8 June 2025 - Buffy Coats?

Intracellular bacteria... What I found interesting was the concept of preparing a buffy coat to examine. In this day and age this is exacttly the sort of thing from which we are moving away.

7 June 2025 (Saturday) - NEQAS 2503 BF

I got the results of NEQAS 2503BF today.

 

For NEQAS 2503 BF1 I felt the red cells were unremarkable. The white cells showed blast cells, folded nuclei, cytoplasmic blebbing/hairy cells and neutropenia. The platelet count was reduced.

I spotted the salient features – the patient had AML.

 

For NEQAS 2503 BF2 I felt the red cells showed anisopoikilocytosis with nucleated red cells, target cells and burr cells seen. The white cells showed neutrophilia and monocytosis (with vacuolation). Some cells showed cleft nuclei  and clover leaf nuclei. I spent a while before deciding these were not Sezary cells. There were also smear cells there.

The platelet count was reduced.

I spotted the salient features – the patient had CMML.

6 June 2025 (Friday) - UKAS Update

The United Kingdom Accreditation Service sent their update today. You can read it by clicking here.

This time they were talking about how “training supports professional development in the conformity assessment sector”. However, as is always the case, they seemed to be talking in riddles. It is all very well referring to how something or other does or doesn’t fit in with their standards. But all the time you have to spend serious money to see what their standards actually are, there’s a large amount of guesswork going on.

I’m reminded of my days as a manager when another manager would always get his way by insisting that whatever he wanted was “an MHRA requirement”. As no one in the meetings ever knew what MHRA required, his demands were always met without argument.

Perhaps if the UKAS people were more open about their standards we might all learn something. After all their predecessor was quite open about what their standards were.

6 June 2025 (Friday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise. I was presented with one case – a forty-nine year-old woman needing four units of blood for a surgical procedure.

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

I selected four units of O Rh(D) Positive K – negative blood.

I got the thumbs-up.

 

4 June 2025 (Wednesday) - Warm Autoantibodies

Back in the day when presented with a patient who has warm-acting autoantibodies we would crossmatch half a dozen units and give those which seemed to be least incompatible.

These days we sent samples to NHSBT.

Here’s a little article on the matter.

3 June 2025 (Tuesday) - Fritsma Factor Newsletter

The Fritsma Factor newsletter appeared in my in-box today. You can read it by clicking here. As always it has some useful snippets… but bleeding time and whole blood clotting time? Seriously?

 

3 June 2025 (Tuesday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise. I was presented with one case – a twenty-nine year-old woman in the haematology clinic needing two units of cryo for Factor VIII deficiency

Their ABO group was indeterminate but the Rh(D) group was positive.

Their antibody screen was negative.

 

The guidelines say that cryo is NOT indicated when virus-inactivated factor concentrates are available.

And in my world they are.

So I didn’t issue any.

 

I got it right…