Download 2WW-HaematologyPathway -NICE_Sept 15

Plymouth Hospitals Trust - Page 1 of 2
URGENT TWO WEEK REFERRAL FOR SUSPECTED HAEMATOLOGICAL CANCER
If patient does not fulfil the criteria- please consider urgent/routine referral or treat/watch and wait approach.
PATIENT DETAILS
Surname:
Forename(s):
DOB:
Age:
Male/Female:
NHS Number:
Address:
Postcode:
Telephone 1:
Telephone 2:
GP DETAILS
Referring GP:
Registered GP:
Practice name/address:
Postcode:
Telephone:
Fax:
Date of Referral:
Translator required
Yes
No
Is patient aware of a possible Cancer diagnosis
If yes, please contact GP surgery
Yes
No

Immediate (not 2ww) referral is needed for patients with spinal cord compression or acute renal failure suspected to be
caused by myeloma
Immediate (not 2ww) referral is needed if blood film suggests an acute leukaemia (in practice a haematologist will
generally telephone the GP to arrange urgent admission)
If the criteria for 2ww referral below are not fulfilled please consider a different referral route or telephone the
haematologist for advice. Please note CLL is not an indication for a 2WW referral.
Please remember that occasionally patients
Lymphoma
Lymphadenopathy (Site:………………) or Splenomegaly
With symptoms include:
Persistent more than 6 weeks
Increasing in size
Greater than 2cm in size
Weight loss
Fever
Drenching night sweats
Generalised pruritus
Version:
Date for Review:
03
March 2016
Owner/Name:
Cancer Services
Plymouth Hospitals Trust - Page 2 of 2
Shortness of Breath
Alcohol induced pain in lymph glands
Myeloma
Results of protein electrophoresis or a Bence-Jones protein urine test suggests Myeloma
Blood count suggestive of CML
Additional clinical information including drug history; (please email clinical summary if available)
If there is a problem with CAB then please email to the following address – [email protected]
In Case of problems phone: Plymouth Hospitals 01752 437506 or Devon Referral Support Services 01752 398993
Version:
Date for Review:
03
March 2016
Owner/Name:
Cancer Services