Statement of Principles
concerning
 
CHRONIC LYMPHOCYTIC LEUKAEMIA/SMALL LYMPHOCYTIC LYMPHOMA
No. 85 of 2014
 
for the purposes of the
 
Veterans’ Entitlements Act 1986
and
Military Rehabilitation and Compensation Act 2004
Title
1.         This Instrument may be cited as Statement of Principles concerning chronic lymphocytic leukaemia/small lymphocytic lymphoma No. 85 of 2014.
Determination
2.         The Repatriation Medical Authority under subsection 196B(3) and (8) of the Veterans’ Entitlements Act 1986 (the VEA):
(a)        revokes Instrument No. 10 of 2005 concerning chronic lymphoid leukaemia; and
(b)       determines in its place this Statement of Principles.
Kind of injury, disease or death
3.         (a)        This Statement of Principles is about chronic lymphocytic leukaemia/small lymphocytic lymphoma and death from chronic lymphocytic leukaemia/small lymphocytic lymphoma.
(b)                           For the purposes of this Statement of Principles, "chronic lymphocytic leukaemia/small lymphocytic lymphoma" means a malignant lymphoproliferative disorder, characterised by the progressive accumulation of small, morphologically mature, but functionally incompetent monoclonal B lymphocytes in the lymph nodes, bone marrow and peripheral blood, admixed with prolymphocytes and paraimmunoblasts (pseudofollicles), usually expressing CD5 and CD23, and that persists for at least three months.  It can present as either a leukaemia or a lymphoma.  Clinical manifestations may include lymphadenopathy, organomegaly or signs of bone marrow failure.
This definition includes hairy cell leukaemia and B cell prolymphocytic leukaemia.  This definition excludes other B cell lymphoproliferative disorders, adult T cell lymphoma/leukaemia, T cell prolymphocytic leukaemias, and non-Hodgkin's lymphoma other than small lymphocytic lymphoma.
Basis for determining the factors
4.         After examining the available sound medical-scientific evidence the Repatriation Medical Authority is of the view that it is more probable than not on the sound medical-scientific evidence available, that the only factor that can be related to the cause of or material contribution to or aggravation of chronic lymphocytic leukaemia/small lymphocytic lymphoma or death from chronic lymphocytic leukaemia/small lymphocytic lymphoma and which can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the Military Rehabilitation and Compensation Act 2004 (the MRCA) is that set out in clause 5.
Factors that must be related to service
5.         The factor that must exist before it can be said that, on the balance of probabilities, in relation to the circumstances of a person’s relevant service causing or materially contributing to or aggravating chronic lymphocytic leukaemia/small lymphocytic lymphoma or death from chronic lymphocytic leukaemia/small lymphocytic lymphoma is inability to obtain appropriate clinical management for chronic lymphocytic leukaemia/small lymphocytic lymphoma.
Other definitions
6.         For the purposes of this Statement of Principles:
"death from chronic lymphocytic leukaemia/small lymphocytic lymphoma" in relation to a person includes death from a terminal event or condition that was contributed to by the person’s chronic lymphocytic leukaemia/small lymphocytic lymphoma;
"relevant service" means:
(a)                eligible war service (other than operational service) under the VEA;
(b)               defence service (other than hazardous service and British nuclear test defence service) under the VEA; or
(c)                peacetime service under the MRCA;
"terminal event" means the proximate or ultimate cause of death and includes:
(a)                pneumonia;
(b)               respiratory failure;
(c)                cardiac arrest;
(d)               circulatory failure; or
(e)                cessation of brain function.
Application
7.         This Instrument applies to all matters to which section 120B of the VEA or section 339 of the MRCA applies.
Date of effect
8.         This Instrument takes effect from 22 September 2014.
Dated this   twenty-second   day of   August   2014
The Common Seal of the                    )
Repatriation Medical Authority          )
was affixed at the direction of:          )
PROFESSOR NICHOLAS SAUNDERS AO
CHAIRPERSON