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Tag Archives: chemotherapy
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 Bone marrow transplant, chemotherapy, Chronic lymphocytic leukaemia, Cytogenetics, elderly, Lymphocytosis
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 chemotherapy, Chronic lymphocytic leukaemia, Cytogenetics, elderly, Lymphocytosis
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 chemotherapy, Chronic lymphocytic leukaemia, Cytogenetics, elderly, Lymphocytosis
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
Case 75 – summary
Case 75 – Summary! Thank you for all of the contributions with Case 75, where we encountered a 43 year old who presented with back pain and circulating plasma cells in his peripheral blood. In summary we established that this … Continue reading
Posted in Myeloma/paraproteins
Tagged Bone marrow transplant, chemotherapy, Cytogenetics, diagnosis, Flow cytometry, myeloma, Plasma cell leukaemia
Case 75 – update 3
Bortezomib-based regimes are associated with better outcomes as it more rapidly reduces tumour load and reverses complications. What would you combine Bortezomib with in our patient? How would you consolidate this treatment if response achieved? Would the cytogenetics results influence … Continue reading
Posted in Myeloma/paraproteins
Tagged chemotherapy, myeloma, Plasma cell leukaemia
Case 69 – part 2 – summary
This patient has a medical emergency. She has pancytopenia with evidence of bleeding. There are abnormal promyelocytes and faggot cells (below) which are indicative of acute promyelocytic leukaemia. Acute promyelocytic leukaemia is a subtype of acute myeloid leukaemia characterised by … Continue reading
Posted in Acquired bleeding, Acute leukaemia
Tagged Acute myeloid leukaemia, acute promyelocytic leukaemia, AML, APML, Blood film, chemotherapy, coagulopathy, morphology
Case 69 – part 2 – the beginning
A 21 year old female presents with epistaxis and bleeding gums and the following blood count: Hb 69g/L Platelets 27×10*9/L WCC 12×10*9/L Questions What is your immediate management? What tests would you like to perform? Please reply … Continue reading
Posted in Acquired bleeding, Acute leukaemia
Tagged Acute myeloid leukaemia, acute promyelocytic leukaemia, AML, APML, Blood film, chemotherapy, coagulopathy, morphology
Case 62 – summary
Haematological emergencies Patient A presented with an episode of neutropenic sepsis. As a junior you should be suspicious of someone being neutropenic if they have had recent chemotherapy (usually within the past 1-2 weeks). Reviewing patients previous blood results … Continue reading
Case 62 – part A – update
Patient A has been with us for 48hrs. He stabilised with the prompt treatment delivered on admission, but has spiked a temp in the last 12 hours. His hickman line is still in situ. He was anaemic on admission … Continue reading
Posted in Bone marrow failure, Transfusion
Tagged blood transfusion, chemotherapy, neutropenia, neutropenic sepsis, transfusion reaction
Case 62 – part A
This week our aim is to develop a few short cases based on emergencies in haematology. The case will be mostly aimed at junior doctors and medical students, timing with the transition of juniors in UK to new rotations this … Continue reading
Posted in Bone marrow failure
Tagged chemotherapy, neutropenia, neutropenic sepsis
Case 57 – summary
Thankyou for all your input with this case! This week we looked at classical Hodgkin’s disease. Our patient was initially diagnosed with stage 2B early unfavourable Hodgkin’s disease. Following 4 cycles of ABVD and radiotherapy he was in remission. Unfortunately … Continue reading
Posted in Lymphoma
Tagged chemotherapy, Hodgkins lymphoma, lymphadenopathy, radiotherapy, relapse
Case 57 – update 2
Our patient has been diagnosed with stage 2B classical Hodgkin’s. Using the German Hodgkin’s study group criteria he has early unfavourable disease. We followed the German approach to treatment and he had 4 cycles of ABVD and radiotherapy to the … Continue reading
Posted in Lymphoma
Tagged chemotherapy, Hodgkins lymphoma, lymphadenopathy, radiotherapy, relapse
Case 57 – update 1
Our patient has been referred to the haematology team. He presented with a left sided inguinal node which he noticed around 4 weeks ago, this had been enlarging and was around 2x3cm when he initially presented. He has been feeling … Continue reading
Posted in Lymphoma
Tagged chemotherapy, Hodgkins lymphoma, lymphadenopathy, radiotherapy, relapse
2 Comments
Case 57 – the beginning
Welcome to our new case!This week we start in a gp practice. A 32 year old gentleman attends with a left sided groin lump which he feels is enlarging. What other information would you like to ask in the history? … Continue reading
Posted in Lymphoma
Tagged chemotherapy, Hodgkins lymphoma, lymphadenopathy, radiotherapy, relapse
Case 56 – Summary
This weeks case dealt with the presentation of a rare lymphoma. James was found to have an NK cell lymphoma of the sinuses with a single cervical lymph node. He had an IPI score of 0 and no other co-morbidity. … Continue reading
Posted in Lymphoma
Tagged chemotherapy, Extranodal lymphoma, Lymphoma, T cell lymphoma
Case 56 – update 3
IPI score is calculated as 0 and there is evidence this may be prognostic to some extent in NK lymphomas. The MDT had no trials available so felt SMILE (Dexamethasone, methotrexate, Ifosfamide, L-Asparaginase and Etoposide) chemotherapy was a suitable option, … Continue reading
Posted in Lymphoma
Tagged chemotherapy, Extranodal lymphoma, Lymphoma, T cell lymphoma
Case 56 – update 2
The biopsy shows an angiocentric distribution of atypical lymphoid cells penetrating the blood vessel walls.The immunophenotype shows CD2 +, Surface CD 3 -, Cytoplasmic CD3 + and CD 56 + cells. James’ biopsy confirms a diagnosis of Nasal NK/T cell … Continue reading
Posted in Lymphoma
Tagged chemotherapy, Extranodal lymphoma, Lymphoma, T cell lymphoma
Case 56 – update 1
So far we have found out James has not been abroad, he is a lifelong non-smoker and has had no previous procedures. He has no past medical history and has no regular medications. Tests: Wcc 13, Hb 130, plt 260, … Continue reading
Case 56 – the beginning
James a 48 year old painter presents to his GP with facial pain over his right cheek and a blocked nose with rhinorrhoea. James is given antibiotics for probable sinusitis. Three weeks later his symptoms are worse; he has constant … Continue reading
Posted in Lymphoma
Tagged chemotherapy, Extranodal lymphoma, Lymphoma, T cell lymphoma
