What are the key clinical features that should raise suspicion for leukaemia in a primary care setting?

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

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

In a primary care setting, key clinical features that should raise suspicion for leukaemia include:

  • Unexplained pallor, which may indicate anaemia .
  • Persistent fatigue that is unexplained and ongoing .
  • Unexplained fever, especially if persistent or recurrent ,.
  • Unexplained persistent or recurrent infections ,.
  • Generalised lymphadenopathy without a clear cause .
  • Unexplained bruising or bleeding, including petechiae ,.
  • Hepatosplenomegaly (enlarged liver and/or spleen) .

In children and young people, additional features raising suspicion include unexplained petechiae or hepatosplenomegaly, which warrant immediate specialist assessment .

When these features are present, NICE guidelines recommend offering a very urgent full blood count within 48 hours to assess for leukaemia ,.

Related Knowledge Topics

Educational content only. Always verify information and use clinical judgement.