1 September 2026 (Tuesday) - A.I.

The latest missive from the United Kingdom Accreditation Service arrived in my in-box today. You can read it by clicking here.

Good luck.

I actually laughed out loud when I read the bit about using artificial intelligence. I actually use that with any UKAS publications with which I come into contact. Seriously. I really do.

Last month I mentioned on here that I found one of their articles to be incomprehensible so I emailed UKAS to ask for it to be translated into words that I could understand. No one replied so I copied the lot into Microsoft Copilot and asked it to translate it into everyday English, and it did.

So that’s what I do with stuff from UKAS nowadays. I want to understand it, and here’s one way that I can…

 

31 August 2026 (Monday) - Learning Monday

The correct answer is option 3. Matched sibling donor transplantation using bone marrow. For younger patients with severe or very severe aplastic anemia who have an available HLA-identical sibling donor, upfront allogeneic transplantation is the preferred first-line treatment.
The priority order of donor source for bone marrow transplantation is: (1) HLA-identical sibling, (2) HLA-matched unrelated donor, and (3) HLA-haploidentical donor if an HLA-matched unrelated donor is not rapidly available. Each of these donor marrow sources may be preferable to nontransplant IST.
Upfront transplantation from an HLA-identical sibling donor is preferred in eligible patients because immunosuppressive therapy is associated with a continued risk of relapse and clonal evolution to MDS or AML, whereas allogeneic transplantation offers a potentially curative treatment.

30 August 2026 (Sunday) - Lymphoblasts

 

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