2ww Haematology
Immediate Paediatric referral
Unexplained petechiae or hepatosplenomegaly in children and young people [Leukaemia]
Very Urgent referral to Paediatrician within 48 hours
Unexplained lymphadenopathy or splenomegaly in children [non‑Hodgkin's lymphoma]
Unexplained lymphadenopathy in children [Hodgkin's lymphoma]
Very Urgent Full Blood Count within 48 hours [Leukaemia]
In adults, children and young people who present with any:
pallor
persistent fatigue
unexplained fever
unexplained persistent or recurrent infection
generalised lymphadenopathy
persistent or unexplained bone pain [in children]
unexplained bruising, bleeding
unexplained petechiae [in adults]
Hepatosplenomegaly [in adults]
Urgent 2ww Haematology referral
Results of protein electrophoresis or a Bence‑Jones protein urine test suggest myeloma [Myeloma]
Adults with unexplained lymphadenopathy or splenomegaly [non‑Hodgkin's lymphoma]
Adults with unexplained lymphadenopathy [Hodgkin's lymphoma]
When considering referral, take into account any associated symptoms of lymphoma:
Fever
Night sweats
Shortness of breath
Pruritus
Weight loss
Alcohol‑induced lymph node pain [Hodgkin’s lymphoma in adults]
Myeloma screening: FBC, Calcium, plasma viscosity, ESR, serum protein electrophoresis, urine Bence‑Jones protein test
≥60y + persistent bone pain, particularly back pain, or unexplained fracture
≥60y + hypercalcaemia or leukopenia and a presentation that is consistent with possible myeloma (very urgent <48hr testing)
Plasma viscosity or ESR and clinical presentation are consistent with myeloma(very urgent <48hr testing)