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 , , , , ,

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

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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 , , , , , ,

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 , ,

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 , , , , , , ,

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 , , , , , , ,

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

Posted in Bone marrow failure, Myeloma/paraproteins | Tagged , , , , , ,

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 , , , ,

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 , ,

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

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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

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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 , , , , | 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 , , , ,

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 , , ,

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 , , ,

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

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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

Posted in Lymphoma | Tagged , , , | 2 Comments

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

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