2.2 Assessments by the general practitioner

2.2 Assessments by the general practitioner

If a serious blood disorder is suspected, a focused medical history and thorough clinical assessment should be undertaken.

Full blood count and film should be performed immediately.

If the patient is clinically unwell (presents with symptomatic anaemia, spontaneous bleeding, sepsis and has symptoms of hyperviscosity), immediate referral to an emergency facility is recommended without waiting for blood results.

Pathology laboratories should directly contact the referring doctor if leukaemia is suspected (e.g. unexplained pancytopenia or blasts detected in the blood). Results should be actively followed up by the general practitioner and acted upon on the same day. Morphologic evidence of APL, disseminated intravascular coagulation, severe thrombocytopenia and any organ dysfunction (renal/liver failure) should be considered a medical emergency.

Patients with a laboratory diagnosis of possible AML should be referred for immediate assessment by a haematologist at an appropriate facility.

The general practitioner should begin investigations immediately if AML is suspected.

Laboratory results should be actively followed up and progressed on the same day. It is the responsibility of both the referring doctor and pathology laboratory to identify the possibility of a diagnosis of AML and take appropriate action.