Hematopoietic and Lymphoid Neoplasm Project Background Peggy Adamo

Hematopoietic and Lymphoid Neoplasm Project

Background Peggy Adamo, RHIT, CTR NCI SEER September 2009

Objectives (1) • Explain why rules were developed • Describe Hematopoietic working group • General information • Membership • Objectives 3

Objectives (2) • Introduce products developed • Manual (Rules) • Database • Explain why two products were needed 4

Why New Rules? • • • Under-reporting of hem/lymph cases Medical advances New terminology Revised WHO Classification of Hem Tumors Abbreviated reporting rules Lack of documentation covering all neoplasms 5

Hematopoietic Working Group (1) Led by NCI SEER Representatives from • National Program of Cancer Registries Centers for Disease Control (NPCR CDC) • American College of Surgeons Commission on Cancer (ACo. S Co. C) • National Cancer Registrars Association (NCRA) • North American Association of Central Cancer Registries (NAACCR) • Canadian Cancer Registries (CCR) 6

Hematopoietic Working Group (2) • Membership includes • Hospital registrars • Central registry registrars • Specialty physicians • Pathologists 7

Working Group Objectives • Define problems • Recommend actions • Develop solutions to • support cancer registrars • Improve data quality 8

What is New / Different? (1) • Authoritative reference = WHO • New histology terms • Transformation = new primary 9

What is New / Different? (2) • Manual • Covers all hematopoietic and lymphoid neoplasms 10

What is New / Different? (3) • Database • Replaces Single Versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases” table • Replaces previous casefinding & reportable lists 11

Manual & Database • Designed to work together • Use database in conjunction with manual 12

Manual (Rules) Database • • Definition • Synonyms • Definitive diagnostic method • Transformations • Abstractor notes • Treatment types • Genetic testing & immunophenotyping • MP calculator Reportability Multiple primary Primary site & histology Grade Glossary Tables 13

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Case Reportability and Coding Manual Glossary Allogeneic bone marrow/stem cell transplant: Marrow is used from a donor whose Human Leukocyte Antigens (HLA)… Anemia: The number of red blood cells is below normal… Apheresis: Process in which the blood of a donor or patient… BCR-ABL cancer gene: A mutant gene that is formed… 15

APPENDIX A HISTORY OF HEMATOPOIETIC AND LYMPHOID NEOPLASM CODING OBSOLETE TERMS AS DEFINED IN ICDO-3 HEMATOPOIETIC AND LYMPHOID NEOPLASMS 16

Table A 2: Hodgkin Lymphoma (Hodgkin Disease) Obsolete Terms Obsolete Term Notes Hodgkin disease, lymphocyte predominance, diffuse Hodgkin disease, lymphocyte predominance, NOS Hodgkin disease, lymphocytichistiocytic predominance Source: Lukes-Butler classification, 1966; Obsolete: REAL classification 1994 ICD-O-3 Code Current Term 9651/3 Lymphocyterich Hodgkin lymphoma Source : Rye classification, 1966 ; Obsolete : REAL classification 1994 9651/3 Lymphocyterich Hodgkin lymphoma Source: Lukes-Butler classification, 1966; Obsolete as of REAL classification 1994 9651/3 Lymphocyterich Hodgkin lymphoma 17

APPENDIX B WHO CLASSIFICATION OF TUMORS OF HEMATOPOIETIC AND LYMPHOID TISSUES HISTOLOGY LINEAGE Note: Only the WHO Preferred Terms are listed. Use the Hematopoietic Database to identify synonyms that correspond to the WHO Preferred Term 18

Table B 1: Myeloproliferative Neoplasms WHO Preferred Term Chronic eosinophilic leukemia, NOS Chronic myelogenous leukemia, BCR-ABL 1 positive Chronic neutrophilic leukemia Cutaneous mastocytosis Essential thrombocythemia Mast cell leukemia Mast cell sarcoma Myeloproliferative neoplasm, unclassifiable Polycythemia vera Primary myelofibrosis Systemic mastocytosis ICD-O- 3 9964/3 9875/3 9963/3 9740/1 9962/3 9740/3 9975/3 9950/3 9961/3 9741/3 19

APPENDIX C LYMPH NODE/LYMPH NODE CHAIN REFERENCE TABLE 20

Table C 1: Lymph Node / Lymph Node Chain Reference Table Lymph Node / Lymph Node Chain Abdominal Anorectal Anterior axillary Anterior cecal Anterior deep cervical Anterior jugular Aortic NOS; ascending aortic lateral aortic; lumbar aortic; paraaortic; peri-aortic ICD-O-3 Code Lymph Node Region(s) C 772 Intra-abdominal C 773 Axilla or arm C 772 Intra-abdominal C 770 Head, face and neck C 772 Intra-abdominal AJCC Lymph Node Region(s) Pelvic, right and left* Axillary, right and left* Para-aortic Cervical, right and left* Para-aortic 21

APPENDIX D NEW HISTOLOGY TERMS AND CODES HEMATOPOIETIC AND LYMPHOID NEOPLASMS 22

Tables D 1 a & D 1 b New Histology Terms and Codes New Histology Term ICD-O Code Acute myeloid leukemia (megakaryoblastic) with 9911/3 t(1; 22)(p 13; q 13); RBM 15 -MKL 1 Acute myeloid leukemia with inv(3)(q 21 q 26. 2) or 9869/3 t(3; 3)(q 21; q 26. 2); RPN 1 EVI 1 Acute myeloid leukemia with t(6; 9)(p 23; q 34) DEK 9865/3 NUP 214 ALK positive large B-cell lymphoma 9737/3 B lymphoblastic leukemia/lymphoma with 9814/3 t(12; 21)(p 13; q 22); TEL-AML 1 (ETV 6 -RUNX 1) B lymphoblastic leukemia/lymphoma with 9812/3 t(9; 22)(q 34; q 11. 2); BCR-ABL 1 B lymphoblastic leukemia/lymphoma with t(v; 11 q 23); 9813/3 MLL rearranged 23

Table D 2: Histologic Terms and Codes with Changes in Case Reportability (Newly Reportable Conditions) Histology Term Langerhans cell histiocytosis, NOS Myeloproliferative neoplasm, unclassifiable/ Myelodysplastic/Myeloproliferative neoplasm, unclassifiable T-cell large granular lymphocytic leukemia/ Chronic lymphoproliferative disorder of NK-cells ICD-O Code 9751/3 9975/3 9831/3 24

Appendix E Histology “NOS” Tables 25

Table E 1: ICD-O-3 “NOS” Terms and Codes and WHO New “NOS” Terms and Codes Alphabetic List Term Malignant lymphoma, NOS Malignant lymphoma, non-Hodgkin, NOS Hodgkin lymphoma, NOS Burkitt lymphoma, NOS Mixed phenotype acute leukemia, B/myeloid, NOS Mixed phenotype acute leukemia, T/myeloid, NOS B lymphoblastic leukemia/lymphoma, NOS Reference ICD-O WHO Code 9590/3 9591/3 9650/3 9687/3 9808/3 WHO 9809/3 WHO 9811/3 26

Appendix F Master Code Lists 27

Table F 1 a: WHO/ICD-O-3 Master List of Histology Codes – Alphabetical List Histologic Term Acute basophilic leukemia Acute biphenotypic leukemia Acute erythroid leukemia Acute megakaryoblastic leukemia Acute monoblastic and monocytic leukemia Acute myeloid leukemia (megakaryoblastic) with t(1; 22)(p 13; q 13); RBM 15 -1 2010 ICD-O-3 WHO and WHO Only ICD-O-3 9870/3 9805/3 9840/3 9910/3 9891/3 9911/3 28

Summary • • Reason rules were developed Describe Hematopoietic working group Introduce Manual & Database Reason for two products 29

Conclusion • The new hematopoietic and lymphoid neoplasm rules go into effect for cases diagnosed January 1, 2010, and after • Email address for questions askseerctr@imsweb. com 30