Search Database ICD-O-3 Code Lists

Name

B-lymphoblastic leukemia/lymphoma [B-ALL/LBL] with BCR::ABL1 like features (BCR::ABL1-like B-ALL/LBL)

ICD-O-3 Morphology

9819/3: B-lymphocytic leukemia/lymphoma, BCR-ABL1-like
Effective 2001 and later

Reportable

for cases diagnosed 1978 and later

Primary Site(s)

See Module 4: Rules PH7, PH8 and Module 7 (for primary site for lymphoma presentation)
Usually presents as a leukemia (primary site C421). Lymphomatous presentation is rare.

See abstractor notes.

Coding Manual: Hematopoietic Coding Manual (PDF)

Abstractor Notes

(This code is effective for cases diagnosed 2021 and later. For cases diagnosed prior to 2021, see code: 9811/3)

B-lymphoblastic leukemia/lymphoma [B-ALL/LBL] with BCR::ABL1 like features (BCR::ABL1-like B-ALL/LBL) is part of the Precursor B-cell neoplasms lineage table in the WHO 5th edition of Hematolymphoid Tumors. (See Appendix B in the Hematopoietic Manual, Table B14)

All subtypes of ALL are coded as the same primary. If you have an ALL diagnosed, then a subsequent ALL diagnosed at a later time, this is the same primary.

If there are multiple diagnoses for ALL
- 9812/3-9819/3 take priority over 9811/3
- 9812/3 takes priority over 9813/3-9819/3
- Remaining combinations: Use the first diagnosis

B-ALL always involves the bone marrow and usually also involves the peripheral blood. Extramedullary involvement is common and is by definition the primary site of involvement in B-LBL, with frequent sites being the CNS, testes, lymph nodes, liver, spleen, skin, and soft tissues

Immunophenotyping will confirm that the patient has a B-lymphoblastic B-ALL; the genetic testing provides the information needed to classify this neoplasm as a B-lymphoblastic leukemia/lymphoma with BCR::ABL1 like features.

Diagnostic Confirmation

This histology can only be determined by positive genetics, diagnostic confirmation will always be 3.

Module Rule

Module 4: Rules PH7, PH8

Alternate Names

BCR::ABL1-like B-ALL/LBL
B-lymphoblastic leukemia/lymphoma, BCR-ABL1-like
Philadelphia-like (Ph-like) B-ALL BCR::ABL1-like B-ALL/LBL

Definition

BCR::ABL1-like B-lymphoblastic leukemia/lymphoma (B-ALL/LBL) is a neoplasm of lymphoblasts of B-cell lineage defined by DNA alterations that induce a phenotype similar to that of BCR::ABL1-positive B-ALL but lack the pathognomonic BCR::ABL1 rearrangement. (WHO 5th edition)

Definitive Diagnostic Methods

Cytogenetics
Genetic testing

Genetics Data

BCR::ABL1-like features

Immunophenotyping

Immunophenotyping not relevant, diagnosed via genetic analysis

Treatments

Chemotherapy
Hematologic Transplant and/or Endocrine Procedures
Radiation therapy

Transformations to

There are no known transformations

Transformations from

There are no known transformations

Same Primaries

Corresponding ICD-10 Codes (Cause of Death codes only)

C83.5 Non-Hodgkin lymphoma lymphoblastic (diffuse) (Lymphoma presentation)
C91.0 Acute lymphoblastic leukemia (Leukemia presentation)

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

C83.5_ Lymphoblastic (diffuse) lymphoma [LBL] (effective October 01, 2015)
C83.5A Lymphoblastic (diffuse) lymphoma [LBL] in remission (effective October 01, 2024)
C91.0 Acute lymphoblastic leukemia [ALL] (effective October 01, 2015 - September 30, 2024)
C91.00 Acute lymphoblastic leukemia [ALL] not having achieved remission (effective October 01, 2024)
C91.01 Acute lymphoblastic leukemia [ALL], in remission (effective October 01, 2024)
C91.02 Acute lymphoblastic leukemia [ALL], in relapse (effective October 01, 2024)

Signs and Symptoms

Anemias
Arthralgias
Bone pain
Elevated white blood cell (WBC) count
Hepatomegaly
Lymphadenopathy
Neutropenia
Splenomegaly
Thrombocytopenia

Diagnostic Exams

Blood chemistry studies
Bone marrow aspiration and biopsy
CT (CAT) scan
Cytogenetic analysis
Flow cytometry
Immunohistochemistry
Immunophenotyping
Laparoscopy (rarely performed)
Laparotomy (rarely performed)
Lymph node biopsy
PET (positron emission tomography) scan

Progression and Transformation

None

Epidemiology and Mortality

Age: all ages, lowest in children
Incidence: occurs in 10-25% of patients with ALL
Survival: Poor prognosis

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: B-lymphoblastic leukemia/lymphoma
Pages: Part B: 345-347

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 Lymphoblastic Leukemia Treatment. Bethesda, MD: National Cancer Institute. Updated <02/13/2025>. Available at: https://www.cancer.gov/types/leukemia/hp/adult-all-treatment-pdq. Accessed <02/28/2025>. [PMID: 26389171]
Section: Acute Lymphoblastic Leukemia Treatment (PDQ®)–Health Professional Version
Pages: Acute Lymphoblastic Leukemia Treatment (PDQ®) - NCI
Glossary