Leukaemias – Acute and Chronic
North South North West Statewide
All referrals should comply to referral standards and include in particular:
- Relevant investigations, including previous results to assess temporal pattern.
Chronic Lymphocytic Leukaemia (CLL) is generally an indolent lymphoproliferative disorder and will be triaged accordingly.
- Traditional indications for treatment of CLL include the following and are an indication of the need to discuss the case for a more prompt review:
- Symptomatic lymphadenopathy
- Auto-immune cytopenias (Autoimmune haemolytic naemia, Immune Thrombocytopenia Purpura)
- Lymphocyte doubling time of <six months
- Presence of disabling "B Symptoms" (fevers, loss of >10% body weight, drenching night sweats)
To refer a patient with this condition, please see the Haematology clinic page for the full referral process and templates.
Any newly diagnosed acute leukaemia should be discussed with the Haematologist/Registrar On-Call and may be referred directly to the Emergency Department for assessment, stabilisation and investigation.
For more information please see the Tasmanian Health Pathways website.
Suspected acute leukaemia (evidenced by blood film report)
Severe cytopenias if patient is unwell (i.e. infection, symptomatic anaemia, active bleeding):
- Neutrophils < 0.5 x 10^9/L
- Haemoglobin < 80g/L
- Platelets <20 x 10^9/L
Rapidly progressive leucocytosis (white cell count > 75 x 10^9/L) in the absence of infection/inflammation where there may be a risk of leucostasis/hyperviscosity
Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.
Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405 Fax: (03) 6777 5201
MCH ED – Phone: (03) 6478 5120 Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340 Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100 Fax: (03) 6173 0489 - Discuss with the on call Haematologist/Registrar via switch (03) 6166 8308
Urgent Referrals generally need to be seen in the next one to two weeks
Please discuss these with the Haematology Registrar/Haematologist on call via switchboard on 6166 8308
Triaged by medical staff and generally seen in the next six to eight weeks
Triaged by medical staff and given the next available appointment