13 October 2023 (Friday) - NEQAS 2306 BF

I got hold of the results of NEQAS 2306 BF today.
 
2306BF1 
 

Blasts          (1)

Low Plts       (2)

Neutrophilia (7)

Smear cells (8)

lymphocytosis 

 

?? Megakaryoblastic leukaemia. It was AML with Megakaryoblastic appearance. 

 

2306BF2 

 

Red cell fragments      (1)

Toxic granulation         (2)

Left shifted neutrophil  (3)

Low plts                        (5)

 

? Microangiopathic Haemolytic anaemia ? DIC and sepsis. It was fulminant sepsis and disseminated intravascular coagulation (DIC)

I’m rather pleased with that…

 

13 October 2023 (Friday) - 2303 DF

I got hold of the results of manual diff NEQAS 2303 DF. Here’s my diff and the 2sd range:
 
Neut  32.2   25.7-52.3
Lymph15.7   2.7 – 23.3
Mono  0.9    0 – 14.4
Eos   0.0      0
Baso  0.0     0
Meta  0.0     0.0 – 2.0
Myelo 0.0    0.0 – 4.0
Pro   0.0      0.0 – 1.5
Blast 12.6   18.6 – 55.4
Nrbc  0.0     0
 
Well… there’s no denying that I rather underestimated the blast cell count. But when you look at the spread of those 2sd ranges…

11 October 2023 (Wednesday) - Storage Changes?

If I see something like this my initial thought would be that this is artefactual; a change brought about by storage.

But not necessarily… Botryoid nuclei are also seen in cases of feature of burns and of hyperthermia, and… (this is where I learned something today) – in cases of abuse of cocaine or methamphetamine.

 

There’s an article about this that you can read by clicking here

10 October 2023 (Tuesday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise. It presented me with one case – an eighty-five year old woman with appendicitis requiring group and save.

She grouped as AB Rh(D) Positive with a negative antibody screen.

 

It gave me the thumbs-down claiming I’d said she was O…  Seriously?

Rather fed up with the entire thing I asked for another one. This time I got an eighty-seven year old woman in the haematology clinic requiring group and save.

She grouped as O Rh(D) Positive with antibody screen positive in cells 1 & 2.

I requested antibody panels. The IAT panel was positive in cells 2, 3, 5, 7 & 9 which corresponded with anti- S but did not exclude anti-E or anti-Lu(a)

The enzyme panel was negative which did exclude anti-E (according to BTLP-TACT; not according to anyone who’s ever worked in a blood bank…not that I’m sulking about getting the thumbs down earlier).

Did this exclude anti-Lu(a)? Bearing in mind that the NHSBT guidelines say to crossmatch patients with anti-Lu(a) by IAT I’ll take this to say it does…

So we’ve got someone who is O Rh(D) Positive with anti-S

This time I got the green light.

 

5 October 2023 (Thursday) - Fritsma Factor Update

The Fritsma Factor newsletter appeared in my in-box this morning. You can read it by clicking here. I like this newsletter. There’s not too much of it, it is manageable… perhaps not directly related to me this time, but gratefully received nonetheless.

 

3 October 2023 (Tuesday) - The IBMS Gazette (!)

The IBMS Gazette came through the post today (how last century!) Usually the thing goes straight into the dustbin unopened but today I thought I might have a look at it.
It’s not called the IBMS Gazette any more – it’s now “The Biomedical Scientist”… it’s amazing what happens when you aren’t paying attention.
 
There was something about advanced and consultant biomedical scientist roles in which three different people seemed to compete to see who could write the most unintelligible article. I couldn’t understand what any of them were getting at.
There was an article about a histopathology lab which was on target to achieve ninety-eight percent turnaround of all its work within ten days… back in the day at the (now demolished) Royal East Sussex Hospital we used to do all the histology sectioning in the morning, have an early lunch break, do all the cut-up in the early afternoon and be finished by three o’clock…
Admittedly there were a few articles about people’s personal experiences which were interesting, but there was quite a bit of semi-political ranting and more than a little of the IBMS blowing its own trumpet.
 
I was pleased to see the IBMS Gazette (as it will always be to me) has improved somewhat since I last read the thing…

 

2 October 2023 (Monday) - The Future (?)

The nice people at Oncology Central sent an interesting article about the future of immunotherapy in cancer treatment. You can read it by clicking here.

Back in the day this was billed as the future for the likes of me. Doing blood counts would all be automated and so I’d be using my skills on this sort of thing, coming up with custom-designed therapies for individual patients.

However there’s more and more blood counts for fewer and fewer people, and what with all this competency assessment stuff, our repertoire is getting smaller and smaller. The article talks about “off the shelf” immunotherapies… so is what we were promised likely to happen…

It wouldn’t seem so.