Pure red cell aplasia
Meaning of pure red cell aplasia: For the purposes of this Statement of Principles, pure red cell aplasia: (a) means complete or nearly complete cessation of red cell production in the bone marrow without effects on other haematopoietic cells and characterised by anaemia, reticulocytopaenia and absent or rare erythroid precursor cells in the bone marrow; and (b) excludes: (i) congenital Diamond-Blackfan anaemia; (ii) myelodysplastic syndrome; and (iii) paroxysmal nocturnal haemoglobinuria. (3) While pure red cell aplasia attracts ICD-10-AM code D60, in applying this Statement of Principles the meaning of pure red cell aplasia is that given in subsection (2). (4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.
Reasonable Hypothesis (RH) — Statement of Principles No. 60 of 2020
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 pure red cell aplasia or death from pure red cell aplasia with the circumstances of a person's relevant service:
- (1)being pregnant at the time of the clinical onset of pure red cell aplasia;
- (2)being treated with a drug specified in the Schedule 2 - Drugs of this Instrument within the one year before the clinical onset of pure red cell aplasia;
- (3)being treated with a drug which is associated in the individual with: (a) the development of pure red cell aplasia within six months of drug therapy; and (b) the improvement of pure red cell aplasia within six months of discontinuing or tapering drug therapy;
- (4)taking a non-aspirin, nonsteroidal, anti-inflammatory drug on at least four days per week for a continuous period of at least four weeks, within the one year before the clinical onset of pure red cell aplasia;
- (5)being exposed to benzene as specified on at least 30 days within the one year before the clinical onset of pure red cell aplasia;
Note: being exposed to benzene as specified is defined in the Schedule 1 - Dictionary.
- (6)having acute hepatitis within the one year before the clinical onset of pure red cell aplasia;
- (7)having a liver transplant within the six months before the clinical onset of pure red cell aplasia;
- (8)having an autoimmune disease from the specified list of autoimmune disease within the two years before the clinical onset of pure red cell aplasia;
Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.
- (9)having a haematological malignancy from the specified list of haematological malignancies within the six months before the clinical onset of pure red cell aplasia;
Note: specified list of haematological malignancies is defined in the Schedule 1 - Dictionary.
- (10)having a thymoma or thymic carcinoma before the clinical onset of pure red cell aplasia;
- (11)having an infection with parvovirus B19 or acute infectious mononucleosis within the six months before the clinical onset of pure red cell aplasia;
- (12)being pregnant at the time of the clinical worsening of pure red cell aplasia;
- (13)inability to obtain appropriate clinical management for pure red cell aplasia;
Aggravation-only factors: the factors in subsections 9(12) and 9(13) 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. 61 of 2020
12 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, pure red cell aplasia or death from pure red cell aplasia is connected with the circumstances of a person's relevant service:
- (1)being pregnant at the time of the clinical onset of pure red cell aplasia;
- (2)being treated with a drug specified in the Schedule 2 - Drugs of this Instrument within the six months before the clinical onset of pure red cell aplasia;
- (3)being treated with a drug which is associated in the individual with: (a) the development of pure red cell aplasia within six months of drug therapy; and (b) the improvement of pure red cell aplasia within six months of discontinuing or tapering drug therapy;
- (4)being exposed to benzene as specified on at least 45 days within the six months before the clinical onset of pure red cell aplasia;
Note: being exposed to benzene as specified is defined in the Schedule 1 - Dictionary.
- (5)having acute hepatitis within the one year before the clinical onset of pure red cell aplasia;
- (6)having a liver transplant within the three months before the clinical onset of pure red cell aplasia;
- (7)having an autoimmune disease from the specified list of autoimmune diseases within the two years before the clinical onset of pure red cell aplasia;
Note: specified list of autoimmune diseases is defined in the Schedule 1 - Dictionary.
- (8)having chronic lymphocytic leukaemia/small lymphocytic lymphoma or T-cell large granular lymphocytic leukaemia within the six months before the clinical onset of pure red cell aplasia;
- (9)having a thymoma or thymic carcinoma before the clinical onset of pure red cell aplasia;
- (10)having an infection with parvovirus B19 within the six months before the clinical onset of pure red cell aplasia;
- (11)being pregnant at the time of the clinical worsening of pure red cell aplasia;
- (12)inability to obtain appropriate clinical management for pure red cell aplasia;
Aggravation-only factors: the factors in subsections 9(11) and 9(12) 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.
