Blog Archives

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

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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 95 – summary

Thankyou for all your help this week. This week we had a look at mantle cell lymphoma (MCL). MCL is a type of none Hodgkin’s lymphoma, and comprises between 3 and 10% of NHL, and often has features of both … Continue reading

Posted in Chronic leukaemia, Laboratory morphology, Lymphoma | Tagged , ,

Case 95 – update 2

We have monitored our patient for a year. Unfortunately at his most recent appointment he has begun to complain of weight loss of 7kg, drenching night sweats and fatigue. What would you want to do next? Are there any investigations … Continue reading

Posted in Chronic leukaemia, Lymphoma | Tagged , ,

Case 95 – update 1

So we have found our patient has a lymphocytosis on repeat bloods, we have no historical results. He denies and weight loss, sweats or tiredness. On examination you can feel an enlarged spleen 4cm below the costal margin, but you … Continue reading

Posted in Chronic leukaemia, Laboratory morphology, Lymphoma | Tagged ,

Case 95 – the beginning

Welcome to our new case! This week we start in GP. We have a 59 year old gentleman who A&E have asked you to follow up as he was found to have a slight lymphocytosis on some bloods that were … Continue reading

Posted in Chronic leukaemia, Lymphoma | Tagged

Case 91 – summary

Thank you for all your contributions this week! This week we had a look at MGUS (monoclonal gammopathy of undetermined significance). Our patient was diagnosed with IgA lambda MGUS, which was monitored 6 monthly for 4 years. This then progresses … Continue reading

Posted in Myeloma/paraproteins | Tagged , , ,

Case 91 – update 2

We have been monitoring our patient 6 monthly for 4 years. His para protein has been slowly rising and was 10g/l on his last visit 3 months ago. He has been bought to clinic slightly earlier to monitor his paraprotein. … Continue reading

Posted in Myeloma/paraproteins | Tagged , , ,

Case 91 – update 1

So our patient has been seen by haematology. He initially presented with shoulder pain. Following X-ray and MRI this has been shown to be due to osteoarthritis with no evidence of lytic lesions. Bone marrow had shown a normocellular marrow … Continue reading

Posted in Myeloma/paraproteins | Tagged , , ,

Case 91 – the beginning

Welcome to this week’s TeamHaem case! This week we start in general practice. A 70 year old man saw your colleague complaining of shoulder pain. Some bloods were done as he was due his ‘well man’ bloods around the same … Continue reading

Posted in Myeloma/paraproteins | Tagged , , ,

Case 89 – update 2

Thank you for everyone’s contributions so far! Update of investigation results as requested: Bone marrow trephine: myelofibrosis. BM cytogenetics: monosomy 7 Peripheral blood: JAK2 positive. No circulating blasts identified on blood film. USS abdo: 16cm spleen (Hb 95, Plts 90, … Continue reading

Posted in Anaemia, Myeloproliferative neoplasm, Uncategorised | Tagged , , , , ,

Case 89 – the beginning

A 64  year old man is referred to haematology outpatients with progressive chronic anaemia and leucocytosis. He has previously been very fit but has become very lethargic  over the past few months. Hb 95, MCV 103, Plts 90, WCC 17, … Continue reading

Posted in Anaemia, Myeloproliferative neoplasm | Tagged , , ,

Case 85 – the beginning

Welcome to our new case. We need your help urgently. Our patient is a 55 year old man who is drowsy and confused. His friend is extremely worried and has brought him to the Medical Admissions Unit front door for … Continue reading

Posted in Myeloma/paraproteins | Tagged

Case 84 – summary

Thank you for all your help with this weeks case! This week we looked at a case of a patient with type 1 Gaucher’s disease . She was found to be mildly anaemia with a mild thrombocytopenia. A CT scan … Continue reading

Posted in Acquired bleeding, Bone marrow failure, Laboratory morphology, Related to other specialities | Tagged , , , , ,

Case 84 – update 2

So we have the results of our patient’s bone marrow and it looks to be consistent with Gaucher’s disease! Our patient has a raised serum ACE and ferritin which is typical of Gaucher’s disease. Our bone marrow shows the typical … Continue reading

Posted in Acquired bleeding, Bone marrow failure, Laboratory morphology, Related to other specialities | Tagged , , , , ,