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Cancer Services - Haematology outpatient services in Central Adelaide

The Haematology Service of the Central Adelaide Local Health Network (CALHN) Cancer Service provides inpatient and outpatient services in disorders of the blood and blood forming organs for patients living in the CALHN area. Services are also provided to patients referred from rural and remote areas.

The disorders include:

  • malignant diseases of blood and bone marrow, lymphoid tissues
  • non-malignant disorders of red and white blood cells and platelets
  • bleeding and clotting disorders.

The service is responsible for the blood transfusion and clinical apheresis units in CALHN as well as the survivorship clinics for patients with haematological malignancies.
The service also offers opportunities for patients to enrol in the latest clinical trials testing new treatments and in cutting edge basic and translational research studies.

Services provided at the RAH only:

  • State-wide allogeneic haematopoietic stem cell transplantation
  • State-wide Hemophilia Service
  • State-wide Thalassemia Service

Outpatient appointment locations and contact details

Royal Adelaide Hospital (RAH)

Level 3
Royal Adelaide Hospital
Port Road, Adelaide SA 5000

  • Clinic fax (for referrals): (08) 7074 6247
  • For all appointments: enquiries and new case appointments: (08) 7074 0750
  • Review / change of appointments: (08) 7074 0750

The Queen Elizabeth Hospital (TQEH)

Haematology outpatients: c/o Haematology / Oncology department
Ward North East 1 B (NE1B)
The Queen Elizabeth Hospital
28 Woodville Road, Woodville South SA 5011

  • Clinic fax (for referrals): (08) 8222 7054
  • Appointment enquiries, changes, reviews and treatment: (08) 8222 6828 / (08) 8222 7904
  • New case appointment bookings and changes only: (08) 8222 6579

Haematology clinics
SA Pathology Patient Centre
Frome Road

  • Telephone: (08) 8222 3456
  • Fax: (08) 8222 3026

Haematology Services contact details

To contact the medical officers, please refer to the details below:

Royal Adelaide Hospital (RAH)

Clinical Haematology Service
Telephone: (08) 7074 0750
Fax: (08) 7074 6247

The Queen Elizabeth Hospital (TQEH)

Clinical Haematology Service
Telephone: (08) 8222 6934
Fax: (08) 8222 7054

Our model of care in Haematology outpatients

The objective of our outpatient appointments is to provide an assessment of the patient, an opinion regarding the key clinical issues and advice to the patient and the referring practitioner over a short number of visits followed in appropriate cases by a formal discharge from the clinic. For haematological diseases that require ongoing supervision from a haematologist, patients will be seen throughout their treatment and also in the treatment-free intervals. For survivors, we offer specialist clinics to screen for and manage potential long-term toxicities of curative chemo- and radiotherapy.

Our haematologists have each their prime areas of interest, yet all patients can be seen by each specialist as we all maintain credentials in general haematology. Furthermore, we work as teams using established management protocols to guide best practice. Patients are as a rule seen by a consultant haematologist, either directly or in an overseeing role following inputs from a registrar depending on the reason for referral and the patient’s ongoing care needs.

A list of the clinical leads in the various subspecialties is provided here for your information. Please send a ‘named referral’ instead of a generic ‘Haematology unit’ referral as this provides a clearer guidance as to your preference. Your referral will be triaged to ensure patients are seen at the earliest appropriate time.

Royal Adelaide Hospital (RAH)

Name Position Subspecialty interest
Prof L Bik To Head of Clinical Haematology Service Chronic lymphocytic leukaemia (Lead)
Dr Agnes Yong Deputy Head of Clinical Haematology Service Haemopoietic stem cell transplantation (Co-lead)
Acute leukaemia (Co-lead)
A/Prof Peter Bardy Clinical director of CALHN Cancer Service Haemopoietic stem cell transplantation (Co-lead)
A/Prof Ian Lewis Clinical director of Haematology, SA Pathology Haemopoietic stem cell transplantation (Lead)
Acute leukaemia (Lead)
Prof Tim Hughes Director of RAH Haematology, Department SA Pathology Chronic myeloid leukaemia and related diseases (Lead)
Dr Simon McRae Director of Comprehensive Haemophilia Care Haemophilia (Lead)
Haemostasis, thrombosis and immune thrombocytopenia (Lead)
Thalassemia (Lead)
Dr Noemi Horvath Senior Haematologist Myeloma (Lead)
Dr Devendra Hiwase Senior Haematologist Myelodysplasia (Lead)
Dr David Ross Senior Haematologist Myeloproliferative Neoplasm (Lead)
Dr Pratyush Giri Senior Haematologist Lymphoma (Lead)
Chronic lymphocytic leukaemia (Co-lead)
Prof Brendon Kearney Senior Haematologist Anaemia (Lead)
Dr Cindy Lee Senior Haematologist Myeloma (Co-lead)
Dr Chee Wee Tan Senior Haematologist Haemostasis, thrombosis and immune thrombocytopenia (Co-lead)
Thalassemia (Co-lead)

The Queen Elizabeth Hospital (TQEH)

Name Position Subspecialty interest
Dr Uwe Hahn Head of Clinical Haematology Service Lymphoma (Lead)
Chronic lymphocytic leukaemia (Lead)
Therapeutic and stem cell apheresis (Lead)
A/Prof Peter Bardy Clinical Director of CALHN Cancer Service Haemopoietic stem cell transplantation (Lead)
Chronic myeloid leukaemia (Lead)
Myeloproliferative neoplasm (Co-lead)
Dr Simon McRae Senior Haematologist Haemostasis, thrombosis, immune thrombocytopenia (Lead)
Dr Cindy Lee Senior Haematologist Myeloma (Co-lead)
Dr James Gray Senior Haematologist Acute leukaemia, myelodysplasia and myeloproliferative neoplasm (Lead)
Dr Kathryn Robinson Senior Haematologist Iron deficiency and other anaemias (Lead)
Dr Wilfred Jaksic Senior Haematologist Benign and malignant haematology
Dr Malcolm Green Senior Haematologist Benign and malignant haematology

Heamatology priorities are based on clinical urgency as displayed below

Priorities Examples Referral process
Immediate
Life or limb threatening emergencies
Acute haematological disorders requiring immediate admission
Acute catastrophic bleeding
Acute catastrophic clotting
Acute infection in immunocompromised patients
Acute severe tumour lysis syndrome/acute renal failure in association with a haematological malignancy
Acute hyperviscosity
Hb > 200
leukocytosis > 100
platelet > 2000
paraprotein: IgG > 60, IgA > 60, IgM > 40
Hb < 50
neutropenia < 0.2
thrombocytopenia < 20
Acute leukaemia
Acute pulmonary embolism
Haematologist-on-call
(24 hr availability)
TQEH: call switchboard on
(08) 8222 6000
RAH: call (08) 7074 0750
or switchboard on
(08) 7074 0000
or
Emergency Department referral
Urgent
Conditions with a potential to lead to serious deterioration including death and long-term disability quickly if appropriate care is delayed
Hb < 70
Neutropenia < 0.5
Platelet < 30 or > 1000
Recurrent thrombo-embolic disease
Newly diagnosed haemophilia or other severe bleeding diatheses
Newly diagnosed or recurrent haematological malignancies:
-  high or intermediate grade lymphoma
-  high or intermediate risk myelodysplasia
-  multiple myeloma
Haematologist-on-call
(24 hr availability)
TQEH: call switchboard on
(08) 8222 6000
RAH: call (08) 7074 0750
or switchboard on
(08) 7074 0000
or
Fax referral clearly marked URGENT to :
TQEH: (08) 8222 7054
RAH Outpatients:
(08) 7074 6247
IMVS Clinic: (08) 8222 3026
Semi-urgent
Conditions unlikely to deteriorate if immediate assessment is not available
CML in chronic phase
Chronic lymphocytic leukaemia (CLL)
Indolent lymphoma
Low and intermediate risk Myelodysplastic Syndrome (MDS)
Hb 71-100
Plt 31- 50
Ferritin > 1000
Fax referral:
TQEH: (08) 8222 7054
RAH outpatients:
(08) 7074 6247
IMVS clinic: (08) 8222 3026
If in doubt, consult haematologist during office hours:
TQEH: call switchboard on
(08) 8222 6000
RAH: call (08) 7074 0750
or switchboard on
(08) 7074 0000
Non-urgent Hb 101-134 (male),
101-114 (female)
Paraprotein < 10
Clonal B Lymphocytosis < 5
Fax referral:
TQEH: (08) 8222 7054
RAH Outpatients:
(08) 7074 6247
IMVS Clinic: (08) 8222 3026
Note: It is important to note these guidelines indicate what is clinically desirable, not what is always feasible in terms of delivery.

Guidelines for tests to be performed prior to referral

The following information provides guidelines for tests to be performed prior to appointment so as to facilitate the management process. Please note that this does not cover all situations. When in doubt, please contact the Department.

Referral condition Recommended tests
All conditions CBE, MBA20 including LDH
Acute leukaemia INR aPTT extended clotting study
Chronic myeloid leukaemia BCR-ABL
Chronic lymphocytic leukaemia Lymphocyte surface markers on peripheral blood, serum protein electrophoresis and immunoglobulins
Bleeding and clotting problems Extended clotting study, clotting factor assays if indicated, lupus anticoagulant in clotting problems including prolonged aPTT, thrombophilia screen if indicated
Lymphadenopathy Consider CT scan of neck, chest, abdomen and pelvis, lymphocyte surface marker on peripheral blood; consider fine needle aspirate (note that FNA is inadequate for definitive diagnosis of malignant lymphoma, butuseful to differentiate from reactive or cancerous lymphadenopathy)
Lymphoma CT scan of neck, chest, abdomen and pelvis, please discuss with us about excisional or core biopsy of lymph node, serum protein electrophoresis and immunoglobulins
Neutropenia ANF, fasting B12 and folate
Thrombocytopenia ANF, fasting B12 and folate, HIV
Anaemia Serum iron studies, fasting B12 and folate, CRP and look out for blood loss such as stool occult blood
Increased iron or ferritin Screen for HFE gene mutations
Splenomegaly Thalassemia, ANF, portal hypertension, infection
Paraprotein, myeloma CRP, paraprotein and serum immunoglobulins, consider skeletal survey
Neutrophilia PCR for BCR-ABL, JAK-2 mutation, CRP
Erythrocytosis Serum erythropoietin, PCR for JAK-2 mutation

Clinical trials and laboratory research

The CALHN Clinical Haematology Service is a major clinical trials centre in Australia and attracts many of the latest clinical trials that offer innovative yet experimental therapy. These studies are conducted with a dedicated and experienced clinical trial team. All studies are approved by the Human Ethics Committee of each hospital.

The service counts a number of world class clinical investigators in its team and has made world leading discoveries in haemopoietic stem cell transplantation, leukaemias and associated disorders, multiple myeloma and haemophilia. Staff also manage the biggest blood cancer bio-repository in Australia. 

Patients will be able to consider participating in clinical trials, laboratory research studies and bio-specimen banking depending on the blood disorder and the types of trials and research studies available.

Follow up arrangements

Once the patient has been assessed in the Haematology outpatient clinic, the responsible haematologist will write to you about our findings and plan. Many of the conditions such as acute leukaemia and aggressive lymphomas patients tend to be followed up in the Haematology Service because of the length of treatment and close monitoring required. We will keep you up-to-date with regular correspondence. Patients whose condition has stabilised or resolved and for whom no further appointment is necessary, will be formally discharged. In stable, chronic conditions such as early stage chronic lymphocytic leukaemia, low grade non-Hodgkin lymphoma, low risk myelodysplasia or myeloproliferative neoplasm patients could be monitored in the family doctor's clinic until the need for more active intervention arises. We will provide you with the necessary monitoring parameters.

If the patient or their family doctor is concerned about deterioration in the medical condition requiring earlier assessment than planned, please call the corresponding outpatient or department to make the necessary arrangements.

Post discharge guidelines and information

Patients whose medical condition has stabilized or resolved and for whom no further appointment has been made will be formally discharged. If specialized assessment is required again a 'new referral', preferably named (see consultant list), should be faxed to the Haematology Unit on the fax numbers provided.

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