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We calculated the mean, standard deviation and standard error of the mean at each year of age and sex for the specified parameters. With regard to red cell parameters, we found that haemoglobin and red cell count decreased with increasing age, while mean cell volume increased. This is important as RDW is recognised as a poor prognostic marker in a number of disease states. With regard to white cell and platelet parameters, the WBC declines for both males and females until approximately age 10, and then slowly increases with age. The trend in neutrophils closely follows that of the WBC.
The magnitude of changes in WBC with ageing are relatively minor, with only a relatively small increase in neutrophils and a slight decrease in lymphocytes with rising age. The trend found in platelet count is similar to that in other published research and supports the introduction of age specific reference intervals. Additional questions related to employment productivity and activity impairment including absenteeism, presenteeism impairment whilst working and loss of productivity over the past seven days.
Work and activity impairment outcomes are presented as percentages, where higher numbers indicate greater impairment and less productivity. This is the first detailed analysis of the overall burden associated with an MPN diagnosis in the UK. This analysis indicates that MPN patients in the UK experience a high symptom burden and impact on their ability to work.
The overall pattern of symptoms is comparable with other data but for the first time we report the high economic impact of these conditions. Understanding the economic burden of MPNs will help patients and physicians improve disease management. Disclosure of Interest: C.
Harrison Conflict with: Guy's and St. Ali: None Declared, F. Wadelin: None Declared, J. Mathias: None Declared, C. Thomas: None Declared, M. Waller: None Declared, G. Taylor Conflict with: Novartis, Conflict with: Novartis. Data describing the use of bosutinib in patients with CML in the real world clinical setting are limited. The objective of this study was to describe the efficacy and safety of bosutinib in patients with CML used under routine clinical practice. Surviving patients provided written informed consent for data collection; data from deceased patients were collected by a member of the direct care team to preserve confidentiality.
Data were analysed using descriptive statistics with no imputation of missing values denominators presented where data are missing. Median age at bosutinib initiation was Median bosutinib treatment duration was The proportions of patients with cumulative complete cytogenetic response CCyR , major molecular response MMR , molecular response 4. Claudiani: None Declared, J. Viqueira Conflict with: Employed by Pfizer, K. Lang Conflict with: Employed by Pfizer, A.
Furthermore, JAK2 VF is detected in a cohort of patients who do not meet diagnostic criteria for any MPN; the clinical implications of this remain unclear. The patient group was The indication for treatment was painful splenomegaly in 20 Mutation analysis was available for 32 The median duration of treatment was Clinical assessment of spleen size was available for 29 Weight gain occurred in 32 The most common haematologic adverse events AEs were cytopaenias. Forty patients Thirteen patients One patient died from Aspergillus pneumonia.
Therapeutic response and safety profile was similar to trial data although we observed a higher incidence of minor haematologic AEs that were readily managed with supportive care. Weight gain was associated with a strong survival advantage and could prove a useful clinical marker of response. The majority of patients remain on active treatment. Thrombotic complications are common in patients with myeloproliferative neoplasms MPN and of these splanchnic vein thrombosis SVT is associated with significant morbidity and mortality. We describe the development of a mobile app designed to monitor symptoms, blood results and overall quality of life as well as act as a platform to inform and educate patients about this complicated, burdensome and rare condition.
Following this in the 2 nd phase we developed a patient facing mobile app focusing on recording symptoms in a numeric scale using established validated tools for both MPN and chronic liver disease. This was followed by 2 focus group discussions advertised via the MPN patient website where we introduced patients to the app and obtained immediate feedback. The final phase will be to launch the app following necessary changes made after the pilot phase. The median score was 4. Responses to the baseline questionnaires in phase 1 highlighted the significant burden of symptoms and the need to establish better resources for this patient population.
The methodology described above for phase 2 highlights the acceptance of a mobile app as a suitable tool by the patients and their interest in being involved in its development. Disclosure of Interest: L. Pathirana: None Declared, M. Sekhar Conflict with: Novartis, D. Patch: None Declared. Major bleeding is a recognised complication of oral anticoagulant OAC therapy, but there is little information on its associated outcomes. The aim of this multicentre prospective observational study was to characterise the management and clinical outcomes of patients who develop major bleeding whilst on warfarin or direct oral anticoagulants DOAC in the UK.
Between October and September , patients male, female, 1 missing from 32 hospitals were admitted for major bleeding on OAC, with median [interquartile range, IQR] age of 80 [72—86] years. Although the activated partial thromboplastin time APTT is commonly used for monitoring of unfractionated heparin UFH , because of various confounding factors, it may not provide an accurate measure of the amount of UFH present.
Patients with coagulation factor deficiencies and lupus anticoagulant were excluded. This observation was not seen in infants and children. Some of the variation in adults may be accounted for by fibrinogen level. These risks can be mitigated by meticulous attention to individual patient management. By analysing our incidents we developed an understanding of the tasks the outreach service should deliver. These included warfarin dosing on the wards, correct prescribing of direct oral anticoagulants for indications, identification of missed or duplicate anticoagulant dosing, effective bridging anticoagulation, staff education and patient counselling.
In September we introduced the Outreach Anticoagulation Service with an anticoagulation nurse specialist attending all the inpatient wards on a weekday daily basis. The objectives of the service were to ensure optimal anticoagulation for all patients taking into consideration indications, renal function, comorbidities and weight.
During this period the number of incidents reduced from between 20—30 to 3—15 per month currently averaging 9 per month. We maintain a positive risk reporting culture and most reported risks are now no harm incidents as any issues were identified and acted on before there was an adverse impact on the patient. The feedback for this service has been extremely positive. The patients appreciate the personal touch and being able to discuss any concerns with the specialist nurses directly whilst an inpatient.
The staff appreciate the presence of the anticoagulation nurses as a specialist resource which improves the quality, safety and efficiency of their service. Seeing the patients on the ward has significantly speeded up the discharge process for anticoagulated patients and has also reduced the need for the patient to attend an outpatient clinic for anticoagulation counselling.
Time in therapeutic range for all warfarin patients has improved from We monitor and assess all INRs over 6. We are proactive in making changes to the type of drug prescribed and review or stop anticoagulation if able. The Trust is highly satisfied that the objectives of the outreach service have been fully met and it will be maintained. There were 32 deaths, representing The highest mortality rate was in patients in the upper quartile for antibody levels and lowest quartile for antigen levels: This was not explained by the presence of strong inhibitory antibodies and is most likely.
Increasing antibody levels are associated with increased cardiac and neurological involvement. Thrombomodulin THBD is a amino acid glycoprotein expressed on endothelial cells as well as specific epithelial cells, monocytes and megakaryocytes. Recently, several separate families have been described with a hereditary bleeding disorder caused by a premature stop codon in THBD p. Cysstop , transmitted in an autosomal dominant manner. We have identified a family, with an autosomal dominantly inherited bleeding phenotype spanning 5 generations, with a causative novel THBD variant THBD: c.
The molecular aetiology of this was only recently clarified through targeted high throughput sequencing HTS with the ThromboGenomics panel v2. Her mother and maternal grandfather both had a bleeding history with significant post dental extraction bleeding. In addition three first degree and two second degree relatives have since been confirmed as harbouring the same THBD variant.
Two affected children do not have a significant bleeding history although thus far have not incurred any significant haemostatic challenges. Laboratory analysis revealed normal coagulation screens, and coagulation factor levels. The previously reported premature stop variant in THBD is associated with release of THBD from the endothelium into the blood stream, and this novel mutation also leads to hyperthrombomodulinaemia. Calibrated automated thrombography, using citrated plasma without addition of corn trypsin inhibitor, demonstrated a minor reduction in endogenous thrombin potential.
Whole blood model thrombi formed from affected individuals were more susceptible to lysis than normal controls. A diminished contribution of activated thrombin activatable fibrinolysis inhibitor TAFIa to thrombus stability was evident on inclusion of an inhibitor. In conclusion, clinical and laboratory analysis of this family represents only the second THBD variant identified, which causes a bleeding phenotype.
Identification of this variant will permit appropriate planning of management of elective haemostatic challenges and advice for emergency situations. This finding underscores the utility of targeted HTS in genetic diagnosis of bleeding disorders, permitting family screening and preemptive management strategies. Experience shows women find this difficult to tolerate and compliance is poor.
IV iron is costly, has potential complications and is a less permanent solution compared with oral therapy. Women receiving oral versus IV iron had a similar age Tolerance to oral iron was high, with patients However referral was late, with mean This prospective audit compared current practice against national standards. Data was collected prospectively from two inpatient wards and one day unit using a proforma from December to March Patient records were used to establish neutrophil count, investigations with results and antibiotic choice.
Overall, compliance with the antibiotic guidelines was Median neutrophil count was 0. Delay in administration of antibiotics occurred at all stages. There was significant deviation from the trust policy on antibiotic therapy. A proportion of patients were not neutropenic. Investigation of patients was highly variable. Difficulties with data collection means there may be a subset of patients not included.
In response to these findings a nurse lead prescribing proforma has been introduced, which allows the first antibiotic dose to be given by nurses without prescription by a doctor. There has been a review of the recommend investigations for patients with neutropenic fever and education for all clinical staff. Areas for improvement were highlighted and the introduction of a nurse lead initial prescribing proforma has been implemented. Biological age is not a good indicator of assessing those who would benefit from treatment and participation in clinical trials.
Typically an assessment of performance status, comorbidities, cytogenetic and molecular markers should be undertaken and individual treatment plans made. Data was collected using electronic patient records and a chemotherapy electronic prescribing system. We collected baseline characteristics for patients including age, sex, presenting full blood count, marrow blast count, World Health Organisation WHO classification and cytogenetics. There were 25 patients who received intensive chemotherapy e. They all received supportive care.
In our experience, elderly AML remains a significant challenge with poor outcomes. Outcomes are improved with treatment, particularly intensive therapy, but this is associated with a greater time spent in hospital. A personalized approach in cooperation with the individual patient remains the best approach to managing this group of patients.
Current dogma suggests that posaconazole is superior to itraconazole as antifungal prophylaxis in AML induction chemotherapy, however we have not previously evaluated whether these findings translate into practice in our hospital. We looked at secondary endpoints which included escalation to ambisome, length of hospital stay and mortality at day Mean length of hospital stay was The number of patients who needed to be treated with posaconazole in order to prevent a suspected invasive fungal infection was ten.
There was no significant difference in number escalated to ambisome, length of hospital stay and mortality at day 60 between the two groups. These results reiterate the superiority of posaconazole as the antifungal agent of choice in AML induction chemotherapy.
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Antifungal prophylaxis has contributed to improvements in outcome for neutropenic patients treated for acute myeloid leukemia AML. Despite prophylaxis, breakthrough invasive fungal infections IFIs still happen at significant clinical and financial costs. To date, voriconazole has been used as secondary prophylaxis. With the introduction of generic voriconazole we took the opportunity to review practice with the aim of reducing the incidence of breakthrough IFI and analysing the cost of treatment.
The former died after allograft and the latter whilst being palliated at relapse. Analysis was undertaken to compare the costs if posaconazole or voriconazole were to be used as primary prophylaxis. The cost of breakthrough treatment was estimated based on published data. This, taken with estimated costings for other models of prophylaxis, suggest that either voriconazole or posaconazole prophylaxis would be good alternative regimens with cost savings most marked for generic voriconazole.
A key element to the success of any strategy will be limiting the use of breakthrough antifungal therapy to only those with proven fungal infection. Clearly diagnostics have a key role and need to be incorporated within treatment algorithms. These two mutations are associated with high risk in randomised trials for early relapse and poor overall survival with chemotherapy alone.
Targeted genome sequencing identified a mutation in TP53 : a c. The mutation is predicted to give rise to a p. The combination of TP53 deletion and TP53 mutation is associated with early relapse and confers poor prognosis.
The quantitative nature of MRD evaluation means that the standard curve in which the MRD levels can be quantified are reproducible and accurate at low level or residual disease. Patient and disease specific primers must be incorporated with results from the FISH and karyotype for optimal monitoring of disease and risk stratification.
Patients with AML who present with hyperleukocytosis have a poor prognosis because of a higher risk of early death resulting from complications leucostasis, tumor lysis syndrome, disseminated intravascular coagulation alongside a lower rate of complete remission and higher probability of relapse and death. While initiation of cytoreductive treatment either with mechanical removal by leucopheresis or chemical cytoreduction with oral hydroxycarbamide HC or upfront induction chemotherapy is generally recommended, there is a lack of good quality data to guide definitive treatment with variable practices in the UK.
As a district general hospital with limited access to prompt leucopheresis facilities this audit lends evidence that where appropriate upfront induction chemotherapy in order to reduce early mortality and increase the chances of complete remission should be undertaken in this category of patients. Mihailescu Conflict with: Haematology Registrar, D. Mannari: None Declared. However, it is a relatively more toxic regimen associated with prolonged periods of bone marrow suppression and predisposition to severe infections. In this study, we present a single tertiary centre experience in the use of this regimen.
Important prognostic variables including age, cytogenetics, performance status, previous chemotherapy regimen, response rate and overall survival were collected. The median time to relapse was Age n Median age, years range Acute myeloid leukemia AML is the a haematological malignancy characterized by the over proliferation and block in differentiation of clonal stem cells. In leukaemia potential biomarkers such as SA8 could assesses the progression and remission of AML. In further experiments using AML patient bone marrow samples, treatment with JQ1 showed suppression of SA8 and SA9 in some patient samples but enhanced expression in other bone marrows.
In peripheral blood samples of healthy volunteers, we found that treatment with JQ1 showed notable suppression of both SA8 and SA9; with a greater suppression being observed in the monocyte fraction of the samples. The variability of the response seen amongst AML patient samples and AML cell lines may be reflective of the different genetic profiles driving the leukaemogenic process in these samples. Further work may give more detailed insight into the mechanisms of action and potential use of SA8 and SA9 in AML prognostic markers.
Since recruitment opened at BCH eligible patients have been referred through the centre up to December High risk being t 9;22 q34;q The entire set of the trial patients will be used as a comparator on the presented poster. Results are summarised in the table below Table 1. Further exploration into why recruitment is low for this important patient group is therefore warranted. We hypothesised that many patients are being referred for endoscopy with anaemia from causes other than iron deficiency. We also recorded patients not meeting these criteria who had microcytosis, or those with iron deficiency who were not anaemic.
Of the referrals over this timeframe, A further 28 Twelve new diagnoses of cancer were made from the endoscopies, of which 8 patients had proven IDA, 2 patients had microcytic anaemia without proven IDA and two had iron defiency without anaemia. No patients without microcytosis or iron deficiency had a diagnosis of cancer on endoscopy.
In half of the cohort, we also collected information on B12 and folate testing. In four cases 3. Our results demonstrate confusion around the referral criteria for lower GI endoscopy, and a large number of unnecessary endoscopies as a result. There is a clear need for education around what constitutes iron deficiency and a robust vetting process for endoscopy requests, which we are now pursuing in our trust. Medical students are increasingly using YouTube and other digital resources to supplement their learning. Resources published on the internet are widely accessible and may have greater impact, but feedback for content providers can be difficult to acquire via traditional methods.
Online platforms such as YouTube generate detailed usage data which can be used to scrutinise learning resources. Twelve videos, around ten minutes each in length, were published on the subjects of haemostasis, anaemia, and malignant haematology. Eighteen months following the publication of the resource on YouTube, usage data was analysed to improve the quality and direction of future development. The aim was to compare viewing data between topic areas in haematology, and between different learning styles interactive or didactic. Further aims were to demographically characterise the video users and ascertain the routes through which they accessed the resource.
Descriptive analysis of these data are presented. The videos gained a total of 39, unique views. This analysis suggest that there is a demand for online educational haematology videos. This highlights the potential of digital resources for improving access to medical education, and reminds educators of the need to use accessible language in their learning material. CTL phenotype and its proinflmmatory signature were characterised by flow cytometry. There was, however, no difference in GnB expression between treated and untreated patients.
Our objective was to identify learning needs regarding iron deficiency anaemia amongst the junior doctor cohort. Iron deficiency is one of the most common causes of anaemia and the haematology team are frequently contacted for advice on interpretation of iron studies. It comprised four parts. Firstly all participants were asked to identify the typical blood picture of iron deficiency pertaining to MCV, serum iron, ferritin, transferrin saturation and TIBC.
The question was how would this be treated — oral iron, IV iron, blood transfusion or a combination. The third part asked participants if they knew how to access the trust haematology iron deficiency guidelines and whether or not they would like more teaching on iron deficiency anaemia. The final part gave 4 examples of anaemia and the junior doctors were required to correctly identify which picture represented iron deficiency anaemia.
Based upon these findings we have the following proposals. We will also correlate this to the incidence of blood transfusions in the presence of iron deficiency anaemia. Our hope is that overall junior doctors will be more confident in diagnosing and managing iron deficiency anaemia, and the frequency of transfusion of iron deficient patients will fall. Lastly we are liaising with our biochemistry colleagues to stop the reporting of serum iron in this trust as the survey has clearly indicated that this can adversely influence the interpretation of iron studies.
Social media SoMe is an ever expanding field with many potential areas for medical education development. Operational since , TeamHaem is a successful SoMe medical education initiative. There are various SoMe medical education websites and applications. Different formats are available in order to run a successful online project in a chosen field.
We present fictional clinical cases using the blogging website WordPress www. The hashtag TeamHaem is placed in all of our tweets to enable followers to filter the correct information, follow cases easily and attract discussion. Many SoMe platforms e. Twitter, Facebook and WordPress offer free access so setting up a SoMe initiative requires no financial investment.
Deciding a target audience is key. Alternatively some may wish to focus on one area of medical education e. Dedicating time to a SoMe initiative is important to keep followers involved. Failure to deliver updates in a timely fashion may result in user disengagement. SoMe education projects may take the format of case reports, video blogs, clinical scenarios, journal club, image interpretation etc. Many of the radiology and pathology websites will have very short cases based on a single image.
TeamHaem usually runs one case every two weeks. Each case lasts approximately five days and can involve radiographic imaging, bone marrow slides, blood films or transfusion cards. Some SoMe sites make use of videos and live streaming enabling live debates and would also be useful for demonstrating examination or practical procedures.
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Engaging with other medical education sites and active members of the SoMe community will get you noticed. Sharing information, invoking discussion with other SoMe medical education sites will also widen your audience. TeamHaem also attend conferences and present posters and presentations, as well as attending specialty days to help disseminate our objectives.
TeamHaem have also worked with other institutions and SoMe initiatives to encourage interest in haematology and medical education. We have also set up an archive area on our website to allow this to be used as a retrospective learning resource. Professionalism guidelines must be followed; the General Medical Council have clear guidelines regarding SoMe usage.
It is important to ensure no breach of patient confidentiality. All TeamHaem's cases are fictional to protect patient confidentiality. We are clear that we are not an authoritative body and are here to promote haematology and prompt discussion and learning. A retrospective study was conducted to analyse outcomes for patients treated with meropenem in an inpatient Haematology population to determine: 1. Medical records for 20 patients admitted between April and November were reviewed.
Microbiological advice was sought prior to commencement of meropenem in 11 patients. Cessation of antibiotic occurred in response to clinical improvement, fever resolution, and improving CRP. There was no documented toxicity. Nine patients required further courses of antimicrobials prior to discharge, including 2 patients who had a further course of meropenem. The choices of subsequent agent s were based on clinical findings, microbiological isolates and radiological imaging. Patients were discharged following clinical improvement.
Recommendations for future practice include a summary proforma of microbiological investigations in each patient's medical records and clear documentation of the weekly departmental microbiology meetings. Initiation of meropenem is to be discussed with microbiology for all cases and better documented in the notes. The aim of these interventions is to improve antimicrobial stewardship and achievement of the CQUIN, and ultimately contribute to reduction in the development of widespread antimicrobial resistance driven by inappropriate antimicrobial use.
Background: The numbers of patients attending general haematology outpatient clinics is rapidly increasing. Most of our patients are regularly attending for blood tests and review of relatively stable conditions. An empowered patient would be able to make informed choices about healthcare and seek care only when needed. We were investigating how we can, in the near future, leverage new technologies to empower patients to increase autonomy and reduce dependence on hospitals.
Methods: We conducted a patient survey in order to explore attitudes and preferences towards empowerment. Results: 63 responses were received, 61 could be evaluated. Patients who possess smart phones and younger patients were most likely to opt for remote consultations. Conclusion: Patient empowerment programs are effective and successful in many specialties, such as diabetes or haemophilia care. Our data shows that more than half of our patients would welcome alternatives to routine clinic visits and could imagine to take more control over the management of their conditions.
The benefits for patients are greater autonomy and the benefits for hospitals are more efficient use of their outpatient clinics. Chronic kidney disease is associated with increase serum hepcidin level, which contributes to the severity of anemia and to the resistance of erythropoiesis stimulating agents and dysregulation of iron homeostasis. Serum hepcidin correlates positively with ferritin in patients on hemodialysis. This research included seventy subjects, fifty patients and twenty healthy persons as a control. The patients twenty seven males and twenty three females have end stage renal disease ESRD and on regular hemodialysis and were received regular erythropoietin therapy.
All the subjects were clinically assessed and were applied to laboratory investigations in the form of hemoglobin, serum urea, serum creatinine, serum iron, serum ferritin, total iron binding capacity, serum erythropoietin and serum hepcidin. We concluded that serum hepcidin level contributes to the severity of anemia and to the resistance of erythropoiesis stimulating agents in patients have chronic renal failure and on regular hemodialysis, although recombinant erythropoietin has been used to correct the anemia of chronic renal disease but few number of patients fail to respond, so hepcidin can be used as a marker of iron status and erythropoietin resistance.
Table shows Pearson correlations between hepcidin and the different parameters urea, creatinine, haemoglobin, iron, total iron binding capasity TIBC , Ferritin and Erythropoietin in the different studied groups. Tumour lysis syndrome TLS is a well recognised complication in patients receiving chemotherapy for any haematological malignancies.
Rasburicase acts immediately and is extremely effective agent in TLS to reduce the plasma uric acid levels. He had prophylactice rasburicase prior to CHOP chemotherapy. He received prophylactic rasburicase before DA chemotherapy. He managed to complete his induction chemotherapy with no further TLS. This supports the recommendations in the BCSH guidelines that this group of patients should be considered for rasburicase prophylaxis despite their risk assignment based on tumour features.
From our experience, we suggest that low risk group with severe renal impairment would also benefit from rasburicase prophylaxis as allopurinol could itself be nephrotoxic. Patients were recruited primarily via patient support groups. Content was designed so that results were easily comparable throughout. Physicians had a mean of Patients and physicians reported their treatment goals for each MPN. Results demonstrated that there is an inconsistency in the satisfaction of communication between patients and physicians, and that MPN patients and treating physicians in the UK are not aligned on some key treatment goals.
To increase physician satisfaction and improve patient management, better communication is needed around the agreement of treatment plans and alignment of treatment goals. Mead: None Declared, J. Judge: None Declared, J. She was a mother of 3 who had been previously diagnosed with B12 deficiency and was on regular Hydroxocobalamine injections with her GP. On examination she was of short stature with obvious angular cheilitis and low BMI, but no lymphadenopathy or splenomegaly.
On neurological exam she had tandem gait ataxia and impaired sensation to pinprick and vibration in a stocking distribution, but normal joint position sense. Further investigations were arranged. B12 and folate levels were both noted to be normal. Urinary electrolytes demonstrated a similar picture with low copper 0. The blood film showed marked neutropenia and the presence of atypical lymphocytes. Bone marrow aspirate and trephine showed a cellular marrow with trilineage haemopoiesis, left shifted myelopoiesis with no dysplastic features.
MRI spine was normal. Peripheral neuropathy screen was negative. The findings are consistent with severe copper deficiency secondary to zinc toxicity, with the most likely source the patient's zinc containing dental fixative.
This led to rapid normalisation of her blood counts. A dental referral was made to suggest alternative non zinc containing fixative cream. Sadly however, the neurological symptoms are yet to improve. Copper deficiency or Hypocupraemia is a rare, yet recognised cause of ineffective haemopoiesis and myeloneuropathy.
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Zinc toxicity most commonly occurs due to accidental overconsumption of vitamin supplements, ingestion of coins or zinc containing dental products. Clinicians should consider investigating copper deficiency in patients with cytopenias. This is especially important when there are any concurrent neurological symptoms or the initial investigations are inconclusive. Early recognition is crucial to reversing life threatening blood count abnormalities and preventing progression of the neurological symptoms.
Treatment is simple and shows rapid improvement of the cytopenias with intravenous replacement. Many haematology departments have large numbers of new clinical referrals. Reducing unnecessary clinic appointments should be a priority to optimise limited resources. To date, 16 individual consultant replies have been received. There was also a marked discrepancy in which patients could be discharged from clinic, if at all. However for most conditions there are currently no gold standards to follow.
Of the 20 scenarios given, currentlly only 2 had applicable BCSH guidelines. Background: Autoimmune haemolysis AIHA is a rare condition, presenting in around 1 per , patients per year. It is a chronic condition and the aim of therapy is disease control with minimal side effects. We aim to see if our diagnosis and management reflected BCSH guidelines.
Data on investigations and management were obtained from hospital computer systems. Results: 20 patients were diagnosed with warm AIHA. Data on management of 2 patients was unavailable. There were no unexpected findings on CT. Most BM biopsies demonstrated normal haematopoiesis or erythroid hyperplasia. Background lymphoproliferative disorder was found in 1 patient; this has not needed treatment. The median therapy duration for these patients was