Summary
Definition
History and exam
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
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
Treatment algorithm
Contributors
Authors
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
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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