Acute lymphocytic leukemia (ALL)
What the FAA's documents say about acute lymphocytic leukemia (ALL), in plain words, with the FAA's own words one press away.
Covers: All classes
- The Guide's Item 48 table for blood and blood-forming tissue disease has a row for leukemia, acute and chronic, all types, with a disposition of its own. Crosscheck's page on blood disorders is written from that table.
Short version
The disposition table has two rows.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row ATreatment completed ten (10) or more years ago | Examiner issues | Examiner can issue |
| Row BAll others | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Acute lymphocytic leukemia (ALL)
- Row A · Examiner can issue
Treatment completed ten (10) or more years ago. The examiner must review an oncology evaluation performed within the previous 12 months. If it verifies the individual is cured, with no follow up treatment required, the table says ISSUE, and the examiner summarizes this history in Block 60 and submits the evaluation to the FAA for retention in the pilot's file.
A. Treatment completed ten (10) or more years ago … The AME must review an oncology evaluation performed within the previous 12 months. If the oncology evaluation verifies the individual is cured, with no follow up treatment required: … ISSUE Summarize this history in Block 60 and submit the evaluation to the FAA for retention in the pilot’s file.
- Row B · Special Issuance
All others. The table lists what to submit to the FAA for review. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the airman's authorization letter.
B. All others … Submit the following to the FAA for review: … DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the airman’s authorization letter.
The FAA pathways for acute lymphocytic leukemia (ALL)
Which exam
Which one describes yours?
The FAA's table sorts it these ways. Choose yours to see its plan.
Your step-by-step plan
Step 1: Row A: the oncology evaluation
Treatment completed ten (10) or more years ago.An oncology evaluation performed within the previous 12 months, which your AME must review.
If the oncology evaluation verifies
- The individual is cured
- With no follow up treatment required
At the exam
- Your AME summarizes this history in Block 60
- And submits the evaluation to the FAA for retention in your file
Show the FAA's words: Row A: the oncology evaluation
The AME must review an oncology evaluation performed within the previous 12 months.
FAA source: Acute Lymphocytic Leukemia. FAA date 26 April 2023; checked by Crosscheck 14 October 2026.
If the oncology evaluation verifies the individual is cured, with no follow up treatment required:
ISSUE
FAA source: Acute Lymphocytic Leukemia. FAA date 26 April 2023; checked by Crosscheck 14 October 2026.
ISSUE Summarize this history in Block 60 and submit the evaluation to the FAA for retention in the pilot’s file.
FAA source: Acute Lymphocytic Leukemia. FAA date 26 April 2023; checked by Crosscheck 14 October 2026.
Step 2: See your AME
The examiner must review an oncology evaluation performed within the previous 12 months. If it verifies the individual is cured, with no follow up treatment required, the table says ISSUE, and the examiner summarizes this history in Block 60 and submits the evaluation to the FAA for retention in the pilot's file.Exam day- The examiner must review an oncology evaluation performed within the previous 12 months. If it verifies the individual is cured, with no follow up treatment required, the table says ISSUE, and the examiner summarizes this history in Block 60 and submits the evaluation to the FAA for retention in the pilot's file.
Show the FAA's words: See your AME
A. Treatment completed ten (10) or more years ago
The AME must review an oncology evaluation performed within the previous 12 months. If the oncology evaluation verifies the individual is cured, with no follow up treatment required:
ISSUE Summarize this history in Block 60 and submit the evaluation to the FAA for retention in the pilot’s file.
FAA source: Acute Lymphocytic Leukemia. FAA date 26 April 2023; checked by Crosscheck 14 October 2026.
What the examiner checks
It depends on which row of the FAA's table describes the case.
Row AExaminer issuesExaminer can issue
The examiner must review an oncology evaluation performed within the previous 12 months. If it verifies the individual is cured, with no follow up treatment required, the table says ISSUE, and the examiner summarizes this history in Block 60 and submits the evaluation to the FAA for retention in the pilot's file.
Row BDefers to the FAASpecial Issuance
The table lists what to submit to the FAA for review. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the airman's authorization letter.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Examiner can issue
Treatment completed ten (10) or more years ago. The examiner must review an oncology evaluation performed within the previous 12 months. If it verifies the individual is cured, with no follow up treatment required, the table says ISSUE, and the examiner summarizes this history in Block 60 and submits the evaluation to the FAA for retention in the pilot's file.
A. Treatment completed ten (10) or more years ago … The AME must review an oncology evaluation performed within the previous 12 months. If the oncology evaluation verifies the individual is cured, with no follow up treatment required: … ISSUE Summarize this history in Block 60 and submit the evaluation to the FAA for retention in the pilot’s file.
- Row B · Special Issuance
All others. The table lists what to submit to the FAA for review. The examiner defers and submits the information to the FAA for a possible Special Issuance. Follow-up issuance will be per the airman's authorization letter.
B. All others … Submit the following to the FAA for review: … DEFER Submit the information to the FAA for a possible Special Issuance. Follow up Issuance Will be per the airman’s authorization letter.
If the examiner defersSpecial Issuance
The table marks Row B, all others, DEFER.
What the FAA lists to send
- Item 1. A current, detailed clinical progress note from a clinic visit with the treating oncologist no more than 90 days before the exam.
- Item 2. Items the physician specifically addresses: the initial staging, the treatments used, how long the condition has been stable or in remission, and the other things the table lists. The FAA's progress-note sheet says that when a letter uses the words "it must specifically include", they highlight specific items (that may or may not be part of a standard current, detailed Clinical Progress Note) for the physician to address.
- Item 3. A medication list, with the dates started and stopped and a description of side effects, if any.
- Item 4. Operative notes and the discharge summary, if applicable.
- Item 5. Copies of lab including pathology reports, tumor markers (if already performed by the treating physician).
- Item 6. Copies of imaging reports from testing already performed, such as MRI/CT or PET scan.
- Item 7. Copies of any other testing already performed for this condition.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table marks Row B, all others, DEFER.
B. All others … DEFER Submit the information to the FAA for a possible Special Issuance.
What the FAA lists to send
- Item 1
A current, detailed clinical progress note from a clinic visit with the treating oncologist no more than 90 days before the exam.
A current, detailed Clinical Progress Note generated from a clinic visit with the treating oncologist no more than 90 days before the AME exam.
- Item 2
Items the physician specifically addresses: the initial staging, the treatments used, how long the condition has been stable or in remission, and the other things the table lists. The FAA's progress-note sheet says that when a letter uses the words "it must specifically include", they highlight specific items (that may or may not be part of a standard current, detailed Clinical Progress Note) for the physician to address.
It must specifically include o Initial staging; o Treatments used; o How long the condition has been stable or in remission;
“IT MUST SPECIFICALLY INCLUDE” If this language is in your letter, it is to highlight SPECIFIC items (that may or may not be part of a standard current, detailed Clinical Progress Note). Make sure your physician addresses these specific items important for medical certification or clearance.
- Item 3
A medication list, with the dates started and stopped and a description of side effects, if any.
Medication list: Dates started and stopped. Description of side effects, if any;
- Item 4
Operative notes and the discharge summary, if applicable.
Operative notes and discharge summary (if applicable);
- Item 5
Copies of lab including pathology reports, tumor markers (if already performed by the treating physician).
Copies of lab including pathology reports, tumor markers (if already performed by treating physician);
- Item 6
Copies of imaging reports from testing already performed, such as MRI/CT or PET scan.
Copies of imaging reports from testing already performed (such as MRI/CT or PET scan); and
- Item 7
Copies of any other testing already performed for this condition.
Copies of any other testing already performed for this condition.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workAt later examsSpecial Issuance
The disposition table is headed All Classes.
Show the FAA's words: how often the FAA asks again
Acute Lymphocytic Leukemia (ALL) All Classes
For Row B, the table says follow-up issuance will be per the airman's authorization letter.
Show the FAA's words: at later exams
Follow up Issuance Will be per the airman’s authorization letter.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workFollow-up issuance per the authorization letter
For Row B the table says follow-up issuance will be per the airman's authorization letter.
Show the FAA's words: Follow-up issuance per the authorization letter
Follow up Issuance Will be per the airman’s authorization letter.
Good to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
Under Row A the evaluation still goes to the FAA
Row A is marked ISSUE, and the examiner summarizes this history in Block 60 and submits the evaluation to the FAA for retention in the pilot's file.
Show the FAA's words: good to know, 2
ISSUE Summarize this history in Block 60 and submit the evaluation to the FAA for retention in the pilot’s file.
Ten years since treatment, and an evaluation from the past 12 months
Row A is treatment completed ten (10) or more years ago. The oncology evaluation the examiner reviews is one performed within the previous 12 months.
Show the FAA's words: good to know, 3
A. Treatment completed ten (10) or more years ago … The AME must review an oncology evaluation performed within the previous 12 months.
The Item 48 table also has a leukemia row
This table for Acute Lymphocytic Leukemia (ALL), All Classes, marks its Row A, treatment completed ten (10) or more years ago, ISSUE. The Guide's Item 48 table for blood and blood-forming tissue disease has a row for leukemia, acute and chronic, all types, which asks for a current status report and all pertinent medical reports and says Requires FAA Decision. This page shows each as published.
Show the FAA's words: good to know, 4
Acute Lymphocytic Leukemia (ALL) All Classes … A. Treatment completed ten (10) or more years ago … ISSUE Summarize this history in Block 60
Item 48. General Systemic - Blood and Blood-Forming Tissue Disease … Leukemia, Acute and Chronic - All Types … All … Submit a current status report and all pertinent medical reports … Requires FAA Decision
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
- Acute Lymphocytic LeukemiaOpen to print: Acute Lymphocytic Leukemia, a PDF at the FAA, in a new tab
Examiner can issue, Special Issuance
- Open at the FAA: Blood and Blood-Forming Tissue Disease, a page at the FAA, in a new tab
- Open at the FAA: Pilot Information – What a Detailed Clinical Progress Note must contain, a PDF at the FAA, in a new tab
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.