Name

Acute myeloid leukemia with DEK::NUP214 fusion (ICD-O-4: 98650/3)

ICD-O-3 Morphology

9865/3: Acute myeloid leukemia with t(6;9)(p23;q34);DEK-NUP214
Effective 2001 and later

Reportable

for cases diagnosed 1978 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 9861/3.)

Acute myeloid leukemia with DEK::NUP214 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)

Blood and bone marrow are always involved.

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

Acute myeloid leukemia with t(6;9)(p23;q34.1); DEK-NUP214 fusion (ICD-O-4: 98650/3)

Definition

Acute myeloid leukemia (AML) with DEK::NUP214 fusion is characterized by fusion of the proto-oncogene DEK and the nucleoporin 214 gene (NUP214). (WHO 5th edition)

Definitive Diagnostic Methods

Cytogenetics
Genetic testing

Genetics Data

t(6;9)(p23;q34.1); DEK-NUP214 fusion

Immunophenotyping

Not applicable, genetics required for diagnosis

Treatments

Hematologic Transplant and/or Endocrine Procedures

Transformations to

None

Transformations from

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)
C92.01Acute myeloblastic leukemia, in remission (effective October 01, 2024)
C92.02 Acute myeloblastic leukemia, in relapse (effective October 01, 2024)

Signs and Symptoms

Anemia
Easy bruising or bleeding
Fatigue
Fever
Pancytopenia
Petechiae
Shortness of breath
Thrombocytopenia
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

Elevated white blood cell counts associated with shorter overall survival
Increased bone marrow blasts associated shorter disease-free survival

Epidemiology and Mortality

Age: 13 years median age in children, 35 years median age in adults
Incidence: 0.7-1.8% of AML cases
Survival: poor prognosis for both children and adults

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: 121-122

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

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
Glossary