Database at http://seer.cancer.gov/tools/heme/. Click on Hematopoietic Project. Click on Hematopoietic and Lymphoid Database. For 2010-2011 diagnoses, click on the "use the 2010 database" label in the upper right corner of the screen. The 2010 Hematopoietic Coding Manual (PDF) button will appear to indicate the correct version of the program is available now for query.
