Referral to a specialist for hairy cell leukaemia
Your GP should refer you for an urgent blood test if you have symptoms that could be due to hairy cell leukaemia. They might refer you to a blood specialist (haematologist).
Depending on your symptoms and other factors, this might be an urgent suspected cancer referral.
You will see a specialist as soon as possible. Ask your GP when this is likely to be.
Seeing your GP
It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better. Or if they respond to treatment, such as antibiotics.
Hairy cell leukaemia is a chronic leukaemia. Symptoms might develop slowly. Sometimes it does not need an urgent referral.
It is important to remember that:
-
your symptoms are likely to be caused by something other than cancer, but it is important to have them checked by your GP
-
hairy cell leukaemia is rare
UK referral guidelines
There are guidelines for GPs to help them decide who needs a referral. These vary slightly between the different UK nations. Your GP will use these guidelines as well as their own experience and judgement.
Some of the guidelines have targets around how quickly you are referred. For example, you might have blood tests within 2 days. Or you may see a specialist immediately (within a few hours).
The guidelines for England and Wales are for leukaemia. And the Northern Ireland and Scottish guidelines are for all blood cancers, not just leukaemia.
In England and Wales
If you are over 24 years old
Your GP should consider a full blood count blood test within 48 hours if you have any of the following:
- look unusually pale
- extreme tiredness (fatigue) that won’t go away
- unexplained high temperature (fever)
- unexplained infections that won't go away or keep coming back
- swollen
lymph nodes 
- bruising or bleeding for no reason
- unexplained red, purple or dark spots on the skin (
petechia ) - an enlarged
spleen or liver on examination
Your GP should then refer you to a blood specialist if blood test results show that you might have leukaemia.
There are separate guidelines for children and young people under 24 years of age. Hairy cell leukaemia is extremely rare in children and young people. So we have not included these guidelines.
In Northern Ireland
The Northern Ireland guidelines are for all blood cancers, not just leukaemia.
Your GP should refer you immediately to see a specialist if:
- your blood test results show you have acute leukaemia
- you have either
spinal cord compression or kidney failure which your GP thinks could be caused by myeloma
Your GP should refer you urgently if you have an unexplained enlarged spleen that doesn’t get smaller.
Your GP should do further tests and consider referring you to a specialist if you have a combination of some of the symptoms listed below. The urgency of the referral depends on how severe your symptoms are and your test results. Symptoms include:
- extreme tiredness (fatigue)
- heavy sweating at night
- high temperature (fever)
- losing a lot of weight
- itching all over your whole body
- feeling breathless
- bruising
- bleeding
- infections keep coming back
- bone pain
- pain after drinking alcohol
- tummy (abdominal) pain
- swollen lymph nodes
- enlarged spleen
If swollen lymph nodes are your only symptom, you do not usually need to see a specialist.
In Scotland
The Scottish guidelines are for all blood cancers, not just leukaemia.
You should have an urgent referral to a specialist if:
- your blood test result suggests that you have acute
leukaemia or chronic myeloid leukaemia - your swollen lymph nodes are larger than 2 cm and have either been swollen for more than 6 weeks or are getting bigger
- you have a swollen (enlarged) liver or
spleen but you don’t have any known liver disease - you have bone pain together with
anaemia or an abnormal paraprotein - a bone x-ray suggests you may have myeloma
You might have an urgent referral if you also have any of the following signs or symptoms:
- extreme tiredness (fatigue)
- heavy sweating, especially at night
- weight loss
- itching
- bruising
- infections that keep coming back
- bone pain
- weeing a lot and feeling very thirsty due to high calcium levels in your blood
Remember most people with one or more of these symptoms don't have leukaemia. But it's important to get any symptoms checked out by your GP.
Other symptoms
Your GP will consider any other symptoms you have, so do mention these.
If you're still worried
Sometimes you might feel that your GP is not concerned enough about your symptoms. If you think they should be more concerned, print this page and the symptoms page. Ask your GP to explain why they don’t think you need a referral.
Contact your GP again if your symptoms don't get better or you notice any new or unusual symptoms.
What should you do if you don’t get an appointment?
If your GP has referred you to a specialist, ask them when you should get your appointment. Contact them again if you don’t get one. Or some hospitals have a referral service you could try contacting if you know which hospital you are going to. Explain that you are waiting for an urgent suspected cancer referral.
Waiting times
Your hospital is working towards waiting time targets. For example, a target to find out whether you have cancer or not. And there are targets to start treatment if you are diagnosed with cancer. These are slightly different depending on where you live in the UK.
