What criteria should I use to determine when to refer a patient with suspected Waldenström's Macroglobulinaemia to a haematologist?

Refer a patient with suspected Waldenström's macroglobulinaemia to a haematologist if they present with unexplained lymphadenopathy or splenomegaly accompanied by systemic symptoms such as night sweats, weight loss, fever, or pruritus. These features suggest a possible lymphoproliferative disorder requiring specialist assessment.

Additionally, if blood tests reveal abnormalities such as anaemia, elevated immunoglobulin M (IgM), or other signs suggestive of a lymphoid malignancy, urgent referral for haematology evaluation is warranted.

Consider a suspected cancer pathway referral for adults presenting with these symptoms and signs to ensure timely specialist assessment.

In children and young people, similar criteria apply, with urgent referral recommended when these features are present.

Overall, the decision to refer should be based on the presence of unexplained lymphadenopathy or splenomegaly combined with systemic symptoms and relevant blood test abnormalities, reflecting the approach for suspected lymphomas and related haematological malignancies.

These criteria align with NICE guidance on suspected cancer recognition and referral pathways.