Haematology referrals

COVID-19 and Haematology Referrals

These are the things which should be referred during the COVID-19 pandemic as agreed by the NNUH Haematology consultants, in order to allow us to deal with the most urgent cases:

• New Polycythaemia Vera – JAK2 positive or JAK2 negative erythrocytosis Hct >0.6

• New Essential Thrombocythaemia – JAK2/CAL-R/MPL positive or Thrombocytosis with negative molecular results but platelets >1000 x109 /L • New Acute leukaemia

• Unexplained: Thrombocytopenia, plt <30×109 /L Neutropenia neuts <0.5 x109 /L Haemoglobin <80g/L (with normal haematinics)

• Acquired haemophilia

• New autoimmune haemolysis

• New diagnosis of lymphoma (biopsy-proven)

• CLL with Hb<100g/L, plt<100 x109 /L or massive lymphadenopathy/splenomegaly

• Paraprotein >30g/L or paraprotein with (new) anaemia, renal failure or hypercalcaemia

• Serum free light chain ratio (affected to non-affected) >100

Consideration should be given to deferring letters for advice or referral for other, non-urgent haematology concerns until after the pandemic has passed.