Haematological cancers

Adults-Unexplained lymphadenopathy or splenomegalyLeukaemia -Leukemia occurs when alteration in normal cell regulatory processes cause uncontrolled proliferation of haematopoeitic stem cells in the bone marrow

Symptoms can be vague and non-specific A GP may only see one case of blood cancer every 2 years High rate of presentation as emergency ( all blood cancers )Particularly Acute Lymphoblastic Leukaemia ( ALL ) Leukaemia can present with○ anaemia○ reduced normal white cells○ thrombocytopaenia Symptoms may include○ pallor○ bruising○ propensity to infection Chronic leukaemias are usually symptomless and only identified on routine FBC testing Four common subtypes seen in primary care are○ acute lymphoblastic leukaemia ( ALL )○ acute myelogenous or acute myeloid leukaemia ( AML )○ chronic lymphocytic leukaemia ( CLL )○ chronic myelogenous or chronic myeloid leukaemia ( CML )

Adults with any of the following-Pallor Persistent fatigue Unexplained fever Unexplained persistent or recurrent infection Generalised lymphadenopathy Unexplained bruising Unexplained bleeding Unexplained petechiae Hepatosplenomegaly-Consider a very urgent FBC ( within 48 hrs ) to assess for leukaemia

Children and young people-Unexplained petechiae or hepatosplenomegaly.Refer for immediate specialist assessment ( admit )

Pallor Persistent fatigue Unexplained fever Unexplained persistent infection Generalised lymphadenopathy Persistent or unexplained bone pain Unexplained bruising Unexplained bleeding-Offer a very...