Author Archives: TeamHaem

About TeamHaem

Online education and discussion about all things haematological

TeamHaem Saves Christmas Part 2

Jingle bells, jingle bells Jingle all the way Oh what fun it is to tweet TeamHaem’s case today!   Father Christmas is so worried Jingle sorts out both his lists He checks on who’s behaving And makes sure no-one’s missed. … Continue reading

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TeamHaem help us save Christmas 2019! 🎄❄️ Part 1

Jingle bells, jingle bells Jingle all the way Oh what fun it is to tweet TeamHaem’s case today!   A day or two ago  Father Christmas needed help Jingle, his top packing elf, Just wasn’t feeling himself   Jingle bells, jingle bells Jingle … Continue reading

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Case 121 – Summary!

This week we followed our patient with relapsed/refractory DLBCL through CAR T-cell therapy. We managed her cytokine release syndrome (CRS) and she is in remission thus far. CAR T-cell therapy Chimeric Antigen Receptor (CAR) T-cells are modified T cells in … Continue reading

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Case 121 – update 3!

We manage our patient with CAR T-cell therapy related CRS/ICANS with supportive care, including organ support from our critical care colleagues, and tocilizumab (anti-IL-6) therapy. She responds well to therapy and is stepped down to the haematology ward for ongoing … Continue reading

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Case 121 – Update 2!

We suspect cytokine-release syndrome (CRS) in our patient 5 days post CAR T-cell infusion. We manage her with aggressive fluid boluses, low-flow nasal cannula oxygen and paracetamol. We also complete a septic screen and cover her with broad-spectrum antibiotics. Her … Continue reading

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Case 121 – Update 1!

Our 48 year old patient with relapsed/refractory DLBCL is referred for consideration of CAR T-cell therapy. She is managed with IVE chemotherapy as a ‘bridging treatment’ and is subsequently admitted for CAR T-cell infusion. You are the on-call haematology SpR. … Continue reading

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Case 121 – The Beginning!

Welcome to another TeamHaem clinical case! Get involved and help shape the care of our fictional patient…… You review a 48 year old patient in lymphoma clinic. She was diagnosed with stage IVA diffuse large B cell lymphoma (DLBCL), with … Continue reading

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Case 120 – Summary!

Thank you for everyone’s contributions this week. We discussed the management of a 57 year old lady who was suffering a major haemorrhage secondary to a road traffic accident. The key points of managing a major haemorrhage (from haem perspective) … Continue reading

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Case 120 – Update 4!

Well done team – with your input I’m pleased to say she has now stabilised and has stopped bleeding!!! To achieve this she has been transfused: 8 units red blood cells 8 units FFP 1 pool of platelets 2 pools … Continue reading

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Case 120 – Update 3!

Thank you for everyone’s ongoing input. Our patient is more haemodynamically stable but continues to have ongoing bleeding. She is now receiving group specific/compatible blood products. She has currently received: 6 units packed red cells. 6 units FFP 1g tranexamic … Continue reading

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Case 120 – Update 2!

Thanks for everyone’s contributions so far! Our 57 year old female patient is haemorrhaging following a road traffic accident. The multidisciplinary team are trying to establish source control of the bleeding. The major haemorrhage protocol has been activated. She has … Continue reading

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Case 120 – Update 1!

Thanks for everyone’s contributions. Following recommendations from yourselves our patient  is being managed by a multidisciplinary team and the major haemorrhage protocol has been activated. The only information the clinical team know about our patients that she is called ‘Betty … Continue reading

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Case 120 – The Beginning!

A 57 year old female is in Accident and Emergency following a road traffic accident. She has multiple injuries including a suspected pelvic fracture. She is haemodynamically unstable (heart rate 130, BP 86/54, oxygen saturations 97%). The clinical team are concerned she … Continue reading

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Case 119 – Summary

 Many thanks for all your great suggestions and contributions this week. We highlighted the multidisciplinary treatment of our patient with mycosis fungoides, who eventually required systemic treatment with brentuximab vedotin for his CD30+ disease. Primary cutaneous T cell lymphoma (CTCL) … Continue reading

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Case 119 – Update 2

Our patient with Stage IIB Mycosis Fungoides was discussed at the relevant MDT and his care remained primarily under the dermatology and clinical oncology service. They instigated topical treatment alongside localized radiotherapy to his tumour site on the right arm. … Continue reading

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Case 119 – Update 1

We are assisting the dermatology team in their investigation of a 68 year old man, with a longstanding history of eczema, presenting with erythematous, well defined patches and plaques over his trunk and limbs, a 2cm firm lesion on his … Continue reading

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Case 119 – The beginning

Welcome to a new case for TeamHaem! You get a phone call for advice from a dermatology registrar who has seen a 68 year old man in outpatient clinic. The patient has a 20-year history of eczema which has been … Continue reading

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Case 118 – the summary

This is a case of a 3 month old infant girl presenting with evidence of haemolysis. Blood film showed irregularly contracted cells, target cells and polychromasia.  The reticulocyte count was raised and direct antibody test (DAT) was negative. This is … Continue reading

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Case 118 – update 2

You ask the paediatrician about the baby’s history and discover: she has never had a blood tranfusion mum does not have an allogenic antibody there is no known family history of haemolysis there are signs of jaundice Further tests show … Continue reading

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Case 118 – update 1

You review a peripheral blood film on the sample (shown below).  What is your differential diagnosis?  What questions to you want to ask the paediatrician?

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