ICD-O-3 Morphology
9869/3: Acute myeloid leukemia with inv(3)(q21;q26.2) or t(3;3)(q21;q26.2); RPN1-EVI1
Effective
2010 and later
Reportable
for cases diagnosed
2010 and later
Primary Site(s)
C421
Primary site must be bone marrow (C421)
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 9861/3.)
Patients may have a prior MDS or present with splenomegaly.
If the leukemia occurs before or simultaneously with Myeloid Sarcoma (9930/3), see M3 and Module 5:PH10
Patients may have a prior MDS or present with splenomegaly.
If the leukemia occurs before or simultaneously with Myeloid Sarcoma (9930/3), see M3 and Module 5:PH10
Diagnostic Confirmation
This AML is part of the "AML with recurrent genetic abnormalities" group. Since this AML is diagnosed based on genetics, diagnostic confirmation will always be 3.
Grade
Not Applicable
Module Rule
None
Definition
Acute myeloid leukemia with inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2) resulting in deregulated MECOM (also called EVI1) and GATA2 expression is an AML with greater than or equal to 20% peripheral blood or bone marrow blasts. It is often associated with normal or elevated platelet counts and has increased dysplastic megakaryocytes with unilobed or bilobed nuclei and multilineage dysplasia in the bone marrow.
Definitive Diagnostic Methods
Genetic testing
Immunophenotyping
Peripheral blood smear
Genetics Data
CBL
FLT3
GATA2
inv(3)(q21.3q26.2)
KRAS
MDS1-EV11
MECOM at 3q26.2
NRAS
PTPN11
RPN1
SF3B1(often with GATA2)
t(3;3)(q21.3;q26.2)
t(3;21))q26.2;q22.1) resulting in MECOM-RUNX1 fusion
Immunophenotyping
CD7+ (aberrant expression/positive)
CD13+ (expression/positive)
CD33+ (expression/positive)
CD34+ (expression/positive)
CD38+ (expression/positive)
CD41+ (expression/positive)
CD61+ (expression/positive)
HLA-DR+ (expression/positive)
KIT (CD117)+ (expression/positive)
Treatments
Hematologic Transplant and/or Endocrine Procedures
Transformations to
None
Transformations from
Same Primaries
Corresponding ICD-9 Codes
205.0 Acute myeloid leukemia
Corresponding ICD-10 Codes
C92.0 Acute myeloid leukemia
Corresponding ICD-10-CM Codes (U.S. only)
C92.0 Acute myeloblastic leukemia (effective October 01, 2015)
Signs and Symptoms
Anemia
Easy bruising or bleeding
Fatigue
Fever
Petechiae
Shortness of breath
Splenomegaly
Thrombocytopenia
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
Physical exam and history
Progression and Transformation
None
Epidemiology and Mortality
Age: predominantly adults
Sex: no male or female predominance
Survival: aggressive neoplasm with short survival
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: 138-139
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Acute myeloid leukemia and related precursor neoplasms
Pages: 138-139
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