26 September 2020 (Saturday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise.

07981 A request for two units of blood on a thirty-one year old male undergoing allogeneic HSCT conditioning.
The chap was A Rh(D) Positive with a negative antibody screen. I selected two CMV-negative irradiated units of A Rh(D) Positive blood for him. 

67653 A request for four units of blood on a ninety-eight year old chap having a GI bleed
I accepted the sample on this one despite his address of “0 Sea View”. This chap was also A Rh(D) Positive with a negative antibody screen.
I selected four units of A Rh(D) Positive blood for him.

I got the green light despite the software having gone berserk and claiming that I’d issued ten units of blood to the second case.
But a green light is a green light….

25 September 2020 (Friday) - A.S.H. Update

The American Society of Hematology sent their update today which was focussing on lymphomas and lymphoid neoplasia. Admittedly much of it was rather too highbrow for me, but it was relevant to me. Bearing in mind the tripe I read yesterday, the IBMS could learn a lot from The American Society of Hematology
(sorry...)

	Evaluating Selinexor in Patients With Relapsed/Refractory DLBCL Oral selinexor demonstrated durable activity and a 28% response rate in patients with previously treated relapsed and refractory diffuse large B-cell lymphoma.
	Bispecific Immune Cell Engager AFM13 Plus Pembrolizumab Produces High Responses in Heavily Treated Hodgkin Lymphoma Results from a phase Ib study published in Blood suggest that the combination of AFM13 with pembrolizumab may be more effective than either agent alone in patients with heavily treated Hodgkin lymphoma.
	First CAR T-Cell Treatment Approved for Mantle Cell Lymphoma The FDA granted accelerated approval to brexucabtagene autoleucel (formerly KTE-X19), a chimeric antigen receptor T-cell therapy for the treatment of adult patients with relapsed or refractory mantle cell lymphoma.

24 September 2020 (Thursday) IBMS Update

 The IBMS Newsletter arrived in my in-box this morning. Was it their usual one? There was a logo on it about being for “Council and Fellows”. It didn’t seem very different from their usual missives to be honest. But in a novel break with tradition one article caught my attention. What with the ongoing pandemic, there is no IBMS conference this year. Instead there will be an on-line event.

 I’ve never been to any of the IBMS annual parties… purely because everyone I’ve spoken to about them tells me that it is a party at which everyone goes to have a catch-up and booze-up with their old mates at someone else’s expense. Moving to an on-line event is a good thing – hopefully the IBMS are going to move away from being the “Old Boys’ (and Girls’) Club”.

23 September 2020 (Wednesday) - Transfusion Evidence Alert Update

The nice people at the Transfusion Evidence Alert sent their update today. Still very much focussed on COVID-19, but something for nothing is always worth having…

HIGHLIGHTED ARTICLE Effect of Recombinant Human Granulocyte Colony-Stimulating Factor for Patients With Coronavirus Disease 2019 (COVID-19) and Lymphopenia: A Randomized Clinical Trial. Cheng, L. L., et al. (2020). Jama Internal Medicine.

TOP ARTICLES Prognostic significance of hemoglobin level and autoimmune hemolytic anemia in SARS-CoV-2 infection. Algassim, A. A., et al. (2020). Annals of Hematology. SARS-CoV-2 Antibody Avidity Responses in COVID-19 Patients and Convalescent Plasma Donors. Benner, S. E., et al. (2020). The Journal of Infectious Diseases. Clinical characteristics and risk factors for mortality in hematologic patients affected By COVID-19. Cattaneo, C., et al. (2020). Cancer. Thrombocytopenia Is Associated with COVID-19 Severity and Outcome: An Updated Meta-Analysis of 5637 Patients with Multiple Outcomes. Zong, X., et al. (2020). Laboratory Medicine.

22 September 2020 (Tuesday) - COVID-19 and Haemostasis

The boss sent all of us a PDF flyer that discussed the implications of haemostasis and viscoelastic testing for patients with COVID-19 infection.

There is an established Trust protocol in place, but the boss suggested we all reviewed the flyer she sent as it provided an overview on the impact of the coronavirus on haemostasis markers. 

She also suggested that those doing their specialist portfolio might prepare a “compare and contrast” between the flyer she sent and the Trust protocol; it would be an excellent piece of evidence for the portfolio.

It would be an excellent bit of CPD too… I shall content myself with reading the two and reflecting on them and maybe even discussing them with the trainees… without doing the hard work of actually writing the essay.

18 September 2020 (Friday) - ASH Update

The American Society of Hematology sent an update today. Probably more along the lines of “background reading” than directly relevant to me, but an update on myeloma is always useful.

	EHA25 Virtual: Phase I Trial Supports CC-92480 for Heavily Pretreated Myeloma Results from a first-in-human trial of CC-92480 plus dexamethasone in patients with relapsed/refractory myeloma show a manageable safety profile and promising efficacy.
	Belantamab Mafodotin-blmf Approved for Relapsed/Refractory Multiple Myeloma Approval was based on results from DREAMM-2, in which treatment with belantamab mafodotin-blmf 2.5 mg/kg every 3 weeks led to a clinically meaningful response in 31% of patients.
	EHA25 Virtual: Idecabtagene Vicleucel Demonstrates Deep, Durable Responses in Relapsed/Refractory Myeloma The BCMA-targeted CAR T-cell therapy induced responses in nearly 75% of patients with triple-class-exposed myeloma.

17 September 2020 (Thursday) - Transfusion Evidence Alert Upate

A lot of nice people send me stuff. This missive was from the nice people at the Transfusion Evidence Alert. It made more sense to me than the one I got in the last blog entry, and was probably more relevant to me….

ARTICLES OF THE MONTH: SICKLE CELL DISEASE Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease LJ, Estcourt, et al., Cochrane Database Syst Rev 2020 PICO Summary available Preoperative blood transfusions for sickle cell disease LJ, Estcourt, et al., Cochrane Database Syst Rev 2020 PICO Summary available