Outreach monitoring service for patients with indolent B-cell and plasma cell disorders: a UK experience

Disease progression occurs in over 1% of monoclonal gammopathy of undetermined significance, monoclonal B-cell lymphocytosis and early stage chronic lymphocytic leukaemia patients every year therefore regular monitoring is indicated. We assessed the efficacy of an outreach service to replace clinic monitoring using local phlebotomy with central haematologist review of laboratory parameters and symptoms identified by a patient self-assessment questionnaire. The service was used by 299 patients for 2 years and provided accurate monitoring, improved patient satisfaction, support for primary care and reduced the burden on haematology clinics without an increase in inter-assessment admissions due to disease progression.