Our recommendations for considering a referral to an academic center
| Reasons for referral . | Our suggestions for considering a referral . |
|---|---|
| Diagnostic challenges | Diagnosis is challenging, and pathology requests a second opinion. |
| Consider referral/expert discussion before palliative treatment, even in elderly patients. | |
| Treatment challenges | Presentation is complex and requires supportive care that is not available at the facility. |
| Requires immediate therapy, but potential delays in diagnosis prevent start of therapy | |
| Consider on the basis of subtype of leukemia | Acute promyelocytic leukemia |
| Older adults | |
| Adolescents and young adults with acute lymphoblastic leukemia | |
| Consider referral for secondary leukemias | |
| Refractory after one induction | |
| Relapsed leukemia | |
| HCT is a consideration. |
| Reasons for referral . | Our suggestions for considering a referral . |
|---|---|
| Diagnostic challenges | Diagnosis is challenging, and pathology requests a second opinion. |
| Consider referral/expert discussion before palliative treatment, even in elderly patients. | |
| Treatment challenges | Presentation is complex and requires supportive care that is not available at the facility. |
| Requires immediate therapy, but potential delays in diagnosis prevent start of therapy | |
| Consider on the basis of subtype of leukemia | Acute promyelocytic leukemia |
| Older adults | |
| Adolescents and young adults with acute lymphoblastic leukemia | |
| Consider referral for secondary leukemias | |
| Refractory after one induction | |
| Relapsed leukemia | |
| HCT is a consideration. |