Coding Manual:
Hematopoietic Coding Manual (PDF)
Abstractor Notes
(This code is effective for cases diagnosed 2010 and later. For cases diagnosed prior to 2010, see code 9801/3.)
Patients present with features similar to those of other patients with acute leukemia. Mixed phenotype acute leukemia (MPAL) diagnosis should not be made in patients known to have had CML.
Patients present with features similar to those of other patients with acute leukemia. Mixed phenotype acute leukemia (MPAL) diagnosis should not be made in patients known to have had CML.
Diagnostic Confirmation
This histology can only be determined by positive genetics and/or immunophenotyping, diagnostic confirmation will always be 3.
Grade
Not Applicable
Module Rule
None
Definition
Mixed-phenotype acute leukemia (MPAL) with t(9;22)(q34.1;q11.2) fulfills the criteria for MPAL and has blasts with t(9;22) and/or BCR-ABL1 rearrangement. Some patients with chronic myeloid leukemia (CML) develop or even present with a mixed blast phase that would fulfill the criteria for MPAL; however, this diagnosis should not be made in patients known to have had CML.
Definitive Diagnostic Methods
FISH
Genetic testing
Karyotyping
Polymerase chain reaction (PCR)
Genetics Data
BCR-ABL1
p210 transcript
t(9;22)
Immunophenotyping
None
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
208.0 Acute leukemia of unspecified cell type
Corresponding ICD-10 Codes
C95.0 Acute leukemia of unspecified cell type
Corresponding ICD-10-CM Codes (U.S. only)
C95.0 Acute leukemia of unspecified cell type (effective October 01, 2015)
Signs and Symptoms
Bone or joint pain
Easy bruising or bleeding
Eczema-like skin lesions
Fatigue
Fever
High white blood cell counts
Night sweats
Pain or feeling of fullness below the ribs
Painless lumps
Petechiae
Shortness of breath
Weakness
Diagnostic Exams
Progression and Transformation
None
Epidemiology and Mortality
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 leukemias of ambiguous terminology
Pages: 182-183
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Acute leukemias of ambiguous terminology
Pages: 182-183
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