What are the referral criteria for a suspected case of ALL to a specialist haematology service?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For a suspected case of acute lymphoblastic leukaemia, a **very urgent full blood count (within 48 hours)** should be offered in children and young people .

Bone pain that is persistent or unexplained in children and young people warrants consideration for urgent investigation, including blood tests .

In cases with unexplained lymphadenopathy, splenomegaly, or weight loss in children and young people, a very urgent referral for specialist assessment is recommended .

Any neurological symptoms, such as newly abnormal cerebellar or other central neurological function, should prompt a very urgent referral within 48 hours .

Consider a very urgent referral for children and young people presenting with symptoms suggestive of leukaemia, such as unexplained bone pain, lymphadenopathy, splenomegaly, or neurological symptoms .

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