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Acute leukaemia — MCCQE Part 1 MCQ

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ModerateLymphadenopathyAcute leukaemiaMCCQE Part 1

A 42-year-old man presents with fatigue, gingival bleeding and recurrent infections. CBC shows haemoglobin 72 g/L, platelets 22 x 10^9/L and circulating blasts. Which of the following is the most appropriate next step?

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Correct answer: A — Urgent haematology referral/admission for bone marrow assessment and supportive care

Pancytopenia with circulating blasts suggests acute leukaemia and requires urgent haematology assessment, infection precautions and supportive transfusion planning. Iron deficiency does not cause blasts or severe thrombocytopenia. Anticoagulation and splenectomy are unsafe before diagnosis and stabilization.

Reference: Canadian haematology practice; provincial leukaemia pathways