Rapid Assesment Clinic (RAC)
Who do we see?
Patients with suspected or confirmed diagnosis of acute leukemia or high risk myelodysplastic syndrome (MDS)*
* What about consultations for other bone marrow disorders
We also accept referrals for patients with suspected or confirmed myelodysplastic syndrome, myelofibrosis and other non-acute marrow disorders. These referrals will be triaged and seen as soon as possible, but usually at a later date. Please fax request to New Patient Referrals Department at 416-946-2900.
How does the clinic work?
Newly referred patients will be seen within 24-48 hours of receiving the referral. Appointments will be scheduled in the outpatient Hematology Clinic on the 2nd floor, Monday to Friday from 9:00am-5:00pm. Please note that visits usually take 6-8 hours.
The goal of the consultation is to assess the patient, provide preliminary diagnosis, and discuss treatment options in one visit, if possible. A second visit is often required.
The goal of the consultation is to assess the patient, provide preliminary diagnosis, and discuss treatment options in one visit, if possible. A second visit is often required.
How can I refer a patient?
1
Contact the staff leukemia physician on call to discuss your patient by paging them via the hospital switchboard at 416-946-4501 ext. 3155
2
Once your patient has been accepted, you will be asked to fax a referral form and package to the New Patient Referrals Team at 416-946-2900. To avoid any delays, please include the following information in the referral package:
- Referral letter and/or consultation note
- Blood work
- Relevant imaging/diagnostic reports
- Pathology reports (if official reports are not yet available, please indicate which analyses are pending, and specify the laboratory processing the specimens.)
Referral Forms
Supporting Documents
For patients coming from another hospital
Please complete the
Patient Transfer Summary Form [PDF] within one hour of sending the patient by ambulance. Patients coming via ambulance will be directed to arrive at the Urgent Care Clinic, which is on the 2nd floor at Princess Margaret Cancer Centre. The Urgent Care Clinic opens at 9:00am. Be sure to read the
Princess Margaret's policy about transferring patients to RAC from another hospital.
The Acute Leukemia Rapid Assessment Clinic is an outpatient clinic. In order to care for patients safely in this setting, they
must meet the following criteria.
Outpatient Clinic Acceptance Criteria
- Be conscious and alert
- No major ongoing bleeding, and be hemodynamically stable
- Oxygen saturation greater than 93%, and must not be on more than 35% O2 via mask
- Not in an Intensive Care Unit (ICU) bed
- Stable blood pressure (BP); not requiring fluid resuscitation or inotropes
- No recent onset of chest pain unless investigated by the referring facility
- Able to walk and can transfer with 1 person
- Must have OHIP coverage. If not, alternative arrangements for payment must be confirmed
prior to referring the patient.
- Infectious processes have been considered, and appropriate isolation requirements have been communicated.
For patients not meeting these criteria, or questions about suitability for assessment in an outpatient setting, the referring physician should discuss with the Leukemia Physician on call whether a direct admission to the ward or to the ICU may be warranted.
If the patient's clinical status deteriorates after the referral to Princess Margaret Cancer Centre has been accepted, the referring physician/institution MUST contact the Leukemia physician on call prior to sending the patient, to inform the receiving physician of this change, and to discuss if an alternative plan is required.
For admitted patients, please send the patient with a hospital escort, and with all of the medications your patient may need for their visit.
What to Expect After You Make Your Referral
- Upon receipt of referral information, the attending Hematologist will triage the referral and the administrative assistant will arrange the consultation appointment time (typically within 24 hours).
- The patient, or the referring hospital/physician, will be contacted directly by the administrative assistant to review appointment details, what to expect, answer questions, etc.
- As we often have a wait list for admission for induction chemotherapy, inpatients seen in consultation will usually be sent back to the referring centre to await transfer to Princess Margaret Cancer Centre, if medically appropriate. Therefore, please hold the patient's hospital bed unless otherwise notified.
NOTE: Please inform your patient that we will likely repeat the bone marrow aspirate and biopsy during this clinic visit.