Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • pallor
  • ecchymoses or petechiae

Other diagnostic factors

  • fatigue
  • dizziness
  • palpitations
  • dyspnoea
  • infections or fever
  • lymphadenopathy
  • hepatosplenomegaly
  • mucosal bleeding
  • skin or testicular mass
  • skin infiltration
  • gingival enlargement
  • bone pain
  • abdominal pain

Risk factors

  • age over 65 years
  • previous treatment with chemotherapy
  • previous haematological dyspoiesis
  • genetic factors
  • constitutional karyotype abnormalities
  • radiation exposure
  • benzene exposure
  • environmental exposures
  • male sex

Diagnostic investigations

1st investigations to order

  • FBC with differential
  • peripheral blood smear
  • coagulation panel
  • serum electrolytes
  • renal function
  • LFTs
  • serum lactic dehydrogenase
Full details

Investigations to consider

  • bone marrow biopsy or aspiration
  • immunophenotyping and molecular studies
  • lumbar puncture
  • HLA antigen typing
  • chest x-ray
  • echocardiogram
  • multi-gated acquisition scan
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Consultant Haematologist

Guy's and St Thomas' NHS Trust

London

UK

Disclosures

KR declares that she has no competing interests.

Consultant Haematologist

University Hospital Bristol

Bristol

UK

Disclosures

PM declares that she has no competing interests.

Peer reviewers VIEW ALL

Chief Fellow

Section of Hematology and Oncology

Department of Internal Medicine

Wake Forest University Baptist Medical Center

Winston-Salem

NC

Disclosures

RC declares that she has no competing interests.

Clinical Professor of Medicine

University of Texas Health Science Center

San Antonio

Cancer Care Network of South Texas

San Antonio

TX

Disclosures

RML declares that he has no competing interests.

Consultant Haematologist

Department of Haematology and Stem Cell Transplantation

Heartlands Hospital

Birmingham

UK

Disclosures

SP declares that he has no competing interests.

Professor of Haematology & Stem Cell Transplantation

Department of Molecular and Cellular Medicine

University of Bristol

UK

Disclosures

DM declares that he has no competing interests.

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