Search Database ICD-O-3 Code Lists

Name

Acute myelomonocytic leukemia

ICD-O-1 Morphology

9867/3: Chronic granulocytic leukemia
Effective 1978 - 1991

ICD-O-2 Morphology

9867/3: Acute myelomonocytic leukemia
Effective 1992 - 2000

ICD-O-3 Morphology

9867/3: Acute myelomonocytic leukemia
Effective 2001 and later

Reportable

for cases diagnosed 1978 and later

Primary Site(s)

C421

Coding Manual: Hematopoietic Coding Manual (PDF)

Abstractor Notes

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 myeloid leukemia, M4
AMML
AMMoL
FAB M4

Definition

Acute myelomonocytic leukemia is an acute leukemia characterized by the proliferation of both neutrophil and monocyte precursors. The peripheral blood or bone marrow has a greater than or equal to 20% blasts (including promonocytes); neutrophils and their precursors and monocytes and their precursors each constitute greater than or equal to 20% of bone marrow cells.

Definitive Diagnostic Methods

Bone marrow biopsy
Immunophenotyping
Peripheral blood smear

Genetics Data

Gain of chromosome 8

Immunophenotyping

CD4 monocytic differentiation
CD7+ (expression/positive)
CD11b monocytic differentiation
CD11c monocytic differentiation
CD13+ (expression/positive)
CD14 monocytic differentiation
CD15+ (expression/positive)
CD33+ (expression/positive)
CD34+ (expression/positive)
CD36 monocytic differentiation
CD64 monocytic differentiation
CD65+ (expression/positive)
CD68 (PGM1) monocytic differentiation
CD163 monocytic differentiation
HLA-DR
KIT (CD117)+ (expression/positive)
Lysozyme monocytic differentiation
Macrophage-restricted CD68 (PGM1)

Treatments

Chemotherapy
Hematologic Transplant and/or Endocrine Procedures

Transformations to

None

Transformations from

Same Primaries

Corresponding ICD-9 Codes

206.0 Acute monocytic leukemia

Corresponding ICD-10 Codes

C92.5 Acute myelomonocytic leukemia

Corresponding ICD-10-CM Codes (U.S. only)

C92.5 Acute myelomonocytic leukemia (effective October 01, 2015)

Signs and Symptoms

Anemia
Easy bruising or bleeding
Fatigue
Fever
High white blood cell count with numerous blasts and promonocytes
Petechiae
Thrombocytopenia
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: 50 years median age
Incidence: 5-10% of all AML cases
Sex: female predominance

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: 159-160

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

National Cancer Institute
Section: General Information About Acute Myeloid Leukemia
Pages: https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq
Glossary