Name
Acute panmyelosis with myelofibrosis
ICD-O-1 Morphology
9951/1: Acute panmyelosis
Effective
1978 - 1991
ICD-O-2 Morphology
9932/3: Acute myelofibrosis
Effective
1992 - 2000
ICD-O-3 Morphology
9931/3: Acute panmyelosis with myelofibrosis
Effective
2001 and later
Reportable
for cases diagnosed
1992 and later
Primary Site(s)
C421
Primary site must be bone marrow (C421)
Coding Manual:
Hematopoietic Coding Manual (PDF)
Abstractor Notes
This is primarily a disease of adults but has been reported in children. Bone marrow aspiration is usually unsuccessful; either no BM is obtained or the specimen is suboptimal. Bone marrow biopsy supplemented with immunohistology is required for a diagnosis.
If the leukemia occurs before or simultaneously with Myeloid Sarcoma (9930/3), see M3 and Module 5:PH10.
If the leukemia occurs before or simultaneously with Myeloid Sarcoma (9930/3), see M3 and Module 5:PH10.
Diagnostic Confirmation
This histology can be determined by positive histology (including peripheral blood) with or without genetics and/or immunophenotyping. Review the Definitive Diagnostic Methods, Immunophenotyping and Genetics Data sections below, and the instructions in the Hematopoietic Manual for further guidance on assigning Diagnostic confirmation.
Grade
Not Applicable
Module Rule
See abstractor notes
Alternate Names
Acute megakaryocytic leukemia
Acute myelodysplasia with myelofibrosis
Acute (malignant) myelofibrosis
Acute panmyelosis, NOS
APMF
Malignant myelofibrosis
Malignant myelosclerosis [OBS]
Definition
Acute panmyelosis with myelofibrosis (APMF) is an acute panmyeloid proliferation with increased blasts (greater than or equal to 20% of cells in the bone marrow or peripheral blood) and accompanying fibrosis of the bone marrow.
Definitive Diagnostic Methods
Bone marrow biopsy
Genetic testing
Immunophenotyping
Genetics Data
-5/del(5q)
-7/del(7q)
Immunophenotyping
CD13+ (expression/positive)
CD33+ (expression/positive)
CD34+ (expression/positive)
KIT (CD117)+ (expression/positive)
Myeloid hematopoietic stem cell
Treatments
Chemotherapy
Hematologic Transplant and/or Endocrine Procedures
Transformations to
There are no known transformations
Transformations from
There are no known transformations
Same Primaries
Corresponding ICD-9 Codes
205.0 Acute myeloid leukemia
Corresponding ICD-10 Codes
C94.4 Acute panmyelosis
C94.5 Acute myelofibrosis
Corresponding ICD-10-CM Codes (U.S. only)
C94.4 Acute panmyelosis with myelofibrosis (effective October 01, 2015)
Signs and Symptoms
Bone pain
Easy bruising or bleeding
Fatigue
Fever
Pancytopenia
Petechiae
Shortness of breath
Weakness
Weight loss or loss of appetite
Diagnostic Exams
Bone marrow aspiration and biopsy
CT (CAT) scan
Cytogenetic analysis
Immunophenotyping
Lumbar puncture
Peripheral blood smear
Progression and Transformation
None
Epidemiology and Mortality
Age: primarily in adults but does occur in children
Incidence: very rare form of AML
Survival: few months
Sources
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds):
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Acute myeloid leukemia and related precursor neoplasms
Pages: 165-166
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Acute myeloid leukemia and related precursor neoplasms
Pages: 165-166
International Classification of Diseases for Oncology, Third Edition, Second Revision. Geneva: World Health Organization, 2020.
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577
Section: ICD-O-3.2 (2020) Morphological Codes
Pages: http://www.iacr.com.fr/index.php?option=com_content&view=category&layout=blog&id=100&Itemid=577
National Cancer Institute
Section: General Information About Acute Myeloid Leukemia
Pages: https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq
Section: General Information About Acute Myeloid Leukemia
Pages: https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq