(a)Anaemia
(1)Anaemia demonstrated by a reduced haemoglobin level should require investigation. A fit assessment may be considered in cases where the primary cause has been treated (e.g. iron or B12 deficiency) and the haemoglobin or haematocrit has stabilised at a satisfactory level. The recommended range of the haemoglobin level is 11–17 g/dl.
(2)Anaemia which is unamenable to treatment should be disqualifying.
(b)Haemoglobinopathy Applicants with a haemoglobinopathy should be assessed as unfit. A fit assessment may be considered where minor thalassaemia, sickle cell disease or other haemoglobinopathy is diagnosed without a history of crises and where full functional capability is demonstrated.
(c)Coagulation disorders
(1)Significant coagulation disorders require investigation. A fit assessment may be considered if there is no history of significant bleeding or clotting episodes and the haematological data indicate that it is safe to do so.
(2)If anticoagulant therapy is prescribed, AMC1 ATCO.MED.B.010(g) should be followed.
(d)Disorders of the lymphatic system Lymphatic enlargement requires investigation. A fit assessment may be considered in cases of an acute infectious process which is fully recovered, or Hodgkin’s lymphoma, or other lymphoid malignancy which has been treated and is in full remission, or that requires minimal or no treatment.
(e)Leukaemia
(1)Applicants with acute leukaemia should be assessed as unfit. Once in established remission, applicants may be assessed as fit.
(2)Applicants with chronic leukaemia should be assessed as unfit. A fit assessment may be considered after remission and a period of demonstrated stability.
(3)Applicants with a history of leukaemia should have no history of central nervous system involvement and no continuing side effects from treatment which are likely to interfere with the safe exercise of the privileges of the licence. Haemoglobin and platelet levels should be satisfactory.
(4)Regular follow-up is required in all cases of leukaemia.
(f)Splenomegaly Splenomegaly requires investigation. A fit assessment may be considered if the enlargement is minimal, stable and no associated pathology is demonstrated, or if the enlargement is minimal and associated with another acceptable condition.