Blog Archives

Case 130 – Update 1

Thanks for all the input thus far. We are dealing with a panreactive antibody screen (see below) in a patient not previously known to our hospital trust. The sample has been sent to NHSBT red cell immunohaematology (RCI). We are … Continue reading

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Case 130 – the beginning

It is 5pm. You are the haematology SpR and you have just congratulated yourself on clearing the blood films and aspirates to report – good job! But just as you are taking off your lab coat, a transfusion BMS pops … Continue reading

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Case 127 – the summary

Thanks for all your input this week, as we worked through the investigation and management of CML; highlighting a few areas for discussion as we went! See below summary notes on CML – mainly taken from the European Leukaemia Network … Continue reading

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Case 127 – The beginning

You are the haematology SpR reviewing routine blood films in the lab at 4pm when you come across the following FBC differential and film from a GP request. The patient is a 31 year old female. Clinical details state ‘for … Continue reading

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Case 126 – Update 1!

  We advised the GP to repeat the asymptomatic 57 year old patient FBC (with film) in 4-6 weeks and to refer to haematology if absolute lymphocyte count was >10 or if he had associated cytopenias / B symptoms / … Continue reading

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Case 126 – The beginning!

You are the on-call haematology registrar who has been contacted by a conscientious GP regarding a fit and well 57 year old man who has an incidental finding of lymphocytosis. The FBC was performed as part of his monitoring for … Continue reading

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Case 124 – Summary

Many thanks for all of your input this week. We covered the case of a 68 year old lady presenting with macrocytic anaemia and thrombocytosis. Key points in initial investigation: Exclude common causes – iron deficiency, B12/folate deficiency, myeloma screen, … Continue reading

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Case 124 – Update 2

Thank you for all of your input and suggestions. To summarise the case thus far: 68 year old lady referred with a macrocytic anaemia and thrombocytosis: Haemoglobin              87 g/L (115 – 165) White cell count          5.2 x 109/L … Continue reading

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Case 124 – Update 1

We are investigating a 68 year old lady referred with a macrocytic anaemia and thrombocytosis. Thanks for all of your helpful input thus far. Tests you have requested to date: Haemoglobin              87 g/L (115 – 165) White cell count … Continue reading

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Case 124 – The beginning

You are helping out in new patient haematology clinic. You have just had your post-lunch coffee and are raring to go! The next patient has been referred via the 2ww pathway by their GP for investigation of an abnormal FBC, … Continue reading

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Case 123

44 year old man present to GP with fatigue, SOB and petechial rash. What investigations would you perform?  Level of urgency?? Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please … 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 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 110 – summary

Thankyou for all your help this week This week we had a look at 4 films where there were visible organisms. Film 1 – babesia Film 2 – malaria – p.vivax Film 3 – malaria – p.falciprum Film 4 – … Continue reading

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