Reportable
for cases diagnosed
1978 and later
Primary Site(s)
C421
Primary site must be bone marrow (C421)
Coding Manual:
Hematopoietic Coding Manual (PDF)
Abstractor Notes
If the leukemia occurs before or simultaneously with Mast Cell Sarcoma (9740/3), see M3 and Module 5:PH 9.
Diagnostic Confirmation
This histology can be determined by positive histology (including peripheral blood) with or without genetics and/or immunophenotyping. Review the Definitive Diagnostic Methods, Immunophenotyping and Genetics Data sections below, and the instructions in the Hematopoietic Manual for further guidance on assigning Diagnostic confirmation.
Grade
Not Applicable
Module Rule
None
Alternate Names
MCL
Definition
Mast cell leukemia is the leukemic variant of systemic mastocytosis (9741/3) in which bone marrow aspirate smears contain greater than or equal to 20% mast cells. These mast cells are usually immature and atypical and are often round rather than spindle-shaped.
In classic mast cell leukemia, mast cells account for greater than or equal to 10% of the peripheral white blood cells.
In most patients, skin lesions are detectable. Bone marrow biopsy shows a diffuse, dense infiltration with atypical, immature mast cells. Organ damage is usually present at diagnosis.
General criteria for systemic mastocytosis have been established and there are 5 variants. Each variant has specific criteria, below are the criteria for mast cell leukemia.
1. Meets the general criteria for systemic mastocytosis.
2. Bone marrow biopsy shows diffuse infiltration (usually dense) by atypical, immature mast cells.
3. In classic cases, mast cells account for greater than or equal to 10 percent of the peripheral blood white blood cells, but the aleukemic variant (in which mast cells account for less than 10%) is more common.
4. Skin lesions are usually absent
In classic mast cell leukemia, mast cells account for greater than or equal to 10% of the peripheral white blood cells.
In most patients, skin lesions are detectable. Bone marrow biopsy shows a diffuse, dense infiltration with atypical, immature mast cells. Organ damage is usually present at diagnosis.
General criteria for systemic mastocytosis have been established and there are 5 variants. Each variant has specific criteria, below are the criteria for mast cell leukemia.
1. Meets the general criteria for systemic mastocytosis.
2. Bone marrow biopsy shows diffuse infiltration (usually dense) by atypical, immature mast cells.
3. In classic cases, mast cells account for greater than or equal to 10 percent of the peripheral blood white blood cells, but the aleukemic variant (in which mast cells account for less than 10%) is more common.
4. Skin lesions are usually absent
Definitive Diagnostic Methods
Bone marrow biopsy
Genetic testing
Immunophenotyping
None
Treatments
Chemotherapy
Transformations to
There are no known transformations
Transformations from
There are no known transformations
Same Primaries
Corresponding ICD-9 Codes
207.8 Other specified leukemia
Corresponding ICD-10 Codes
C94.3 Mast cell leukemia
Corresponding ICD-10-CM Codes (U.S. only)
C94.3 Mast cell leukemia (effective October 01, 2015)
Signs and Symptoms
Abdominal pain
Arthralgias
Bleeding (hemorrhage)
Bone pain
Dermatographism
Diaphoresis
Fatigue
Fever
Flushing
Fractures
Gastrointestinal distress
Headache
Hepatosplenomegaly
Hypotension
Myalgias
Neutropenia
Organ impairment
Osteopenia/osteoporosis
Peptic ulcer
Pruritis
Respiratory problems
Syncope
Tachycardia
Thrombocytopenia
Urticaria
Weight loss
Diagnostic Exams
Progression and Transformation
None
Epidemiology and Mortality
Survival: ~ few months
Sources
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J (Eds):
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mastocytosis
Pages: 69
WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition)
IARC: Lyon 2017
Section: Mastocytosis
Pages: 69
International Classification of Diseases for Oncology, Third Edition, Second Revision. Geneva: World Health Organization, 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
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