Initial mandatory investigations
| Test | Indication |
| Chest X-ray | To identify a mediastinal mass, consolidation due to infection or alveolar infiltrates suggestive of leucostasis. |
| Serial full blood counts | Assessment of white cell count and rate of change, anaemia and thrombocytopaenia. |
| Serial urea, electrolytes, creatinine, bone profile and uric acid | Tumour lysis syndrome is characterised by hyperuricaemia hyperphosphataemia, hyperkalaemia and hypocalcaemia leading to renal injury. |
| Blood cultures (if indicated) | Prior to staring intravenous antibiotics, blood cultures should be taken. |
| Group and save | In anticipation of potential need for blood products |
| Clotting (prothrombin time, activated partial thromboplastin time and fibrinogen) | Disseminated intravascular coagulation is occasionally seen in association with acute leukaemia. |
| Blood film | Can usually be examined by the on-call haematologist at the referring hospital, with a second film made and sent with the child to the PTC. |
| Additional EDTA sample | Peripheral blood can be sent to the PTC for immunophenotyping, which may be sufficient to confirm or refute the diagnosis of leukaemia. |
| Viral serology | Pretransfusion viral serological tests (especially VZV) are required for every child with a new diagnosis of cancer. Typically a virology screen includes VZV, HSV1, HSV2, EBV, measles, hepatitis BÂ and hepatitis C. |
PTC, primary treatment centre.