Author Archives: TeamHaem

About TeamHaem

Online education and discussion about all things haematological

Case 99 – Summary

Thank you for your contribution in our #TeamHaem case this week. This week we have been looking at Diamond Blackfan anaemia (DBA). This is a rare, genetically and clinically heterogeneous, inherited red cell aplasia. It is one of the Inherited … Continue reading

Posted in Uncategorised

Case 99 – update 5

Genetic testing on both parents and her brother are carried out and are all negative. Hence this is a de novo mutation of RPL5 in our little girl. You also carry out HLA typing on her and her brother, who … Continue reading

Posted in Uncategorised

Case 99 – update 4

Based on a diagnosis of Diamond Blackfan anaemia, a decision is made to start a regular transfusion programme until she is over 1 year of age to minimise the impact of steroids on her growth. It will also allow her … Continue reading

Posted in Uncategorised

Case 99 – update 3

A bone marrow biopsy has been carried out: (see below) Aspirate shows erythroid hypoplasia but no dysplastic features. Cellularity is normal and megakaryocyte & granulocyte lineages are normal. For interest, also see Trephine IHC with Glycophorin-C staining – demonstrating reduced … Continue reading

Posted in Uncategorised

Case 99 – update 2

A blood film has been looked at, no specific findings are noted except for anaemia and occasional spherocytes. There are no red cell fragments, no dysplastic features and no primitive cells. EMA & G6PD are in progress. Parvovirus B19 serology … Continue reading

Posted in Uncategorised

Case 99 – update 1

You call Mum and repeat the baby’s blood count urgently. Her repeat bloods show: Hb 63g/L Platelet 506 x 10^9 MCV 99.9fL, WBC 9.36x 10^9 Neutrophil 3.46 x 10^9 You explain to Mum that her baby is anaemic and you … Continue reading

Posted in Uncategorised

Case 99 – the beginning

Welcome to our new #TeamHaem case. You are working in General practice. You see a 9 month old baby girl in the morning. Her mother tells you that in recent weeks she has needed more naps and has not been … Continue reading

Posted in Uncategorised

Case 98 – summary

Following several obinutuzumab reactions, which resulted in overnight hospital admissions, our patient decided he did not wish to continue with obinutuzumab. He continues on chlorambucil monotherapy and has tolerated it reasonably well and his disease appears to be responding. Thankyou … Continue reading

Posted in Chronic leukaemia | Tagged , , , , ,

Case 98 – part 2 – update 1

We have confirmed progression in our patient’s CLL. There is no evidence of haemolysis. He has a pmh of HTN, diabetes, mild copd and osteoarthritis which limits his mobility. He has an ecog of 2 (was 1 prior to the … Continue reading

Posted in Chronic leukaemia | Tagged , , , ,

Case 98 – part 2 – the beginning

Thankyou for your help with part 1. Here is the second part of this weeks case. You are in the haematology clinic and are seeing an 82 year old gentleman who was diagnosed with CLL 10 years ago. He has … Continue reading

Posted in Chronic leukaemia | Tagged , , , ,

Case 98 – part 1 – update 3

Our patient has been started on venetoclax and has had an excellent response. Following discussions with our patient and referral to the transplant team he has decided to go ahead with a sibling allo SCT. What considerations are there for … Continue reading

Posted in Chronic leukaemia | Tagged , , , ,

Case 98 – part 1 – update 2

Our patient has been diagnosed with CLL and has been found to have deletion 17p on cytogenetics. He has now been on ibrutinib for 15 months. He has tolerated it very well and did get an improvement in his Hb … Continue reading

Posted in Chronic leukaemia | Tagged , ,

Case 98 – part 1 – update 1

We have found our patient has a lymphocytosis with mild anaemia and mild thrombocytopenia. Blood film show lymphocytosis with mature lymphocytes and smear cells. We have some flow results. What do these show? What is our diagnosis? Would you like … Continue reading

Posted in Chronic leukaemia, Laboratory morphology | Tagged , ,

Case 98 – part 1 – the beginning

Welcome to our new case! We will do 2 short cases this week. In our first case we start in general practice. A 42 year old patient has come to see you as he has been training for a marathon … Continue reading

Posted in Chronic leukaemia

Case 97 – Summary

This week we looked at a neuropathy presenting via the neurology team associated with a plasma cell dyscrasia. This area of haematology is often challenging! The diagnosis can be difficult and even after diagnosis there is a lack of evidence … Continue reading

Posted in Lymphoma, Myeloma/paraproteins, Related to other specialities | Tagged , , , , , , , , , ,

Case 97 – update 3

Thanks for your help so far with this case. so far we know our patient is a 54 year old male who presented to clinic with distal sensory loss and a broad based gait which has been slowly progressing over … Continue reading

Posted in Lymphoma, Myeloma/paraproteins, Related to other specialities | Tagged , , , , , , , , , ,

Case 97 – update 2

The bone marrow aspirate did appear to show an excess of Plasmacytoid and lymphoplasmacytoid cells. Immunophenotype results: Abnormal population: Kappa restricted B cell population = 18% of total nucleated cells. Immunophenotype: CD19+, CD5 negative, CD23 negative/wk, CD10 negative, CD103 negative, … Continue reading

Posted in Laboratory morphology, Lymphoma, Myeloma/paraproteins, Related to other specialities | Tagged , , , , , ,

Case 97 – update 1

Thanks for your help so far The neurology team contact you as they have the results of the Nerve conduction studies they performed a few weeks ago these show “prolonged conduction velocities consistent with demyelination in an axonal loss pattern” … Continue reading

Posted in Lymphoma, Myeloma/paraproteins, Related to other specialities | Tagged , , ,

Case 97 – the beginning

Welcome to another #TeamHaem case You are in the Haematology new patient clinic and receive a letter from the local Neurology team asking you to assess a 54 year old male who has an Ig M kappa paraprotein of 6g/dl … Continue reading

Posted in Lymphoma, Myeloma/paraproteins, Related to other specialities | Tagged , , ,

Case 96 – summary

Thank you for participating in our case this week. This week we have been looking at a case of JMML (Juvenile myelomonocytic leukaemia), which is a rare clonal haematopoietic disorder of childhood, characterised by the proliferation of granulocytic and monocytic … Continue reading

Posted in Bone marrow failure, Myeloproliferative neoplasm, Paediatric haematology | Tagged , , , , , , , , , , , , ,