Haematology, including oncological disorders

Assessment and management of general haematological disorders including malignant and non-malignant conditions.

Availability

North South North West Statewide

Scope

THS Southern and North West Region

General haematological disorders including:

  • Lymphomas
  • Leukaemias
  • Paraproteinaemia
  • Multiple myeloma
  • Anaemia: for iron deficiency anaemia, see Gastroenterology
  • Neutropaenia
  • Thrombocytopaenia or other cytopaenias
  • Thrombosis
  • Haemostasis
  • Polycythaemia
  • Hyperferritinaemia: for Hyperferritinaemia with abnormal liver function tests, see Gastroenterology

Paediatric malignancies should be referred to Paediatric Oncology

Haematological disorders of adolescence may be seen in this clinic but initial referral is to Paediatrics.

Long term survivors of multimodality cancer treatment with complications from this, or their cancer, may benefit from referral to Oncology Late Effects Clinic.


THS Northern Region

Information unavailable at this time.

Emergency conditions

Emergency conditions/symptoms include (not an exhaustive list):

Any patient with a known or suspected haematological disorder and fever/unwell should be referred directly to the emergency department and discussed with the on-call Haematologist/Registrar.

Also these are considered as emergencies:

  • Suspected acute leukaemia (evidenced by blood film report)
  • Severe cytopenias if patient is unwell (i.e. infection, symptomatic anaemia, active bleeding):
    • Neutrophils < 0.5 x 10^9/L
    • Haemoglobin < 80g/L
    • Platelets <20 x 10^9/L
  • Superior vena cava obstruction (secondary to lymph node compression)
  • Suspected spinal cord compression (pain and neurological symptoms) in a patient with known or suspected multiple myeloma
  • Impending pathological fracture (radiologically identified) in a patient with known or suspected multiple myeloma
  • Significant hypercalcaemia >2.9 mmol/L
  • Rapidly progressive leucocytosis (White cell count > 75 x 10^9/L) in the absence of infection/inflammation where there may be a risk of leucostasis/hyperviscosity.
  • Blood film suggestive of thrombotic thrombocytopenic purpura (TTP/HUS)
  • Massive thromboembolus

Referral process

A referral (preferably faxed) is required for all new appointments and must conform to the Referral Standards as outlined on For Clinicians.

Specific requirements are detailed in the individual clinic and condition referral guidelines.

Referrals are registered by the clinic to whom they are referred and are triaged according to the specific clinic guidelines.

Clinic Appointments - Appointments are based on clinical priority:

Emergency

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6426 5115
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6430 6691
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6222 8919 - Discuss with the on call Haematologist/Registrar via switch (03) 6166 8308

Urgent / category 1

Urgent Referrals generally need to be seen in the next one to two weeks

Please discuss these with the Haematology Registrar/Haematologist on call via switchboard on 6166 8308

Semi-urgent / category 2

Triaged by medical staff and generally seen in the next six to eight weeks

Routine / category 3

Triaged by medical staff and given the next available appointment

Referral template

For use by health professionals only