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SEER Inquiry System - Report
Produced: 05/23/2026 10:52 PM
Question 20100073
Inquiry Details
References:
Heme & Lymph Manual & DB
Question:
Discussion:
Answer:
Updated May 2026
Accession two primaries per Rule M10, the first is a chronic neoplasm RAEB2 [9983/3] and the second is an acute neoplasm AML, NOS [9861/3]. Rule M10 states abstract as multiple primaries when a neoplasm is originally diagnosed in a chronic phase (MDS RAEB2) and an acute disease (AML) is diagnosed after the initial clinical workup of the chronic neoplasm is completed. This is the rule that fits your case.
There are several important pieces of information. There were two bone marrows biopsies; one confirmed the chronic disease and a second confirmed the acute disease. The dates of the bone marrows are more than 3 months apart. Because you have a chronic and an acute disease, Rules M8-M13 in the coding manual apply.
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 have several important pieces of information. There were two bone marrows biopsies, one confirmed the chronic disease and a second that confirmed the acute disease. The dates of the bone marrows are more than 3 months apart.
For cases diagnosed 2010-2011, use the 2010 Heme & Lymph Manual and the Hematopoietic Database to determine the number of primaries for this case.
Go to the MP rules. M7 does not fit because it specifies that the diagnosis is within 21 days and there can only be ONE bone marrow biopsy.
M8 applies to diagnoses within 21 days. Therefore, this rule is not applicable.
M9 does not apply because it specifies the diagnoses are within 21 days and there can be no documentation of a bone marrow biopsy.
M10 states abstract as multiple primaries when a neoplasm is originally diagnosed in a chronic phase (MDS RAEB2) and an acute disease (AML) is diagnosed more than 21 days later. This is the rule that fits your case. Accession two primaries, the first RAEB2 and the second AML.
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.
