Home > SOP Information > SOPs and Supporting Information – alphabetic listing > A to B > Acute Lymphoblastic Leukaemia / Lymphoblastic Lymphoma B014

Acute Lymphoblastic Leukaemia / Lymphoblastic Lymphoma B014

Date published 
Monday, June 15, 2015
Last amended 
Thursday, March 18, 2021
Current RMA Instruments
Reasonable Hypothesis SOP [1]
33 of 2021
Balance of Probabilities SOP [2]
34 of 2021
Changes from previous Instruments

SOP Bulletin 219 [3]

ICD Coding
  • ICD-9-CM Codes: 204.0
  • ICD-10-AM Codes: C91.0
Brief description

This is a cancer of immature white blood cells (lymphoblasts).  There are two overlapping clinical presentations of the same disease - leukaemia, when bone marrow blast cells predominate, and lymphoma, when a mass lesion in the mediastinum or elsewhere is the predominant feature.

Confirming the diagnosis

Diagnosis is usually suspected based on a finding of swollen lymph nodes or a blood test showing abnormal white cells.  A bone marrow biopsy is required to confirm the diagnosis and differentiate the condition from other diseases.

The relevant medical specialist is a haematologist.

Diagnoses covered by SOP
  • acute lymphoid leukaemia
  • acute lymphocytic leukaemia
  • B-lymphoblastic leukemia/lymphoma (B-ALL/LBL)
  • T-lymphoblastic leukemia/lymphoma (T-ALL/LBL)
  • lymphoblastic lymphoma
Conditions excluded from SOP
  • acute myeloid leukaemia*
  • acute undifferentiated leukaemia#
  • adult T-cell leukaemia/lymphoma* (non-Hodgkin lymphoma SOP)
  • Burkitt’s lymphoma/leukaemia* (non-Hodgkin lymphoma SOP)
  • chronic lymphoid leukaemia*
  • chronic myeloid leukaemia*
  • indolent T-lymphoblastic proliferation#
  • non-Hodgkin lymphoma*

* another SOP applies

# non-SOP condition

Clinical onset

Clinical onset will be when the diagnosis was confirmed, or shortly before that time if characteristic symptoms were present, such as easy bruising/bleeding, recurrent infections or symptoms from anaemia. 75% of cases occur in children under 6, but there is a second peak in adults > 60 years old.

Clinical worsening

The only worsening factor is for inability to obtain appropriate clinical management.  The prognosis in adults is generally poor.  Worsening beyond the normal progression of the disease will be difficult to establish and will require specialist opinion.

Rulebase for acute lymphoid leukaemia

Place holder node for Rulebase for acute lymphoid leukaemia

A course of therapeutic radiation

Acute lymphoid leukaemia - A course of therapeutic radiation Factor

Last reviewed for CCPS 21 June 2002.

Preliminary questions [32015]

7629 [5] there is some evidence that therapeutic radiation may be a factor in the development of the condition under consideration.

5031 [5] the veteran has received a course of therapeutic radiation at some time.

32021 [6] the veteran underwent a course of therapeutic radiation for the treatment of an illness or injury which is identifiable.

32017 — the veteran has established the causal connection between the course of therapeutic radiation and VEA service for the clinical onset of acute lymphoid leukaemia.

32019 — the veteran has established the causal connection between the course of therapeutic radiation and eligible service for the clinical onset of acute lymphoid leukaemia.

or

32018 — the veteran has established the causal connection between the course of therapeutic radiation and operational service for the clinical onset of acute lymphoid leukaemia.

Clinical onset and operational service [32018]

[7]32020

where the veteran underwent a course of therapeutic radiation for treatment of the identified illness or injury, the first such exposure occurred more than one year before the clinical onset of the condition under consideration.

5326 — the identified illness or injury for which the course of therapeutic radiation was received is causally related to operational service. [8] [9]

Clinical onset and eligible service [32019]

[10]32022

where the veteran underwent a course of therapeutic radiation for treatment of the identified illness or injury, the first such exposure occurred more than two years before the clinical onset of the condition under consideration. [11]

5327 — the identified illness or injury for which the course of therapeutic radiation was received is causally related to eligible service. [12] [9]

Atomic radiation

Acute lymphoid leukaemia - Atomic radiation Factor

Last reviewed for CCPS 21 June 2002.

Investigative Documents

Claimant Report - Exposure to Atomic Radiation [CR9171]

Preliminary questions [1659]

[13]30275

there is some evidence that atomic radiation may be a factor in the development of the condition under consideration.

1790 — the veteran has established the causal connection between atomic radiation and VEA service for the clinical onset of acute lymphoid leukaemia.

31993 — the veteran has established the causal connection between atomic radiation and operational service for the clinical onset of acute lymphoid leukaemia.

or

31994 — the veteran has established the causal connection between atomic radiation and eligible service for the clinical onset of acute lymphoid leukaemia.

Clinical onset and operational service [31993]

31995 [14] the veteran received a cumulative equivalent dose of at least 0.01 Sievert of atomic radiation to the bone marrow.

[15]31996

the veteran received a cumulative equivalent dose of at least 0.01 Sievert of atomic radiation to the bone marrow where this dose was accumulated at least two years before the clinical onset of the condition under consideration.

[16]35162

the veteran's operational service made a material contribution to the cumulative equivalent dose of at least 0.01 Sievert of atomic radiation to the bone marrow where this dose was accumulated at least two years before the clinical onset of the condition under consideration.

[17]10916

the cumulative equivalent dose of at least 0.01 Sievert of atomic radiation to the bone marrow, to which operational service made a material contribution and this dose was accumulated at least two years before the clinical onset of the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline.

Clinical onset and eligible service [31994]

[18]32001

the veteran received a cumulative equivalent dose of at least 0.1 Sievert of atomic radiation to the bone marrow.

[19]32003

the veteran received a cumulative equivalent dose of at least 0.1 Sievert of atomic radiation to the bone marrow where this dose was accumulated at least two years before the clinical onset of the condition under consideration.

[20]32002

the veteran's eligible service made a material contribution to the cumulative equivalent dose of at least 0.1 Sievert of atomic radiation to the bone marrow where this dose was accumulated at least two years before the clinical onset of the condition under consideration.

[21]10919

the cumulative equivalent dose of at least 0.1 Sievert of atomic radiation to the bone marrow, to which eligible service made a material contribution and this dose was accumulated at least two years before the clinical onset of the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline. [18]

HTLV-1 infection

Acute lymphoid leukaemia - HTLV-1 infection Factor

Last reviewed for CCPS 21 June 2002.

Preliminary questions [1665]

10932 [22] there is some evidence that being infected with HTLV-1 may be a factor in the development of acute lymphoid leukaemia.

32023 [23] the veteran has Adult T-cell lymphoma-leukaemia.

[24]1670

the veteran has been infected with HTLV-1.

1668 [25] the veteran was infected with HTLV-1 before the clinical onset of acute lymphoid leukaemia. [26]

1669 — the veteran has established the causal connection between being infected with HTLV-1 and VEA service for the clinical onset of acute lymphoid leukaemia.

1671 — the veteran has established the causal connection between being infected with HTLV-1 and operational service for the clinical onset of acute lymphoid leukaemia.

or

10933 — the veteran has established the causal connection between being infected with HTLV-1 and eligible service for the clinical onset of acute lymphoid leukaemia.

Clinical onset and operational service [1671]

1672 — being infected with HTLV-1 is causally related to operational service. [27] [28]

Clinical onset and eligible service [10933]

8081 — being infected with HTLV-1 is causally related to eligible service. [29] [28]

Inability to obtain appropriate clinical management for acute lymphoid leukaemia

Acute lymphoid leukaemia - Inability to obtain appropriate clinical management for acute lymphoid leukaemia Factor

Last reviewed for CCPS 21 June 2002.

Investigative Documents

Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM]

Preliminary questions [10912]

11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.

[30]7066

there is some evidence that an inability to obtain appropriate clinical management for the condition under consideration may be a factor in the worsening of the condition under consideration.

7334 [31] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

[32]7335

the condition under consideration permanently worsened.

[33]7378

the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.

7379 [34] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration.

11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration.

11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration.

or

11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration.

Clinical worsening and operational service [11235]

[35]7384

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service.

[36]21084

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during operational service, as a causal result of operational service.

[37]7387

the veteran's inability to obtain appropriate clinical management for the condition under consideration during operational service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

[18]7389

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.

7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [38] [39]

[40]7392

the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related.

Clinical worsening and eligible service [11236]

[41]7385

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service.

[42]7386

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, during eligible service, as a causal result of eligible service.

[43]7388

the veteran's inability to obtain appropriate clinical management for the condition under consideration during eligible service was due to the veteran's serious default, wilful act or serious breach of discipline.

or

[18]7389

the veteran was unable to obtain appropriate clinical management for the condition under consideration, which contributed to the clinical worsening of the condition under consideration, because of an illness or injury which is identifiable.

7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [38] [39]

[44]7393

the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury that prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related. [45]

Infection with the Epstein-Barr virus

Acute lymphoid leukaemia - Infection with the Epstein-Barr virus Factor

Last reviewed for CCPS 21 June 2002.

Preliminary questions [10911]

32012 [46] there is some evidence that being infected with Epstein-Barr virus may be a factor in the development of the condition under consideration.

10920 [47] the veteran has ALL L3 subtype.

[48]10921

the veteran has been infected with Epstein-Barr virus at some time.

[49]10926

the veteran became infected with Epstein-Barr virus at least one year before the clinical onset of acute lymphoid leukaemia. [50]

10922 — the veteran has established the causal connection between being infected with Epstein-Barr virus and VEA service for the clinical onset of acute lymphoid leukaemia.

10924 — the veteran has established the causal connection between being infected with Epstein-Barr virus and operational service for the clinical onset of acute lymphoid leukaemia.

or

10925 — the veteran has established the causal connection between being infected with Epstein-Barr virus and eligible service for the clinical onset of acute lymphoid leukaemia.

Clinical onset and operational service [10924]

32013 — being infected with Epstein-Barr virus is causally related to operational service. [51] [52]

Clinical onset and eligible service [10925]

32014 — being infected with Epstein-Barr virus is causally related to eligible service. [53] [52]

Source URL (modified on 30/03/2021 - 12:03pm): https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/b/acute-lymphoblastic-leukaemia-b014-c910-c915

Links
[1] http://www.rma.gov.au/assets/SOP/2021/eae501d9e8/033.pdf
[2] http://www.rma.gov.au/assets/SOP/2021/705c092af2/034.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20219.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63192%23comment-form
[5] https://clik.dva.gov.au/ccpsb029rc-15
[6] clikpopup://CCPS/A course of therapeutic radiation for treatment of ill or inj
[7] clikpopup://CCPS/reject32021No
[8] clikpopup://CCPS/reject32020No
[9] clikpopup://CCPS/reject5326,5327No
[10] clikpopup://CCPS/Course of therapeutic radiation for treatment of ill or inj was 2 years before onset
[11] clikpopup://CCPS/reject32022No
[12] clikpopup://CCPS/reject5327No
[13] https://clik.dva.gov.au/ccpsclaimant-240
[14] https://clik.dva.gov.au/1659-atomic-radiation
[15] clikpopup://CCPS/reject31995No
[16] clikpopup://CCPS/reject31996No
[17] clikpopup://CCPS/reject35162No
[18] clikpopup://CCPS/rejectwilful
[19] clikpopup://CCPS/reject32001No
[20] clikpopup://CCPS/reject32003No
[21] clikpopup://CCPS/reject32002No
[22] clikpopup://CCPS/HTLV-1 infection
[23] https://clik.dva.gov.au/standard-commentary-128
[24] clikpopup://CCPS/reject32023No
[25] clikpopup://CCPS/HTLV-1 infection before onset of acute lymphoid leukaemia
[26] clikpopup://CCPS/reject1668No
[27] clikpopup://CCPS/reject1672No
[28] clikpopup://CCPS/reject1672,8081No
[29] clikpopup://CCPS/reject8081No
[30] https://clik.dva.gov.au/ccpsother-31
[31] https://clik.dva.gov.au/node/71091
[32] clikpopup://CCPS/Reject/OnsetAfterService
[33] clikpopup://CCPS/Reject/NoPermanentWorsening
[34] clikpopup://CCPS/Acute lymphoid leukaemia/ACM %C2%96 contributed to worsening
[35] clikpopup://CCPS/ACM/NoContribution
[36] clikpopup://CCPS/ACM/NotOpService
[37] clikpopup://CCPS/ACM/NotOperDuties
[38] clikpopup://CCPS/ACM/NoIllness
[39] clikpopup://CCPS/reject7390,7391No
[40] clikpopup://CCPS/Acute lymphoid leukaemia/ACM %C2%96 onset prior to operational service
[41] clikpopup://CCPS/ACM/OnsetFailOper
[42] clikpopup://CCPS/ACM/NotEligService
[43] clikpopup://CCPS/ACM/NotEligDuties
[44] clikpopup://CCPS/Acute lymphoid leukaemia/ACM %C2%96 onset prior to eligible service
[45] clikpopup://CCPS/ACM/OnsetFailElig
[46] https://clik.dva.gov.au/ccpsb006rc-2
[47] clikpopup://CCPS/Acute lymphoid leukaemia L3 subtype
[48] clikpopup://CCPS/reject10920No
[49] clikpopup://CCPS/reject10921No
[50] clikpopup://CCPS/reject10926No
[51] clikpopup://CCPS/reject32013No
[52] clikpopup://CCPS/reject32013,32014No
[53] clikpopup://CCPS/reject32014No