Referral to a chronic myeloid leukaemia (CML) specialist

Many people with chronic myeloid leukaemia (CML) won't have any symptoms. Your GP should refer you to have a blood test or see a blood specialist called a haematologist if they think you might have CML. This might be an urgent referral.

Go to information about the symptoms of CML

Seeing your GP

You may have had a routine blood test for something else. And your GP may contact you about an abnormal result. They will arrange to speak to you about this and explain what this means.

It can be hard for GPs to decide who may or may not have cancer. If you have symptoms, your GP may ask you to wait to see if they get better or respond to treatment, such as antibiotics.

The important thing is to go back to your GP if you’re not getting better.

Urgent referral to a specialist

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.

The England and Wales referral guidelines group all leukaemia's together.

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.

If you are aged 24 or under

Your GP should refer children and young adults immediately (within a few hours) to a specialist if they have either:

• unexplained red, purple or dark spots on the skin (petechia)

• an enlarged liver or spleen

Your GP should consider a full blood count blood test for children and young adults within 48 hours if they 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

• swollen lymph nodes

• bone pain that won't go away and can't be explained

• bruising or bleeding for no reason

Your GP should then refer you to a blood specialist if blood test results show that you might have leukaemia.

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 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 the 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

What should I do if I don’t get my appointment

If your GP suspects you have leukaemia you generally have tests to see a specialist quite quickly. This is usually within a few hours or days. Ask your GP when you should get your appointment and contact them again if you don’t get one. 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.

Go to more information about an urgent referral, what to expect and questions to ask