Name

Mixed-phenotype acute leukemia, B/myeloid, not otherwise specified

ICD-O-3 Morphology

9808/3: Mixed phenotype acute leukemia, B/myeloid, NOS
Effective 2010 and later

Reportable

for cases diagnosed 2010 and later

Primary Site(s)

C421
Primary site must be bone marrow (C421)

Abstractor Notes

(This code is effective for cases diagnosed 2010 and later. For cases diagnosed prior to 2010 see code 9801/3.)

There are no unique clinical features for this leukemia. Although the leukemia meets the criteria for both B and myeloid lineages, the blasts lack the B and myeloid genetic abnormalities.

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

None

Alternate Names

Mixed phenotype acute leukemia, B/myeloid, NOS
MPAL, B/myeloid, NOS

Definition

Mixed-phenotype acute leukemia, B/myeloid, not otherwise specified, fulfills the criteria for B/myeloid leukemia, but does not fulfill the criteria for any of the genetically defined subgroups.

Definitive Diagnostic Methods

Bone marrow biopsy
Genetic testing
Immunophenotyping

Genetics Data

12p11.2 abnormalities
del(5q)
del(6p)
Numerical abnormalities including near tetraploidy
Structural abnormalities of 7

Immunophenotyping

CD13 expression
CD33 expression
KIT (CD117) expression

Treatments

Chemotherapy

Transformations to

There are no known transformations

Transformations from

There are no known transformations

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 rash
Fatigue
Fever
Night sweats
Pain or feeling of fullness below the ribs
Painless lumps
Petechiae
Shortness of breath
Weakness

Diagnostic Exams

Blood chemistry studies
Chest x-ray
Cytogenetic analysis
Immunophenotyping
Lumbar puncture
Lymph node biopsy
Molecular testing
Peripheral blood smear

Progression and Transformation

None

Epidemiology and Mortality

Age: more common in adults (can occur in children)
Incidence: <1% of all Leukemia cases
Survival: poor prognosis

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: 184-185

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
Glossary