Management of CLL Pathway - Referral Criteria
Refer to haematology if:
- Stage A without symptoms + any one of:
- Progressive lymphadenopathy or hepatosplenomegaly (nodes >2cm enlargement)
- Progressive fall in Hb or platelets. If Hb falls, consider autoimmune haemolytic anaemia (AIHA). Check for evidence of red cell destruction (reticulocytes, LDH, bilirubin, coombs test)
- Lymphocyte count doubles in less than 6 months (and the baseline count is >20 x 109/L). The absolute lymphocyte count can rise >200 x109/l and is not by itself a reason to start treatment if this is a slow rise and not associated with cytopenias.
- Hypogammaglobulinaemia associated with recurrent infections
- Weight loss >10%, extreme fatigue or sweats (exclude other causes)
- Stage A with symptoms
- Stage B or C
- Any stage & under 50 years old
Last updated : Monday, May 14, 2018
Next review date : Tuesday, May 14,2019
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