What are the referral criteria for a patient with suspected aplastic anaemia to a haematologist?

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

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Referral criteria for suspected aplastic anaemia to a haematologist:

  • Patients presenting with unexplained pancytopenia (reduction in red cells, white cells, and platelets) or severe isolated cytopenias should be referred urgently to a haematologist for specialist assessment.
  • A very urgent full blood count (within 48 hours) is recommended if aplastic anaemia is suspected based on clinical features such as pallor, bleeding, bruising, or infections due to cytopenias.
  • Referral should be considered if there are symptoms suggestive of bone marrow failure, including fatigue, recurrent infections, or bleeding tendencies.
  • Children and young people with unexplained cytopenias or signs of bone marrow failure should be referred immediately for specialist assessment.

These criteria align with the general principles for urgent referral in haematological disorders, including leukaemia and other marrow failure syndromes, as outlined in UK guidelines for suspected haematological malignancies and marrow failure conditions .

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