High Risk Cytogenetics
Description
High Risk Cytogenetics is defined as one or more of t(4;14), t(14;16), or del 17p identified from FISH test results and is part of the staging criteria for plasma cell myeloma.
The Revised International Staging System (RISS or R-ISS) is now used to stage plasma cell myeloma (9732/3), using several different criteria. The stages are based on the absence or presence of the following related criteria.
* 3931: Serum Beta-2 Microglobulin Pretreatment Level
* 3930: Serum Albumin Pretreatment Level
* 3857: High Risk Cytogenetics
* 3869: LDH Level
Required for Staging: The AJCC Staging System Plasma Cell Myeloma and Plasma Cell Disorders (9732/3 only) and EOD.
* Note: RISS stage is not applicable for the descriptions of plasma multiple myeloma that are listed in the codes 1 and 9 in the SSDI Schema Discriminator 1: Plasma Cell Myeloma Terminology. If you have coded 1 or 9 for this Schema Discriminator, the four data items listed above are BLANK.
The RISS stages are
* Stage I: Serum Beta-2-microglobulin <3.5 mg/L and serum albumin > 3.5 g/dL and no high-risk cytogenetics and Normal LDH
* Stage II: Not R-ISS I or III
* Stage III: Serum Beta-2-microglobulin > 5.5 mg/L and high-risk cytogenetics and/or high LDH
Rationale
High Risk Cytogenetics is a prognostic factor required in AJCC 8th edition, Chapter 82 *Plasma Cell Myeloma and Plasma Cell Disorders*, for staging of plasma cell myeloma. It is a new data item for cases diagnosed 1/1/2018+.
Additional Info
**Source documents:** pathology report
Notes
**Note:** **Physician statement**
* Physician statement of presence or absence of high-risk cytogenetics can be used to code this data item when no other information is available
* Record this data item based on physician statement or FISH test interpretation performed at diagnosis (pre-treatment).
* If the presence/absence of high-risk cytogenetics determined by available test results differs from the physician statement of presence/absence, the physician's statement takes precedence.
Coding Guidelines
**1)** **Code 5** if Schema Discriminator 1: Plasma Cell Myeloma Terminology is coded to 1 or 9
**2)** Code 9 when there is no mention of high-risk cytogenetics
Default
9
Metadata
SSDI
| Code |
Description |
| 0 |
High-risk cytogenetics not identified/not present |
| 1 |
High-risk cytogenetics present |
| 5 |
Schema Discriminator 1: Plasma Cell Myeloma Terminology coded to 1 or 9 |
| 7 |
Test ordered, results not in chart |
| 9 |
Not documented in medical record
High Risk Cytogenetics not assessed or unknown if assessed |
