1. Kentucky Cancer Registry Spring training, 2010 H EMATOPOIETIC AND L YMPHOID N EOPLASM P ROJECT

2. 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

3. N EW R EFERENCE – THE H EMATOPOIETIC D ATABASE Manual (Rules)  Reportability  Multiple primary rules  Site and histology codes  Grade  Glossary  Tables MP Calculator Database  Disease definition  Synonyms  Definitive diagnostic method  Genetic tests and Immunophenotyping  Treatments  Transformations  Abstractor notes

7. H EMATOPOIETIC D ATABASE

8. B RIEF DEMO OF DATABASE FEATURES  Casefinding lists  Hematopoietic Manual  Search feature  By diagnosis or by code  Displayed information  Abstractor notes  Multiple Primary Calculator

9. WHO C LASSIFICATION

10. C ELL L INEAGES

11. “acute”“chronic” “immature”“mature” “undifferentiated”“differentiated” Reference: Hoffbrand, Pettit, Vyas: Color Atlas of Clinical hematology (4 th ed.), 2010

12. M YELOID L INE –6 T ABLES  Myeloproliferative Neoplasms  Myelodysplastic/Myeloproliferative Neoplasms  Myelodysplastic Syndromes  Myeloid and Lymphoid Neoplasms with Eosinophilia and Abnormalities of PDGFRA, PDGFRB or FGFR1

13. 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.

15. FROM PRESENTATION BY G RACA M. D ORES, MD, MPH, C LASSIFICATION, C HARACTERISTICS, AND B EHAVIOR OF M YELOID N EOPLASMS, GIVEN AT THE SEER A DVANCED T OPICS W ORKSHOP ON A PRIL 19, 2010.

16. M YELOID T ABLES 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

17. L YMPHOID L INE –6 T ABLES  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

18. AT : WWW. LYMPHOMATION. ORG / ABOUT - DETAILS. HTM WWW. LYMPHOMATION. ORG / ABOUT - DETAILS. HTM

19. 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

20. 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

21. 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

22. 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

23. D IAGNOSTIC C ONFIRMATION CodeLabelDefinition 1Positive histologyTissue microscopically examined and positive 2Positive cytologyFluid cells microscopically examined and positive 3Positive 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. …

24. R EVIEW M ANUAL S ECTIONS  What’s New  Reportability rules  Multiple Primary rules  Primary site and histology rules  Grade rules  Glossary and Appendices

26. H EMATOPOIETIC D ATABASE

27. R EVIEW DATABASE F EATURES  Display codes  Search terms and codes  Definitions, synonyms  Display special studies, treatment, transformations  Abstractor’s notes  MP Calculator