Hematopoietic and Lymphoid Neoplasm Project
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Transcript Hematopoietic and Lymphoid Neoplasm Project
H EMATOPOIETIC AND
LYMPHOID N EOPLASM
P ROJECT
Kentucky Cancer Registry
Spring training, 2010
W HY N EW R ULES ?
Medical advances
Immunophenotyping, molecular and genetic
testing
New, more specific histology terms
Revised WHO Classification of
Hematopoietic and Lymphoid Neoplasms
New reportability conditions
9751/3, 9975/3, 9831/3, and transformations
N EW R EFERENCE – THE
H EMATOPOIETIC D ATABASE
Manual (Rules)
Database
Reportability
Disease definition
Multiple primary rules
Synonyms
Site and histology codes
Definitive diagnostic
method
Grade
Glossary
Genetic tests and
Immunophenotyping
Tables
Treatments
Transformations
Abstractor notes
MP Calculator
H EMATOPOIETIC
D ATABASE
B RIEF DEMO OF DATABASE
FEATURES
Casefinding lists
Hematopoietic Manual
Search feature
By diagnosis or by code
Displayed information
Abstractor notes
Multiple Primary Calculator
WHO C LASSIFICATION
C ELL L INEAGES
“acute”
“chronic”
“immature”
“mature”
“undifferentiated”
“differentiated”
Reference: Hoffbrand, Pettit, Vyas: Color Atlas of Clinical hematology (4th ed.), 2010
M YELOID L INE –6 TABLES
Myeloproliferative Neoplasms
Myelodysplastic/Myeloproliferative
Neoplasms
Myelodysplastic Syndromes
Myeloid and Lymphoid Neoplasms with
Eosinophilia and Abnormalities of PDGFRA,
PDGFRB or FGFR1
from presentation by Graca M. Dores, MD, MPH, Classification,
Characteristics, and Behavior of Myeloid Neoplasms, given at the
SEER Advanced Topics Workshop on April 19, 2010.
from presentation by Graca M. Dores, MD, MPH, Classification,
Characteristics, and Behavior of Myeloid Neoplasms, given at the
SEER Advanced Topics Workshop on April 19, 2010.
G R A C A M . D O R E S , M D , M P H , C L A S S I F I C AT I O N ,
C H A R A C T E R I S T I C S , A N D B E H AV I O R O F M Y E L O I D N E O P L A S M S , G I V E N AT T H E
S E E R A D VA N C E D T O P I C S W O R K S H O P O N A P R I L 1 9 , 2 0 1 0 .
F R O M P R E S E N TAT I O N B Y
M YELOID TABLES 5 AND 6
Acute Myeloid Leukemia and
Related Precursor Neoplasms
Acute Leukemias of Ambiguous
Lineage
Show no clear differentiation along a single
lineage
Includes those with mixed phenotypes
LYMPHOID L INE –6 TABLES
Precursor Lymphoid Neoplasms
Mature B-Cell Neoplasms
Mature T-Cell and NK-Cell Neoplasms
Hodgkin Lymphoma
Histiocytic and Dendritic Cell Neoplasms
Post-Transplant Lymphoproliferative
Disorders
AT: W W W . LYM P H O M AT I O N . O R G / A B O U T - D E TA I L S . H T M
WHO C LASSIFICATION
2008: P RINCIPLES
Term ‘NHL’ becoming obsolete
Neoplasms of precursor cells classified
separately from those of more mature cells
Leukemia/Lymphoma are different
manifestations of the same disease
Mature lymphoid neoplasms are
subclassified on the basis of differentiation,
morphology, immunophenotype, genetic
tests, and clinical presentation
C LASSIFICATION BASED ON :
Morphology and biologic features
Lymphoma, Myeloid sarcoma, and plasma
cell tumors are diagnosed by tissue biopsy
Leukemias by blood counts and BM biopsy
Genetic tests – DNA analysis
FISH for follicular lymphoma
Karyotyping of CML for Philadelphia
chromosome
C LASSIFICATION BASED ON :
Immunophenotype
Identifies molecules associated with some
lymphomas and leukemias which are
expressed on the outer surface of the cell
Includes IHC and flow cytometry
Examples are Burkitt lymphoma and Adult T
cell leukemia/lymphoma
Clinical features
Myeloproliferative neoplasm, unclassifiable
S PECIAL T YPES OF
D IAGNOSES
Provisional diagnoses
NOS histology – could be awaiting further test results
or could be only information available. Update if more
info comes in
NOS with possible/probable specific histology – DO
NOT USE these ambiguous terms – code the NOS
term until more definitively diagnosed
Ex. MPN (9960/3), probably PV (9950/3). Code 9960
until you have a definitive diagnosis
Diagnosis of exclusion – based on equivocal tests and
clinical presentation
Examples: MDS, refractory thrombocytopenia
D IAGNOSTIC
C ONFIRMATION
Code Label
Definition
1
Positive histology
Tissue microscopically
examined and positive
2
Positive cytology
Fluid cells microscopically
examined and positive
3
Positive histology
PLUS
• Positive
immunophenotyping
AND/OR
• Positive genetic
studies
Histology is positive for
cancer, and there are also
positive
immunophenotyping
and/or genetic test results.
…
R EVIEW M ANUAL
S ECTIONS
What’s New
Reportability rules
Multiple Primary rules
Primary site and histology rules
Grade rules
Glossary and Appendices
H EMATOPOIETIC
D ATABASE
R EVIEW DATABASE
F EATURES
Display codes
Search terms and codes
Definitions, synonyms
Display special studies, treatment,
transformations
Abstractor’s notes
MP Calculator