Scottish referral guidelines for suspected cancer: quick reference guide

Scottish Referral Guidelines for Suspected Cancer is a quick reference guide for cancer referrals.

Haematological Malignancies

Leukaemias, Lymphomas and Myeloma

  • Blood count/film reported as suggestive of acute leukaemia or chronic myeloid leukaemia.*
  • Lymphadenopathy (>1 cm) persisting for 6 weeks.
  • Hepatosplenomegaly in the absence of known liver disease.
  • Bone pain associated with anaemia and an elevated ESR.
  • Bone x-rays reported as being suggestive of myeloma.
  • Constellation of 3 or more of the following clinical features may also merit urgent referral:



Night sweats

Recurrent infections

Weight loss

Bone pain


Polyuria and polydipsia



Chronic lymphatic leukaemia in an older person may not require urgent assessment. Ideally all urgent cases should initially be discussed with a Consultant Haematologist.

Arrangements for biopsy of persistent abnormal lymph glands vary locally.

* Will normally be picked up in the laboratory and communicated to the GP for management to be agreed.

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