27 August 2026 (Thursday) - BTLP-TACT Exercise

I’ve got a day off… and it’s hossing down outside. I suppose I might as well do a BTLP-TACT exercise.

I was presented with one case – a thirty-year-old woman in labour needing group and save.

She grouped as A Rh(D) Positive with a weak reaction in the D. I called that indeterminate as that is what the software likes to see.

The antibody screen was positive in cell 2 so I performed antibody panels. The enzyme and IAT panels were positive in cells 2 and 6 corresponding with anti-K

I got the thumbs-up

26 August 2026 (Wednesday) - Westgard QC Update

The nice people at Westgard QC sent their update today. You can read it by clicking here, but it is rather hard going… Don’t get me wrong – I’m very grateful for this free resource. But it is rather hard going.

25 August 2026 (Tuesday) - Unexpected Drop

DIFF Blood Film Review           Diagnosis                                      

--------------------------------------------------------------------------------

            HBM   WBCM    PLT    HCT   RBCM   MCVM   MCHM  MCHCM    RDW      N

251125      142   5.68    278  0.415   4.86   85.4   29.2    342   12.7   3.04

101225      133   5.31    221  0.391   4.50   86.9   29.6    340   12.5   2.59

020426 F    126   6.58    267  0.364   4.28   85.0   29.4    346   12.5   4.13

240826      137   6.05    134  0.384   4.28   89.7   32.0    357   14.0   4.01

              L      M      E      B   RETP   RETA    IRF    NUC     GF    ESR

251125     1.54   0.51   0.56   0.03                                          

101225     1.52   0.92   0.25   0.03                                          

020426 F   1.70   0.51   0.21   0.03                                        NA

240826     1.38   0.60   0.05   0.01                                          

Here’s an interesting case - an unexplained finding of a low platelet count. The patient was on lamotrigine. This stuff can cause that.

https://pubmed.ncbi.nlm.nih.gov/15741138/

One lives and learns…

 

24 August 2026 (Monday) - Learning Monday

 

Well... the staining isn't perfect But they look like prolymphocytes to me...

The correct answer is option 3. T-cell prolymphocytic leukemia.

The blood film shows abnormal lymphoid cells with nucleoli that are CD4+ T-cells by immunophenotype. Abnormal karyotype with t(X;14)(q28;q11) involving TRA/D-locus at 14q11 and MTCP1 at Xq28 confirms the diagnosis of T-PLL.

Reference: 

GONZáLEZ-RODRíGUEZ LM, JUáREZ-Salcedo LM, Loscertales J, et al. T-cell prolymphocytic leukemia, a case report and review of the literature. Oncol Res. 2025;33(3):505-517. Published 2025 Feb 28. doi:10.32604/or.2025.058175

23 August 2026 (Sunday) - Slide Saturday Challenge

 

Polychromatic red cells...  I thought I was missing something...

21 August 2026 (Friday) - Information Governance

I did information governance e-learning today. It’s a simple enough concept… in the course of your job you will see all sorts of confidential information.

Keep your trap shut and MAKE SURE that you don’t let anything slip.

That’s it.

However there’s quite a few ways that you might let slip. A little refresher never hurts

19 August 2026 (Wednesday) - Transfusion Evidence Library Update

The nice people at the Transfusion Evidence Library sent their update today. I know I keep banging on about the stuff, but tranexamic acid really is *the* stuff, isn’t it?
Two more mentions…

ARTICLE OF THE MONTH

Avatrombopag versus placebo for persistent chemotherapy-induced thrombocytopenia in GI cancers: the phase II ACT-GI trial.
Al-Samkari, H., et al. (2026). Journal of Clinical Oncology. [Record in progress].
PICO SUMMARY

 

 

TOP ARTICLES

Barriers and enablers to non-remunerated plasma donation: a meta-synthesis of the qualitative literature using the theoretical domains framework.
Etherington, C., et al. (2026). Vox Sanguinis. [Record in progress].

The efficacy of tranexamic acid for the prevention of postpartum hemorrhage among women at high risk of postpartum hemorrhage undergoing cesarean section: a meta-analysis.
Gao, Q., et al. (2026). BMC Pregnancy and Childbirth. [Record in progress].

Optimal route of tranexamic acid administration in total knee arthroplasty: a Bayesian network meta-analysis with decision-analytic cost evaluation.
Hershfeld, B.E., et al. (2026). The Journal of Arthroplasty. [Record in progress].

Efficacy and safety of different doses of intravenous immunoglobulin combined with phototherapy in neonatal hemolytic disease: a systematic review and meta-analysis.
Huang, M., et al. (2026). European Journal of Pediatrics.

HLA selected red cell transfusions to prevent HLA sensitisation: a prospective, double-blinded, randomised controlled trial.
McComish, J.S., et al. (2026). Transplant Immunology.

Mortality effect of albumin fluid resuscitation in adults with septic shock: a systematic review and dual frequentist-bayesian meta-analysis of randomised trials.
Mendes, H., et al. (2026). Critical Care.

Adjuvant intravenous immunoglobulin in elderly sepsis: a randomized controlled study of mortality, organ function, and inflammation.
Miao, X., et al. (2026). Frontiers in Medicine.

Effect of blood donation in the glycemic control of prediabetic donors: a blinded randomized controlled trial.
Mora-Gonzalez, D., et al. (2026). Endocrine Practice. [Record in progress].             

Comparative efficacy of intranasal, intramuscular, and intravenous vitamin B12 therapy for hematological recovery in vitamin B12 deficiency anemia: a randomized controlled trial.
Singh, S.K., et al. (2026). American Journal of Hematology.

Diagnostic accuracy of reticulocyte haemoglobin content in detecting iron deficiency without anaemia in blood donors: a systematic review and meta-analysis.
Yanyiam, P., et al. (2026). Vox Sanguinis. [Record in progress].