Spectrum of hematological malignancies in aviators - A Clinical Series

Hematological malignancies (HM) include a broad spectrum of malignancies affecting any component of the hemopoetic system. Like other malignant disorders, HM carry considerable morbidity and mortality and in an aircrew may result in disqualification from flying. The present study describes the profile of HM in aircrew with the view to look at their aeromedical concerns. The available medical documents of all the aviators over a period of ten years (Jan 1997 to Dec 2006) were reviewed and those diagnosed with hematological malignancy included in the study. Clinical examination, investigation, treatment and final disposition regarding flying were analyzed. Nine cases of hematological malignancy were diagnosed among aviators (five civil commercial pilots and four Air Force pilots) during the study period. A wide spectrum of disorder was noted with no particular subtype showing a high incidence. Five of the nine cases subsequently returned to flying duties with waivers. The remaining four cases, a case each of Waldenstrom macroglobulinaemia, non-hodgkins lymphoma, hairy cell leukemia and essential thrombocytosis, are still under treatment and continue being unfit for aviation duties. Hematological malignancies can be picked up early in aviators as they undergo stringent periodic evaluation. Reflighting of aircrew after adequate observation is a definite possibility today in light of potential cure for many of these disorders, leading to optimal utilization of highly skilled manpower.