Primary myelofibrosis
Meaning of primary myelofibrosis: For the purposes of this Statement of Principles, primary myelofibrosis: (a) means a chronic, Philadelphia-chromosome negative myeloproliferative neoplasm characterised by bone marrow megakaryocytic proliferation, resulting in the replacement of bone marrow with fibrous tissue, extramedullary haematopoiesis, splenomegaly and leukoerythroblastosis in the blood; and (b) excludes: (i) myelofibrosis secondary to essential thrombocythaemia, polycythaemia vera or another myeloid neoplasm; and (ii) secondary myelofibrosis resulting from other causes of bone marrow fibrosis including infections, autoimmune disorders or other chronic inflammatory conditions, hairy cell leukaemia or other lymphoid neoplasms, metastatic malignancies and toxic (chronic) myelopathies.
Reasonable Hypothesis (RH) — Statement of Principles No. 89 of 2021
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting primary myelofibrosis or death from primary myelofibrosis with the circumstances of a person's relevant service:
- (1)having smoked tobacco products: (a) in an amount of at least 10 pack-years before the clinical onset of primary myelofibrosis; and (b) commencing at least 5 years before the clinical onset of primary myelofibrosis; and if smoking has ceased before the clinical onset of primary myelofibrosis, then that onset occurred within 15 years of cessation;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
- (2)inability to obtain appropriate clinical management for primary myelofibrosis;
Aggravation-only factors: the factors in subsection 9(2) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 90 of 2021
2 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, primary myelofibrosis or death from primary myelofibrosis is connected with the circumstances of a person's relevant service:
- (1)having smoked tobacco products: (a) in an amount of at least 10 pack-years before the clinical onset of primary myelofibrosis; and (b) commencing at least 5 years before the clinical onset of primary myelofibrosis; and if smoking has ceased before the clinical onset of primary myelofibrosis, then that onset occurred within 15 years of cessation;
Note: one pack-year is defined in the Schedule 1 - Dictionary.
- (2)inability to obtain appropriate clinical management for primary myelofibrosis;
Aggravation-only factors: the factors in subsection 9(2) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
