Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 236

ICD Coding

ICD-10-AM Code C92.1

Brief description

This is a malignant neoplasm of white blood cells, involving increased and unregulated production of the myeloid line of cells (predominantly neutrophils, but also basophils and eosinophils) in the bone marrow.  It is associated with specific gene abnormalities.

Confirming the diagnosis 

Confirmation of the diagnosis is typically based on findings from bone marrow aspiration and biopsy together with genetic testing. 

The relevant medical specialists are a haematologist and a pathologist.

Additional diagnoses covered by SOP

• Chronic myelogenous leukaemia
• Chronic granulocytic leukaemia
• Chronic myeloblastic leukaemia
• Chronic myelocytic leukaemia

Conditions excluded from SOP

• Acute myeloid leukaemia*
• Atypical chronic myeloid leukaemia^#
• Chronic eosinophilic leukaemia^#
• Chronic neutrophilic leukaemia^#
• Leukemoid reactions^#
• Chronic lymphocytic leukaemia* - mature B-cell lymphoid leukaemia and small lymphocytic lymphoma SOP
• Chronic lymphoid leukaemia*
• Chronic myelomonocytic leukaemia^# 
• Myelodysplastic disorder*

* another SOP applies

^# non-SOP condition

Clinical onset

The condition may be asymptomatic and first suspected following a blood test.  Symptomatic presentations may include fatigue, weight loss, bleeding episodes, excessive sweating and abdominal fullness.  An enlarged spleen may be found on examination.  Average age of onset is around 60 years old.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition is potentially curable with a hematopoietic cell transplant.  The condition can now also be controlled long term (without cure) using tyrosine kinase inhibitors.