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Haematology 2WW


Updated information and referral forms for 2WW Haematology


Indications for an urgent referral for a suspected new malignancy are:

  • FBC with film report suggesting acute leukaemia or chronic myeloid leukaemia (Please attach FBC report)
  • Possible myeloma as suggested by paraprotein (or abnormal Serum Free Light Chains ratio) with one of: destructive bone lesion, anaemia, worsening renal function or hypercalcaemia.
  • Lymphadenopathy >2cm or increasing in size and persistent for > 6 weeks and NOT in neck or axilla
  • Unexplained (eg no known liver disease) splenomegaly >15cm

In the setting of an abnormal FBC and a constellation of 3 or more of the following please discuss the case with Haematology via an Advice and Guidance Request or the Duty Haematologist by telephone if urgent:

  • Fever
  • Itching
  • Night sweats
  • Recurrent infections
  • Weight loss

Exclusions: these clinical problems are not suitable for referral to Haematology as a 2WW:

  • Iron deficiency (new): refer as appropriate for GI / gynae
  • Investigations: If sinister GI pathology excluded, refer routinely to Haematology for management if needed
  • Neck lumps (all neck lumps including neck nodes should be referred on the appropriate Head and Neck pathway, including 2WW)
  • Axillary lumps – refer on Breast Pathway
  • Blood film suggesting CLL or other lymphoproliferative disorder (refer routinely to Haematology OPD)

Please hand the patient a Cancer Research UK Information Sheet – follow link


Two Week Wait referrals should now be processed through the NHS eReferral Service (previously known as Choose & Book)

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