11 September 2021 (Saturday) - BTLP-TACT Exercise


I thought I might have another go at the BTLP-TACT website. I was presented with two cases:

80914 – a seventy-one year old woman undergoing a fem-pop bypass requiring group and save 

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

13687 – an eighty year old chap in theatre requiring four units of blood immediately.

He grouped as AB Negative with a negative antibody screen. I selected four units of A Rh(D) Negative blood for him. 

I got the green light.

10 September 2021 (Friday) - Standardisation in Morphology


Here’s an interesting article. An attempt to standardise the reporting of blood film morphology. At the risk of appearing cynical, it isn’t the first and it won’t be the last.

But this one made me sit up and take notice. Someone other than me has finally wondered why we report anisoocytosis as mild, moderate or marked when the RDW tells you the same thing but with far more precision.

The same can be said of hypochromia and MCH, and of macro/micro-cytosis and the MCV. Why wasn't this said years ago?

8 September 2021 (Wednesday) - Fritsma Factor Newsletter


The Fritsma Factor newsletter appeared in my in-box today. You can read it by clicking here.
Now this *does* have stuff of direct relevance to me:

Chromogenic Factor IX Assay - Aug 03

Thrombosis in VWF and Hemophilia - Aug 06

Factor VIII Antigen Enzyme Immunoassay - Aug 19

Factor VIII Antigen in Factor VIII Inactivated Plasma - Aug 19

Chromogenic Vs. Clot-based FVIII Assays - Aug 19

Factor V Inhibitor - Aug 28

7 September 2021 (Tuesday) - The Oncologist Update

The nice people at “The Oncologist  sent their update today. Much of it went over my head, but (as I always say) it is all useful background reading.

Precision Medicine Clinic: Molecular Tumor Board



Clinical Trial Results


Antibiotics and Imiquimod for Cutaneous T‐Cell Lymphoma in Veterans

Christina A. Del Guzzo, Arsenije Kojadinovic, Ravi R. Vinnakota et al.

Study to Compare Capsule and Liquid Formulations of Enzalutamide in Prostate Cancer

Lisa M. Cordes, Keith T. Schmidt, Cody J. Peer et al.

Efficacy and Safety of Trametinib in Non‐V600 BRAF Mutant Melanoma: A Phase II Study

Caroline A. Nebhan, Douglas B. Johnson, Ryan J. Sullivan et al.



Causes of Death Following Nonmetastatic Colorectal Cancer Diagnosis in the U.S.

Ahmed M. Afifi, Ahmed O. Elmehrath, Inas A. Ruhban et al.

Prognostic Role of CTCs in mRCC: A Large, Multicenter, Prospective Trial

Umberto Basso, Antonella Facchinetti, Elisabetta Rossi et al.


Machine Learning Identification of Gene Signatures in Metastatic Prostate Cancer

Edwin Lin, Andrew W. Hahn, Roberto H. Nussenzveig et al.

Patients' and Providers' Perspectives in Tobacco Cessation

Alexandra B. Khodadadi, William Carroll, Erica L. Lee et al.

Personal Payments from Pharmaceutical Companies to Authors of Oncology Clinical? Practice Guidelines

Aaron P. Mitchell, Akriti Mishra, Pranam Dey et al.

The Matilda Effect: Underrecognition of Women in Hematology and Oncology Awards

Shruti R. Patel, Frederique St. Pierre, Ana I. Velazquez et al.

Genomics of Intrahepatic Cholangiocarcinoma

Mason A. Israel, Natalie Danziger, Kimberly A. McGrego et al.

Nivolumab Plus Ipilimumab for the Treatment of HCC Previously Treated with Sorafenib

May Tun Saung, Lorraine Pelosof, Sandra Casak et al.

4 September 2021 (Saturday) - BTLP-TACT Exercise

With a couple of minutes spare I thought I might do another BTLP-TACT exercise. It’s daft – I worry about getting this right more than I worry about real crossmatching… and if I get that wrong that could (quite literally) kill someone.

I was presented with two cases: 

25982 – a ninety-two year-old chap in the out-patients department requiring a group & save

He grouped as O Rh(D) Negative with a negative antibody screen

61707 – an eighty-eight year-old chap on a medical ward requiring two units of blood tomorrow.

He also grouped as O Rh(D) Negative with a positive antibody screen (positive in all three cells) so I requested antibody panels.

The IAT panel was positive in cells 1 3 5 6 9 and 10

This could well be an anti-Fy(a) with anti-E but doesn’t exclude anti-Cw or anti-Lu(a)

The enzyme panel was positive in cells 3 and five which corresponds with anti-E

This was something of a trick question… when I came to select blood there was none that was negative for all four antigens. If I don’t select blood I get the red light. If I give antigen positive I get the red light…

What should I have done here?

 But I got the green light… what was going on here?

3 September 2021 (Friday) - ASH Update

The nice people at the American Society for Hematology sent their update today. Perhaps a tad clinical, but background reading is always good stuff. Especially when it doesn’t cost me a penny.

Here are the highlights in acute leukemias:
Flow Cytometry as a Prognostic Tool for Children With Down Syndrome and AML
A recent study published in Blood found that the use of flow cytometry alone to determine measurable residual disease status did not sufficiently identify children with acute myeloid leukemia and Down syndrome who were eligible for reduced treatment intensity.
Treatment Delays and Hemostatic Abnormalities Predict Death in Newly Diagnosed APL
Major factors associated with early deaths in hospitalized patients with newly diagnosed acute promyelocytic leukemia included treatment delays and the incidence of hemostatic abnormalities, according to research findings published in Blood Advances.
Investigating the Combination of Ivosidenib Plus Venetoclax and Azacitidine in IDH-Mutated Myeloid Malignancies
Treatment with ivosidenib plus venetoclax, with or without azacitidine, had an acceptable safety profile and led to high rates of complete responses in patients with acute myeloid leukemia, according to results presented at the 2021 ASCO Annual Meeting.

3 September 2021 (Friday) - Time To Make Savings?


The IBMS sent their update today. The first article was a revolutionary new way of administering vaccines by squirting it up the nose… like my dogs have been getting their vaccinations for years…
Revolutionary… I didn’t bother with the rest.

Why do I mention this? I get CPD from a wide range of sources. Much of it isn’t of any relevance to me. Much like today’s missive from the IBMS.
Look at it.
What actual hands-on use is it to me? If they aren’t offering professional indemnity cover what *exactly* am I getting for the two hundred quid I give them every year?

Jab in the arm, or puff up the nose?
Jab in the arm, or puff up the nose?

A team of researchers affiliated with multiple institutions in the US and UK has found that administering the AstraZeneca COVID-19 vaccine intranasally to infected hamsters and monkeys reduced viral loads in nasal swabs, suggesting reduced shedding.
Learn more
Brain cancer liquid biopsyBrain cancer liquid biopsy
Early detection of brain cancer has moved one step closer, according to new research.
CRISPR treatment for blood diseasesCRISPR treatment for blood diseases
A collaborative team of researchers has presented preliminary data showing that a CRISPR-based gene-editing therapy for inherited blood disorders is safe and effective.
Discover the Difference with PlexPrime® SARS-CoV-2 Genotyping* 
Multiplex, single well research reagents to streamline testing for COVID-19 variants of concern (VOC) and focus your sequencing efforts. *Research use only, not for use in diagnostic procedures.
Available now to streamline your testing workflow.
Menarini Diagnostics launches HistosMATE: the unique cleaning system for wax contaminated tools 
We are excited to announce the expansion of our comprehensive instrument range with the new fully automated cleaning system HistosMATE for wax contaminated tools.
The big question: how can we make labs more sustainable?

A recent IBMS Chat on Twitter discussed sustainability in the laboratory and it was interesting to see examples provided of waste, both within and outside of the laboratory.
Learn more
The silent pandemic: antimicrobial resistance

Infections caused by antimicrobial-resistant organisms are increasing. From dog food to climate change, we look at the issues.
Learn more
Mapping your career

Mapping your career

Podcaster Amelia Travers explains how and why she charts the careers of STEM professionals and showcases some of the maps she’s created. 
Learn more

2 September 2021 (Thursday) - Professional Indemnity Cover

I had emails from both the HCPC and the IBMS today. As part of re-registering with the HCPC I had to confirm I’m meeting their CPD standards. Hopefully this blog is doing the trick?

I also had to confirm that I’ve got professional indemnity cover which I have with the IBMS…

And then having agreed to everything I had a look to see what the IBMS had to say. They announced that they were stopping their professional indemnity cover from the end of this month. In their email they did say: “If you are employed by the NHS, then any claim made against the NHS in respect of poor or negligent treatment of a patient, which you may have been a part of, will be insured by the NHS under the State’s medical malpractice cover. In this circumstance, you will not need to buy your own medical malpractice policy”.

I can’t help but wonder if this is true? Perhaps I might need to join a union again just in case?