2.2 Assessments by the general practitioner
2.2 Assessments by the general practitioner
General practitioner examinations and investigations should include the following:
- a thorough history and examination should be taken, specifically looking for evidence of splenomegal.
- a full blood count will usually indicate the strong possibility of CML based on the increased numbers of white blood cells (WBC) and/or platelets and the WBC differential. A pathologist report on the blood test will usually raise the possibility of CML based on the blood count and blood film, but this may not always be the case. Very occasionally, CML can present with a high platelet count and a minimally raised WBC
- the diagnosis can be confirmed by a PCR test on the peripheral blood to detect the BCR-ABL1 transcript in patients with a blood picture consistent with CML. This may be a quantitative or qualitative test.
The general practitioner should conduct a full blood count and check the results within three days, or sooner if the patient is unwell.
It may take several days, or sometimes weeks, to get the PCR test result, but there is no need to wait for the result before organising referral to a haematologist for further investigation. The suspicion of CML is enough to justify a referral.
