1. 2010 Hematopoietic and Lymphoid Neoplasm Project Maneuvering the Hemato DB and Rules

2. Maneuvering the Hemato DB & Rules New Version of Hemato Manual Posted to SEER website http://seer.cancer.gov/tools/heme/ index.html http://seer.cancer.gov/tools/heme/ index.html Sign up for e-mail notifications

3. Maneuvering the Hemato DB & Rules Multiple primaries calculator replaces the 2001 Single versus Subsequent Primaries pull-out table Two references do not match Replaces the 2002 Abstracting and Coding Guide (“the Red Book”) Does not replicate ICD-O-3 Obsolete terms and codes deleted

4. Maneuvering the Hemato DB & Rules Primary Site Code Display One correct primary site code - WHO and ICD-O-3 Abstractor notes list common and rare primary sites Notes do not display on default view Used by data collectors, QI staff and data matching/consolidation staff

5. Maneuvering the Hemato DB & Rules Five Steps of Navigation: Provisional histology; primary site/hist Reportability Instructions MP Rules PH Rules Grade Rules Phenotype/lineage for hematopoietic and lymphoid neoplasms

6. Maneuvering the Hemato DB & Rules 1: Provisional histology; site/hist “Smart” searches Ex: Use “histiocytic, diffuse” to locate histiocytic, diffuse lymphoma Use quotation marks Matched term and sort feature Warnings display for unlikely terms of site/hist combinations

7. Maneuvering the Hemato DB & Rules Example: Search “marginal zone” Select marginal zone lymphoma Display disease information Display abstractor notes Review common and rare primary sites

8. Maneuvering the Hemato DB & Rules 2: Reportability Instructions: Not rules nor hierarchical Informational Abiguous terms; usual treatment(s) Clinical diagnoses Smoldering, early, evolving, indolent and pre-diagnoses

9. Maneuvering the Hemato DB & Rules 2: Reportability Instructions Newly reportable neoplasms Documentation of definitive Dx ICD-O /1 an MD calls malignant New terms and codes (Appendix D) When to query the Hemato DB

10. Maneuvering the Hemato DB & Rules 3: MP Rules M1: Minimal info; single primary M2: Single histology; single primary M3-M12: Multiple histologies M13: Last resort Use MP calculator

11. Maneuvering the Hemato DB & Rules 4: PH Rules PH1-PH3 Path report is not an auto-default PH 1: Code primary site from scans, documentation, path, Hemato DB Path not automatic default PH 2: Dx of inclusion/exclusion Equivocal tests + clincal presentation = Dx PH 3: Minimal information: use documentation, clinical impression, death certificate, office or out-pt report

12. Maneuvering the Hemato DB & Rules PH Modules 1-9: Module 1: Generl instructions Modules 2-6: Histology-specific; based on provisional Dx established in Step 1 Modules 7-8: Speciality modules 7: Primary site for lymphoma (PH25 - 37) 8: Histology (PH 38 - 39) Module 9: Last resort Hemato DB Numerically higher code

13. Maneuvering the Hemato DB & Rules 5: Assigning grade: phenotype/lineage Notes 1 & 2: Assign grade; do not use ICD-O-3 table 13 Use rules; need not be specified on path report Phenotype/lineage inherent in histologic type

14. Maneuvering the Hemato DB & Rules 5: Grade and lineage/phenotype Grade 9: not applicable Myeloproliferative, myeloproliferative / myelodysplastic, myelodysplastic, histiocytic, dendritic, ambiguous lineage Use path or H&P, consult, final Dx, face sheet

15. Maneuvering the Hemato DB & Rules 5: Grade and lineage/phenotype Valid codes are 5-9 Do not use low, intermediate and high grade to code lineage/phenotype Numeric lists of neoplasm lineages T-cell B-cell Null-cell NK cell “Clean up” rule for inadequate documentation, mixed phenotypes

16. Maneuvering the Hemato DB & Rules Diagnostic confirmation Read diagnostic confirmation, genetic data, disease immunophenotyping Are genetics or immunophenotyping part of dx criteria? Need immunohistochemistry (tests tissue, BM, or blood for antigens by staining Was it ordered? Are results available? Dx conf. Code 3: histology and immunohistology (HP/L cases only)

17. Maneuvering the Hemato DB & Rules Treatment: Read abstractor notes High-level information only Use MP calculator Check rules M1 - M12 Follow-back on suspected treatment(s)

18. Maneuvering the Hemato DB & Rules Case Walk-Through Dx: Duodenum: Multiple polyps with intestinal follicular lymphoma Look up “intestinal follicular” Display abstractor notes Read variant information

19. Maneuvering the Hemato DB & Rules Case Walk-Through Read reportability instructions included in histology code range Review MP rules Stop at rule M2: single histology = single primary

20. Maneuvering the Hemato DB & Rules Determine primary histology Open PH modules Find follicular lymphoma code 9690/3 Check module 6, PH 16 and 17

21. Maneuvering the Hemato DB & Rules Determine grade/phenotype/lineage Codes are numerically arranged Look up 9690/3 Stop at rule G6: T-cell neoplasm

22. Maneuvering the Hemato DB & Rules Questions? This work was supported by Contract HHSN26120000024C between the National Cancer Institute and the Connecticut Department of Public Health.