22 March 2024 (Friday) - Getting the BTLP-TACT Wrong (Again!)

Time for another BTLP-TACT exercise… I was presented with one case – a twenty-five year-old woman in the haematology clinic needing two units of irradiated blood for the next day.

 

She grouped as O Rh(D) Positive; albeit a rather weak Rh(D) Positive with a negative antibody screen. I took no chances and gave her two units of O Rh (D) Negative which was also K-negative.

 

I got the thumbs-down. The Rh group was supposedly uninterpretable. Clearly it isn’t. Had I found one in real life it would get sent to NHSBT, but that is positive…

Erring on the side of caution gave me a green light for the blood selection though…

21 March 2024 (Thursday) - Oncology Central Update

I’ve been whinging a lot this week… The nice people at Oncology Central sent their update today. I can’t pretend that this stuff is directly relevant to me, but it is excellent background reading. I feel I can claim this is actual CPD, whereas the last two entries I put up as examples of failed attempts at CPD…

Can AI reveal real-time insights into glioblastoma disease progression?   Read about an innovative approach to trace glioblastoma tumors in large MRI datasets using machine learning and how it could enable real-time insights into disease progression in our latest interview feature.

Stool DNA test yields 94% sensitivity rate for colorectal cancer detection READ MORE >>>

Could AI support the clinical management of cancer patients? WATCH NOW >>>

Why are certain populations at a greater risk of developing cancer? READ MORE >>>

JOURNAL ARTICLES

Design of a single-center, Phase II trial to explore the efficacy and safety of ‘R-ISV-RO’ treatment in advanced tumors The authors designed a single-center, single-arm, open-label, exploratory, Phase II clinical trial to evaluate efficacy and safety in patients with advanced solid tumors (intervention: ‘R-ISV-RO’ plus anti-PD-1 monoclonal antibody). MORE >>>

Clinical outcomes for previously treated patients with advanced biliary tract cancer: a meta-analysis A synthesis of evidence from clinical studies indicates the need for more effective therapies for advanced biliary tract cancer patients whose disease progressed on prior therapy. MORE >>>

Evaluating relugolix for the treatment of prostate cancer in real-world settings of care: the OPTYX study protocol The OPTYX study aims to generate evidence on ORGOVYX's safety and effectiveness in prostate cancer patients in routine care, including treatment course and post-treatment clinical outcomes. MORE >>>

20 March 2024 (Wednesday) - IBMS Update

Two days ago I had a serious whinge about the newsletter from the office of the chief scientific officer.

But I take it all back. That was perfection compared to what arrived in my in-box today from my professional body. Here’s the latest missive from the IBMS. It really is of absolutely no interest or relevance to me. Now that the IBMS don’t offer professional indemnity cover I find myself asking what I get for the sixteen quid I give them every month.

Two days ago I wrote: ”I really don’t want to appear negative but more and more my CPD is an ongoing tirade about how little use various people’s efforts are to me. Very self-centred of me, I know…”

However I feel I’m justified in whinging when I am paying good money for it.

 

18 March 2024 (Monday) - Chief Scientific Officer's Update

The office of the chief scientific officer sent their update today. You can read it by clicking here. Someone has clearly gone to a lot of time and effort to come up with something which looks very impressive… to the layman.

Take for example the article on genotyping testing for people who have sickle cell disorder, thalassaemia and rare inherited transfusion-dependant rare anaemias in England. This isn’t new. This has been going on for ages. It sounds really impressive and it is a very good idea to provide blood which is as close a match to the recipient as possible. However this initiative does nothing to address the shortage of donors. It is all very well knowing the Kell, Duffy, Kidd, MNSs, Rh, Dombrock, Auberger and McCoy groups of the recipient. But knowing them does nothing to provide identical blood.

 

I really don’t want to appear negative but more and more my CPD is an ongoing tirade about how little use various people’s efforts are to me. Very self-centred of me, I know…

17 March 2024 (Sunday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise. The software gave me two cases:

 

38895 – a sixty-nine year-old woman needing group and save. She grouped as A Rh(D) Positive with antibody screen positive in all three cells.

I requested panels.

The IAT panel was positive in cells 1, 3, 4, 6, 7, 9 and 10 - possible anti-Cw  anti-Lu(a) anti-Fy(a) anti-Jk(a)

The enzyme panel was positive in cells 1, 3, 4, 6, 7 - possible anti-Cw anti-Jk(a)

So – this patient has anti-Fy(a) and anti-Jk(a) but anti-Cw cannot be excluded. 

17765 – a seventy-four year-old woman also needing group and save. She too grouped as A Rh(D) Positive with a negative antibody screen.

 

I got the green light.

14 March 2024 (Thursday) - Transfusion Evidence Alert Update

The Transfusion Evidence Library update arrived today. Bearing World Kidney Day in mind, the focus was on renal involvement:

 Top article

Plasma exchange and glucocorticoids to delay death or end-stage renal disease in anti-neutrophil cytoplasm antibody-associated vasculitis: PEXIVAS non-inferiority factorial RCT.
Jayne, D., et al. (2022). Health Technology Assessment.
PICO SUMMARY

 

Selected articles

Safety and efficacy of hypoxia-inducible factor-prolyl hydroxylase inhibitors vs. erythropoietin-stimulating agents in treating anemia in renal patients (with or without dialysis): a meta-analysis and systematic review.
Damarlapally, N., et al. (2023). Cureus.

Acute respiratory distress syndrome, acute kidney injury, and mortality after trauma are associated with increased circulation of syndecan-1, soluble thrombomodulin, and receptor for advanced glycation end products.
Dixon, A., et al. (2023). The Journal of Trauma and Acute Care Surgery.

Can trajectory nor-epinephrine infiltration reduce blood loss during percutaneous nephrolithotomy? A double-blinded randomized controlled trial.
El-Shaer, W., et al. (2022). International Journal of Urology.

Prevention of cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis of non-pharmacological interventions.
Hariri, G., et al. (2023). Critical Care.

Effect of blood transfusion post kidney transplantation on de novo human leukocytes antigen donor-specific antibody development and clinical outcomes in kidney transplant recipients: a systematic review and meta-analysis.
Kang, Z.Y., et al. (2023). Transplant Immunology.

Ferric citrate for the treatment of hyperphosphatemia and anemia in patients with chronic kidney disease: a meta-analysis of randomized clinical trials.
Li, L., et al. (2022). Renal Failure.

The effect of perioperative blood transfusion on survival after renal cell carcinoma nephrectomy: a systematic review and meta-analysis.
Liu, Y., et al. (2023). Frontiers in Oncology.

Efficacy of therapeutic apheresis for cryoglobulinemic vasculitis patients with renal involvement: a systematic review.
Miao, J., et al. (2023). Blood Purification.

Two phase 3 studies on ophthalmologic effects of roxadustat versus darbepoetin.
Sepah, Y.J., et al. (2022). Kidney International Reports.