Pre-referral Guidelines

Please Consider...

The following guidelines should be considered by physicians when referring patients to the Leukemia/BMT Program:

• Patients with acute leukemia, Burkitt's lymphoma and lymphoblastic lymphoma should be considered hematologic emergencies and referred by direct discussion with the Triage Physician or On-Call Staff Physician. A fax referral should not be sent. Call the Program Office directly at 604-875-4863 during office hours; outside office hours contact the Leukemia/BMT Fellow or Staff on call via Vancouver General Hospital locating at 604-875-5000.
• Patients suspected of having severe aplastic anemia who must receive blood products should receive CMV negative and irradiated blood products.
• All patients who have undergone stem cell transplantation should only receive irradiated blood products.
• If a bone marrow examination is done prior to referral to the Leukemia/BMT Program, samples should be taken for routine microscopy, flow cytometry, which is done at Vancouver General Hospital, and cytogenetic analysis and stem cell assays both of which are done at the BC Cancer Agency.
• Patients with multiple myeloma who may be candidates for autologous stem cell transplant should not receive melphalan based therapy until they have been assessed.  Only if the patient is clearly not a candidate for transplant should melphalan containing regimens be used.  Discussion prior to institution of therapy in such patients is always welcomed.  See the multiple myeloma treatment guidelines for further details.