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Treatment with immunosuppressive drugs for systemic malignancy

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Last amended 
16 June 2015

Malignant melanoma of the skin - Treatment with immunosuppressive drugs for systemic malignancy Factor

Immunosuppressive drugs are defined by the RMA to mean 'drugs or agents administered for the purpose of suppressing immune responses, but does not include inhaled or topical steroids'.

Immunosuppressive drug therapy is given for:

  • Solid organ transplantation, blood and bone marrow transplants, and stem cell transplantation to prevent rejection of the 'foreign' organ, tissue or product.
  • Immunosuppressive drugs may also be used as treatment for a systemic malignancy, autoimmune conditions such as SLE (systemic lupus erythematosus) and severe rheumatoid arthritis.
  • Immunosuppressive agents include Azathioprine, Methotrexate, Cyclosporin, Cyclophosphamide. Corticosteroids are the most commonly prescribed immunosuppressive drugs e.g. prednisone (orally) or methylprednisolone (intravenously).
  • Immunosuppressive therapy can rarely be stopped completely after a transplant. However, intensive immunosuppression is usually required only during the first few weeks after a transplant (starting at the time of the transplant) or during a rejection crisis. Subsequently the transplant often seems to become accommodated and can be maintained with relatively small doses of immunosuppressive drugs.
Systemic malignancy

A systemic malignancy is a progressive disorder that affects the body as a whole. It therefore includes all malignant neoplasms other than non-metastatic non-melanotic malignant neoplasm of the skin,

Last reviewed for CCPS 26 September 2007.

Preliminary questions [10853]

10854 there is some evidence that treatment with immunosuppressive drugs for systemic malignancy may be a factor in the development of the condition under consideration.

10856 the veteran has been treated with immunosuppressive drugs for systemic malignancy at some time.

10857  the systemic malignancy requiring the veteran to be treated with immunosuppressive drugs was an illness or injury which is identifiable.

10859  the veteran has established the causal connection between the treatment with immunosuppressive drugs for the identified illness or injury and VEA service for the clinical onset of malignant melanoma of the skin.

10861   the veteran has established the causal connection between the treatment with immunosuppressive drugs for the identified illness or injury and eligible service for the clinical onset of malignant melanoma of the skin.

or

10860   the veteran has established the causal connection between the treatment with immunosuppressive drugs for the identified illness or injury and operational service for the clinical onset of malignant melanoma of the skin.

Clinical onset and operational service [10860]

10858 for treatment of the identified illness or injury, a systemic malignancy, the veteran was treated with immunosuppressive drugs at least one year before the clinical onset of the condition under consideration.

10862 the identified illness or injury, a systemic malignancy for which the veteran was treated with immunosuppressive drugs, is causally related to operational service.

Clinical onset and eligible service [10861]

38754 for treatment of the identified illness or injury, a systemic malignancy, the veteran was treated with immunosuppressive drugs at least two years before the clinical onset of the condition under consideration.

10863 the identified illness or injury, a systemic malignancy for which the veteran was treated with immunosuppressive drugs, is causally related to eligible service.