30 August 2021 (Monday) - BTLP-TACT Exercise

With a spare few minutes I logged in to the BTLP-TACT software to see if I might get a quick one done. If I’m going to get two done every month I realised I was cutting it fine.

I was presented with one case – a seventy-six year old woman with PR blood requiring group & save. She grouped as O Rh(D) Positive with a negative antibody screen.

I pressed the “exit scenario” button with a sense of “was that it?”; convinced I’d missed something, but I got the green light.

27 August 2021 (Friday) - ASH Update

The nice people at the American Society of Hematology focussed on haemostasis in today’s update. Perhaps a tad over my head? But then that’s why I need to do CPD…

Here are the highlights in clotting disorders:
Does Khorana Score Accurately Predict VTE in Patients With Uterine and Ovarian Cancer?
At the 2021 ASCO Annual Meeting, researchers shared results from two studies examining the Khorana score for predicting VTE in patients with gynecologic cancers.
Dabigatran Etexilate Approved for Children with VTE
The FDA has approved the first oral anticoagulant for the treatment of children with venous thromboembolism who have received injectable anticoagulants for at least five days, or as prophylaxis for recurrent thrombosis.
Comparing VTE Recurrence, Bleeding, and Death in Isolated Distal Versus Proximal DVT
Patients with isolated distal DVT and proximal DVT have similar long-term rates of VTE recurrence, bleeding, and death, according to an analysis of real-world data published in the Journal of Thrombosis and Haemostasis.

25 August 2021 (Wednesday) - Transfusion News Update

In something of a break with tradition the Transfusion News email wasn’t as relevant to my daily round as it usually is. But still interesting nonetheless…

Convalescent Plasma Does Not Prevent Disease Progression in COVID-19 Emergency Room Patients
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August 24, 2021
Very few therapeutic options are available early in infectious disease epidemics with the exception of convalescent plasma. In August 2020, the U.S. FDA authorized COVID-19 convalescent plasma (CCP) for the treatment of hospitalized patients with COVID-19 based on a large observational study, which reported the risk of death was substantially lower in patients who received a higher titer CCP. Several more recently published randomized controlled trials, however, did not show CCP improved outcomes in patients with moderate to severe disease. [Read More]
Join us to learn about the blood groups and antigens recently recognized by the ISBT
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In this new Transfusion Science Webinar, Dr. Christoph Gassner, professor of Medical Biology at the Institute for Translational Medicine of the Private University in the Principality of Liechtenstein, will walk us through the process of recognizing new blood group systems and antigens. Using the most recent blood group systems identified by the ISBT from 2019 to 2021, he will show how complex it is for a blood group to be fully recognized. [Register Now]
SARS-CoV-2 Seropositivity of U.S. Blood Donors Prior to Availability of Vaccines
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August 18, 2021
In the United States, blood collection organizations, including the American Red Cross (ARC), started testing all donations for antibodies to SARS-CoV-2 as an incentive for donation and for the identification of COVID-19 convalescent plasma donors. From June 15 to November 30, 2020, prior to the availability of COVID-19 vaccines, the ARC collected 2,191,731 whole blood, red blood cells, and platelet donations from 1,531,221 donors. [Read More]
Mean Fluorescence Intensity to Select HLA-Matched Platelets
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August 13, 2021
Over two million units of platelets are transfused each year in the United States—the majority to hematology-oncology patients. Alloimmunization against class I human leukocyte antigens (HLA) can lead to platelet transfusion refractoriness (PTR); finding matched or compatible platelets is challenging and time-consuming. Thus, other matching methods are under investigation. [Read More]

21 August 2021 (Saturday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise – the boss had sent me an email saying that I hadn’t done one for a while… and to be fair he’s got a point. It is five weeks since I last did anything on there. Which is odd – I can distinctly remember doing one of the morning before the night shift on 3rd August… Just goes to show that you shouldn’t rely on memory… Anyway…

I was presented with two cases.

93616 – an eighty year old chap requiring group & save prior to a splenectomy. He grouped as B Rh(D) Positive with a negative antibody screen

08316 – a forty five year old woman in theatre also requiring group and save

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

 I got the green light.

21 August 2021 (Saturday) - Social Media

There was a question asked on the Facebook “Blood Bank Professionals Group” today. The question was about whether or not two blood groups should be obtained on a patient before issuing anti-D, but that is immaterial. One person in the discussion wrote “With the turnover and incompetence we have in our admissions department, I do not trust them to admit the patient to the right medical record number”. In response to that I did type the question “are some people stupid?”, but realised that I didn’t need to post that question. Some people demonstrably are.

Last year I saw the aftermath of something similar on another Facebook group. Someone had posted something equally damning about their workplace in a public discussion. One of her colleagues saw it, reported it to management, and the woman was out of a job by the end of the week.
In a previous job I once got a written warning for saying that I was tired on a night shift.

It took me less than one minute on Google to find that there were precious few hospitals anywhere near where the author of this comment lives. I’m sure her manager would be horrified to see this in print.

Dear readers – be *extremely* thoughtful about what you post to social media.

20 August 2021 (Friday) - Myeloma

The American Society of Hematology sent a little update on Myeloma today. Some of it went over my head… Knowing that something has gone over my head shows me where I need to be focussing my CPD, doesn’t it…

Here are the highlights in multiple myeloma:
Analyzing Survival Outcomes With Ixazomib-Rd in Relapsed/Refractory Multiple Myeloma
While treatment with ixazomib, lenalidomide, and dexamethasone was shown to improve progression-free survival, recent findings show the triple combination therapy may not prolong overall survival.
FDA Warns of Increased Death Risk for Patients with MM Receiving Melphalan Flufenamide
The FDA requires that Oncopeptides AB suspend enrollment in the OCEAN trial and other ongoing clinical trials involving melphalan flufenamide because of an increased risk of death among patients with multiple myeloma receiving the treatment.
Isatuximab Plus Carfilzomib and Dexamethasone Improves PFS in Relapsed/Refractory MM
Recent results suggest that combination therapy consisting of carfilzomib and dexamethasone plus isatuximab is associated with improvements in progression-free survival and depth of response.

The August issue explores hematologic conditions in athletes, a blue top tube shortage, and more.

20 August 2021 (Friday) - BBTS Conference

The BBTS sent me an invite to their annual conference today. I am *incredibly* cynical about this sort of thing. Whilst in theory there are all sorts of lectures and symposia being presented, for so many years this sort of this was just an excuse for a big party with your old mates in works’ time and at works’ expense.

Have things changed nowadays? I hope so, but at two hundred and fifty quid (plus accommodation costs) it’s a bit steep. I can’ help but think that far more could be achieved by presenting all the lectures as podcasts, and those who want a party can sort one out for themselves.

19 August 2021 (Thursday) - UKAS Update

The nice people from UKAS sent their update today. You can read it by clicking here. As always I question its relevance to what I do every day. I wish someone could explain what use it is in plain simple English…

(Am I being cynical… Even quality managers with whom I have spoken seem to feel that any benefit of quality management is deliberately buried under a mountain of buzz-words and catch-phrases…)

19 August 2021 (Thursday) - The Oncologist Newsletter

The nice people at “The Oncologist” sent their update today. As is always the case with their stuff, much of it went over my head, but some of it made some sense…

Featured Content

Practice-Changing Article

NEPA Versus Aprepitant for Prevention of Chemotherapy-Induced Nausea and Vomiting 

Guidelines suggest that NK1RA agents are interchangeable. This article reports the first study comparing one NK1RA (oral NEPA [netupitant/palonosetron]) with another (aprepitant) in patients receiving chemotherapy.


Review Article

EMA Review of Isatuximab for Multiple Myeloma

This article summarizes the scientific review of the application leading to EMA regulatory approval of isatuximab combination therapy for multiple myeloma.



In the News


Clinical Trial Results

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

Lessons Learned

  • This study suggests that trametinib has significant clinical activity in non-V600 BRAF mutation and BRAF fusion metastatic melanoma, albeit in a small cohort.
  • All patients with metastatic melanoma should undergo sequencing of the BRAF gene to identify noncanonical BRAF mutations that may indicate benefit from treatment with trametinib.

Aaron Hata, MD, PhD, Alice Shaw, MD, PhD and Rebecca Heist, MD, MPH address the therapeutic landscape of MET-, ALK- and ROS1-driven lung cancers, including the role of the drivers in oncogenesis, a review of the latest advances in targeted therapies and drug resistance, and examination of the different approaches in next-generation sequencing.