30 October 2021 (Saturday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise…

I was presented with two cases 

62764 – a sixty-five year old chap in out-patients requiring Group & Save

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

92623 – a forty-year old chap in the haematology clinic requiring two units of irradiated blood

He grouped as A Rh(D) Positive with antibody screen positive in cell 1

I requested antibody panels

The IAT and enzyme panels were positive in cell 1 and negative in all other cells which corresponded with anti-Cw

As no units were labelled as Cw negative I selected C negative blood expecting to get a red light…

 I got the green light about which I was rather pleased…

29 October 2021 (Friday) - Transfusion News Update


The nice people at Transfusion News sent their update today.  A couple of snippets about platelet transfusions. Not too much for me to take in this time…

Pathogen Reduced Platelets are Non-Inferior to Conventional Platelets for Hematology Patients

October 28, 2021Results for the PIPER Phase 4 study of psoralen-UVA pathogen reduced platelets (PRPC) (Cerus Corporation) following transfusion were recently presented at the 2021 Annual AABB meeting. In this prospective, open-label, two-arm study at 15 U.S. hospitals, 1068 hematology-oncology platelet-dependent patients (mean age, 57.0 years) received PRPC, and 1223 comparable patients (mean age, 50.6 years) received conventional platelet concentrates (CPC). [Read More]


Cold Storage Affects Platelet Function and Glycoprotein VI Levels

October 20, 2021Maintaining an adequate supply of platelets is laborious and costly since they can only be stored for 5 to 7 days at room temperature and require additional bacterial testing. In the 1960s and 1970s, platelets were stored at 1-6° C, but circulation time of cold-stored platelets is very short and the practice was abandoned in the 1980s. Some studies, however, suggest that cold storage of platelets might actually preserve their hemostatic function and may be best for actively bleeding patients. [Read More]

28 October 2021 (Thursday) - Stem Cell Evidence Alert


The nice people at the Stem Cell Evidence Alert sent their update today. I won’t lie… much of it was beyond me. But some small part of it made sense, and I’d heard of quite a few of the words. And some of it is slowly going round inside my head…


Allogeneic hematopoietic cell transplantation in patients with myelodysplastic syndrome using treosulfan based compared to other reduced-intensity or myeloablative conditioning regimens. A report of the chronic malignancies working party of the EBMT.Shimoni, A., et al. (2021) British Journal of Haematology [record in progress].PICO SUMMARY



On Behalf of the SFGM-TC: Retrospective Comparison of Reduced and Higher Intensity Conditioning for High-Risk Myelodysplastic Syndrome Treated With Allogeneic Stem-Cell Transplantation.Campidelli, A., et al. (2021) Clinical Lymphoma, Myeloma & Leukemia [record in progress]

Treatment of Allosensitized Patients Receiving Allogeneic Transplantation.Ciurea, S., et al (2021) Blood Advances [record in progress]

Autologous and Allogeneic Hematopoietic Cell Transplantation for Diffuse Large B-cell Lymphoma-Type Richter Syndrome.Herrera, A.F. et al. (2021) Blood Advances [record in progress]

The Effect of Duration of Lenalidomide Maintenance and Outcomes of Different Salvage Regimens in Patients with Multiple Myeloma (MM).Ho, M., et al. (2021) Blood Cancer Journal 11(9):158

Impact of conditioning intensity and regimen on transplant outcomes in patients with adult T-cell leukemia-lymphoma.Innoue, Y., (2021) Bone Marrow Transplantation [record in progress]

Impact of allogeneic stem cell transplantation comorbidity indexes after haplotransplant using post-transplant cyclophosphamide.Jullien, M., et al. (2021) Cancer Medicine [record in progress]

Bone Marrow versus Peripheral Blood Graft for Haploidentical HCT with Post Transplantation Cyclophosphamide.Mehta, R. S., (2021) Transplantation and Cellular Therapy [record in progress]Planned granulocyte-colony stimulating factor adversely impacts survival after allogeneic hematopoietic cell transplantation performed with Thymoglobulin for myeloid malignancy.Orfali, N., et al. (2021) Transplantation and Cellular Therapy [record in progress]

Impact of mother donor, peripheral blood stem cells and measurable residual disease on outcomes after haploidentical hematopoietic cell transplantation with post-transplant cyclophosphamide in children with acute leukaemia.Rocha, V., et al. (2021) Bone Marrow Transplantation [record in progress]


26 October 2021 (Tuesday) - A Discussion

A colleague asked if I had a spare few minutes today… I did, and together we sat and looked through a e-Haematimage case study.
I really did enjoy doing it.

Morphology EQA seems to follow the same format these days… someone at NEQAS HQ manages to track down the most obscure case, provide us with rather poorly made and poorly stained blood films, minimal clinical information and pretty much no laboratory data whatsoever. From this we are supposed to guess whether we’ve got a case of Bendii syndrome, xenopolycythaaemia or Andorian measles (forgive me if I appear a tad frustrated).

But today’s case was excellent. We were given full clinical information, full laboratory data, and clear pictures of individual blood cells and of fields of a blood film. Like we would be given in real life.
It turned out that the case was one of Burkitt’s lymphoma. I learned a lot about that specific condition (learned or remembered stuff I’d forgotten – not sure which!) but it was so good to sit with someone and discuss the case. Was that a blast cell? If yes, we said why it was. If no, we said why not. What is the difference between a myelocyte and a promyelocyte? Why is that ?

I spend so much time looking at blood films.. and pretty much all of that time is on my own. Back in the day we used to have morphology workshops. I wonder if we might have those again?

26 October 2021 (Tuesday) - Transfusion Evidence Alert

The nice people at the Transfusion Evidence Alert sent their update today. More information that my poor brain could take in… but I shall have a look at it over the next day or so and more of it might sink in.
Little and often is the way… like CPD…


First-Line Administration of Fibrinogen Concentrate in the Bleeding Trauma Patient: Searching for Effective Dosages and Optimal Post-Treatment Levels Limiting Massive Transfusion-Further Results of the RETIC Study.
Innerhofer, N., et al. (2021). Journal of Clinical Medicine.
PICO Summary available



Roxadustat for the Maintenance Treatment of Anemia in Patients with End-Stage Kidney Disease on Stable Dialysis: A European Phase 3, Randomized, Open-Label, Active-Controlled Study (PYRENEES).
Csiky, B., et al. (2021). Advances in Therapy.

Prehospital Hemorrhage Assessment Criteria: A Concise Review.
Di Carlo, S., et al. (2021). Journal of Trauma Nursing: the official journal of the Society of Trauma Nurses.

Tranexamic acid for prevention of bleeding in caesarean Delivery: an overview of systematic reviews.
Hurskainen, T., et al. (2021). Acta Anaesthesiologica Scandinavica. [Record in progress]

Social Contagion of Vasovagal Symptoms in Blood Donors: Interactions With Empathy.
Mennitto, S., et al. (2021). Annals of Behavioral Medicine: a publication of the Society of Behavioral Medicine. [Record in progress]

Comparison of single versus double tranexamic acid dose regimens in reducing post-operative blood loss following intramedullary nailing of femoral fracture nonunions.
Shodipo, O.M., et al. (2021). International Orthopaedics. [Record in progress]

Restrictive versus liberal transfusion thresholds in very low birth weight infants: A systematic review with meta-analysis.
Wang, P., et al. (2021). PloS one.

Iron supplementation for patients undergoing cardiac surgery: a systematic review and meta-analysis of randomized controlled trials.
Yang, S.S., et al. (2021). Canadian Journal of Anaesthesia / Journal Canadien d'Anesthesie. [Record in progress]



Randomized study of rivaroxaban vs. placebo on disease progression and symptoms resolution in high-risk adults with mild COVID-19.
Ananworanich, J., et al. (2021). Clinical Infectious Diseases: an official publication of the Infectious Diseases Society of America. [Record in progress]

Use of Novel Antithrombotic Agents for COVID-19: Systemic Summary of Ongoing Randomized Controlled Trials.
Talasaz, A.H., et al. (2021). Journal of Thrombosis and Haemostasis: JTH. [Record in progress]