18 May 2017 (Thursday) - Image Challenge

Whilst perusing Facebook I found a link to the New England Journal of Medicine’s image challenge.
Given the rather ropey photo above I was supposed to choose a probable diagnosis out of:
  • Acute promyelocytic leukemia (APL)
  • Chronic lymphocytic leukemia (CLL)
  • Multiple myeloma (MM)
  • Acute lymphocytic leukemia (ALL)
  • Chronic myeloid leukemia (CML)
  I’d say it was myeloid; the vast majority of twenty three thousand participants went for APL. I’ll take that as something of a success…

16 May 2017 (Tuesday) - Grey Platelet Syndrome

The Lablogatory people sent me an email about a case study today. A twelve year old girl presented with thrombocytopenia. Previous platelet counts performed at a different facility showed a similarly reduced platelet count. The patient had a history of bruising and intermittent epistaxis.

It was a good case study about Gray Platelet Syndrome…

16 May 2017 (Tuesday) - Transfusion News email

The Transfusion News email arrived today:

Higher Hematocrit Levels Are Associated with Increased Thrombosis Risk and Reduced Bleeding

May 10, 2017
A growing number of recent studies have observed an association between elevated hematocrit levels and thrombosis. However, the mechanism behind this pathway has remained elusive. A recent study induced an elevation of hematocrit levels in otherwise healthy mice to tease apart the etiology of the thrombosis formation under increased RBC levels. Compared with control mice [Read More]

Early Administration of Tranexamic Acid Reduces Maternal Deaths Due to Bleeding

May 3, 2017
Administration of tranexamic acid, an antifibrinolytic drug, has been shown to reduce bleeding in trauma and surgery patients. The results of the WOMAN (World Maternal Antifibrinolytic) trial recently published in The Lancet show that tranexamic acid also reduces the risk of maternal death due to bleeding. Between 2010 and 2016, over 20,000 women with post-partum [Read More]

Transfusion of Red Blood Cells from Younger Donors Is Not Associated with Improved Survival

April 26, 2017
Animal models suggest that blood from younger donors may provide revitalizing benefits, but findings from observational cohort studies on this topic have been inconsistent. Investigators in Scandinavia recently performed a retrospective cohort study following 968,264 red blood cell (RBC) transfusion recipients for 10 years. Since multiple transfusions can confound results, researchers used multiple approaches to [Read More]

15 May 2017 (Monday) - Transfusion Evidence Library email

The Transfusion Evidence Library email arrived in my inbox this morning:

Click on any of the links below to view the article in the Transfusion Evidence Library database. Enjoy your update!

Clinical Commentaries

12 May 2017 (Friday) - Case Study

This case appeared on Facebook this morning. “Question is Cll or Prolymphocytic leukemia?? Any ideas”.
At the risk of appearing sarcastic my first idea was to improve the English…

Reading the comments there were as many opinions as there were people to offer them. For myself it has been my experience that automated analysers are good at identifying lymphoid cells. However this device has found a monocyte count of 50 x 109 cells /l (converting units to what I am used to!). Those would be myeloid cells. Several people had said flow cytometry would be useful here. I’d have to agree…