Should I see an acute lymphoblastic leukaemia specialist? | Cancer Research UK
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Should I see an acute lymphoblastic leukaemia specialist?

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This page tells you about UK GP guidelines for referring patients to leukaemia specialists. There is information about

 

A quick guide to what's on this page

Should I see a leukaemia specialist?

It can be very difficult for GPs to decide who may have leukaemia and who may have something much more minor. But it is very important for ALL to be diagnosed and treated quickly. 

NICE guidelines for urgent referral

The National Institute for Health and Care Excellence (NICE) has produced guidelines to help GPs decide who needs to see a specialist and how soon. 

Your GP should refer you for an urgent full blood count within 2 days, if you are an adult and have any of the following symptoms

  • Look unusually pale
  • Extreme tiredness (fatigue) that won't go away
  • Unexplained high temperature (fever)
  • Unexplained infections that won't go away or keep coming back
  • Swollen lymph glands
  • Bruising or bleeding for no reason
  • Red or purple spots on the skin - petechia
  • An enlarged spleen or liver on examination

If you are a child aged 0-15 years or a young person aged 16-24 years, with the above symptoms (except an enlarged spleen or liver), you should be offered an urgent  full blood count within 2 days.

If you are a child or young person with the following symptoms you should be referred to a specialist immediately (within a few hours)

  • Unexplained red or purple spots on the skin - petechia
  • An enlarged spleen or liver on examination

 

CR PDF Icon You can view and print the quick guides for all the pages in the about ALL section.
 

 

Who should see a specialist

It can be very difficult for GPs to decide who may have leukaemia and who may have something much more minor that will go away on its own. With many symptoms, it is perfectly right that your GP should ask you to wait to see if they get better or respond to treatment, such as antibiotics. If GPs referred everyone who came to see them to a specialist immediately, the system would get overloaded and people needing urgent appointments wouldn't be able to get them. But it is very important for ALL to be diagnosed and treated quickly.

Seeing a specialist

Your GP may do a blood test. If the results show signs of acute lymphoblastic leukaemia you should be referred immediately to a blood specialist (haematologist).

 

NICE guidelines for urgent referral

The National Institute of Health and Care Excellence (NICE) has produced guidelines to help GPs decide who needs to see a specialist for suspected acute lymphoblastic leukaemia (ALL), and how soon they should see them. 

According to the guidelines, if you are an adult you should be referred for an urgent full blood count, within 2 days if you have any of the following symptoms

  • Look unusually pale
  • Extreme tiredness (fatigue)
  • Unexplained high temperature (fever)
  • Unexplained infections that won't go away or keep coming back
  • Swollen lymph glands
  • Bruising or bleeding for no reason
  • Red or purple spots on your skin - petechia
  • An enlarged spleen or liver on examination

If you are a child aged 0-15 years or a young person aged 16-24 years, your GP should refer you immediately - within a few hours - to a specialist if you have

  • Unexplained red or purple spots on the skin - petechia
  • An enlarged liver or spleen on examination

If you are a child or young person, your GP should offer you an urgent full blood count within 2 days if you have any of the following symptoms

  • Look unusually pale
  • Extreme tiredness (fatigue)
  • High temperature (fever)
  • Infections that won't go away
  • Swollen lymph glands
  • Bone pain that won't go away
  • Bruising or bleeding for no reason

Some of these symptoms can be caused by other less serious medical conditions and do not always mean that you have acute leukaemia. The doctor’s experience helps them to work out who may have a serious illness and who is more likely to have something more minor that will go away on its own. Your doctor will take into account whether you have any of the risk factors for acute lymphoblastic leukaemia.

 

If you are worried

If you are concerned that your GP is not taking your symptoms as seriously as you think they should, you could print this page and take it along to an appointment. Ask your GP to talk it through with you and then you may be able to decide together whether you need to see a specialist and if so, how soon.

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Updated: 7 July 2015