HAEMATOLOGY 2WW
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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