Effective
2001 and later
Reportable
for cases diagnosed
1978 and later
Primary Site(s)
C421
Primary site must be bone marrow (C421)
Coding Manual:
Hematopoietic Coding Manual (PDF)
Abstractor Notes
Acute myeloid leukemia with CBFB: MYH11 fusion is part of the Acute myeloid leukemia (AML) lineage table in the WHO 5th edition of Hematolymphoid Tumors. (See Appendix B in the Hematopoietic Manual, Table B6)
The blood and bone marrow are nearly always involved. Some patients may present with myeloid sarcoma.
If this leukemia and myeloid sarcoma (9930/3) occur during the same clinical workup, this is one primary, the leukemia.
If the myeloid sarcoma occurs after the diagnosis of the leukemia, that is a manifestation of the leukemia and is the same primary.
See Multiple Primary Rule M3
The blood and bone marrow are nearly always involved. Some patients may present with myeloid sarcoma.
If this leukemia and myeloid sarcoma (9930/3) occur during the same clinical workup, this is one primary, the leukemia.
If the myeloid sarcoma occurs after the diagnosis of the leukemia, that is a manifestation of the leukemia and is the same primary.
See Multiple Primary Rule M3
Diagnostic Confirmation
This histology must be coded as diagnostic confirmation code 3 until the 2027 updates are implemented in your software. Once the software updates are implemented: Assign code 1 for histological confirmation WITH positive genetics
Module Rule
See abstractor notes
Alternate Names
FAB M4Eo (ICD-O-4: 98710/3)
Definition
Definitive Diagnostic Methods
Cytogenetics
Genetic testing
Genetics Data
CBFB rearrangement (inv(16)(p13.1q22) or t(16;16)(p13.1;q22))
Immunophenotyping
Not applicable, genetics required for diagnosis
Treatments
Chemotherapy
Transformations to
None
Transformations from
Same Primaries
Corresponding ICD-10 Codes (Cause of Death codes only)
C92.0 Acute myeloid leukemia
Corresponding ICD-10-CM Codes (U.S. only)
C92.0 Acute myeloblastic leukemia (effective October 01, 2015 - September 30, 2024)
C92.00 Acute myeloblastic leukemia not having achieved remission (effective October 01, 2024)
C92.01 Acute myeloblastic leukemia, in remission (effective October 01, 2024)
C92.02 Acute myeloblastic leukemia, in relapse (effective October 01, 2024)
Signs and Symptoms
Easy bruising or bleeding
Fatigue
Fever
Petechiae
Shortness of breath
Weakness
Weight loss or loss of appetite
Diagnostic Exams
Bone marrow aspiration and biopsy
CT (CAT) scan
Cytogenetic analysis
Flow cytometry
Immunophenotyping
Lumbar puncture
Molecular analysis
Peripheral blood smear
Physical exam and history
Progression and Transformation
Longer complete remissions when treated with high dose cytarabine in the consolidation phase
Older patients and those with KIT mutations have higher risk of relapse and worse survival
Epidemiology and Mortality
Age: predominantly younger patients
Survival: longer complete remissions possible when treated with high dose cytarabine in the consolidation phase
Sources
WHO Classification of Tumours Editorial Board. Haematolymphoid tumours. Lyon (France): International Agency for Research on Cancer; 2024. (WHO classification of tumours series, 5th ed.; vol. 11). https://publications.iarc.who.int/637.
Section: Acute myeloid leukemia
Pages: Part A: 118-120
Section: Acute myeloid leukemia
Pages: Part A: 118-120
International Classification of Diseases for Oncology, 3rd edition (including revisions). Geneva: World Health Organization, 2001, 2011, 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
PDQ® Adult Treatment Editorial Board. PDQ Acute Myeloid Leukemia Treatment. Bethesda, MD: National Cancer Institute. Updated <03/06/2024>. Available at: https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq. Accessed <02/06/2025>. [PMID: 26389432]
Section: Acute Myeloid Leukemia Treatment (PDQ®)–Health Professional Version
Pages: https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq
Section: Acute Myeloid Leukemia Treatment (PDQ®)–Health Professional Version
Pages: https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq
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