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Should I see a chronic myeloid leukaemia (CML) specialist?

Men and women discussing Chronic myeloid leukaemia

This page tells you about the guidelines for seeing a chronic myeloid leukaemia specialist. There is information about

 

A quick guide to what's on this page

Should I see a chronic myeloid leukaemia (CML) specialist?

The symptoms of leukaemia can be similar to other, less serious, medical conditions. It can be very difficult for GPs to decide who may have a leukaemia and who may have something much more minor. But it is very important for CML 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 

CML is not common in young people. The guidelines say 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

If you have symptoms and don’t think your GP is taking them seriously enough, you could print out this page and take it to your GP to discuss.

 

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

 

The NICE guidelines for urgent referral

The symptoms of leukaemia are often similar to those of other less serious medical conditions. So it can be difficult for GPs to decide if you may have leukaemia or not. The National Institute for Health and Care Excellence (NICE) has produced guidelines for GPs in the UK to help them decide which patients need to see a specialist urgently.

NICE say that there are particular symptoms that should alert your GP that you may need to see a specialist urgently. The specialist is usually a haematologist.

Seeing a specialist

While reading these guidelines, do remember that

  • 75 out of every 100 people (75%) diagnosed with a leukaemia are over 60, but you can be diagnosed at any age
  • Risk factors include having had radiotherapy or chemotherapy before
  • Most people are diagnosed with leukaemia after going to their doctor with symptoms such as tiredness, breathlessness, bruising, bleeding, repeated infections and looking pale
  • Infections, bleeding and bruising are not early symptoms of CML
  • CML can cause an enlarged liver and enlarged spleen – doctors call this hepatosplenomegaly
  • Enlarged lymph nodes are a later symptom of CML, but can be a symptom of other types of leukaemia
 

Who should see a specialist urgently

The National Institute for Health and Care Excellence (NICE) and the Scottish Government have produced referral guidelines for cancer. These guidelines help GPs decide who needs to see a specialist 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 adult, 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 
 

If you are still worried

It is important to remember that many of these symptoms are likely to be caused by other less serious medical conditions. They do not always mean that you have chronic leukaemia.

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. 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