Episodes
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On the Ning Nang Nongs where the youths smoke bongs and the marrow all screams HELP! Join the Bloody Minded crew as they go through the round window, follow B12 and folate around the body in a Nang induced haze, presumably just like the writers on Play School once were.
Mandatory viewing: https://www.youtube.com/watch?v=3SUU1f3Mgpc&list=RD3SUU1f3Mgpc&start_radio=1
TIMESTAMPS
0:53 - A Bloody Minded After School Special
1:50 - Megaloblastic Anaemias
2:59 - An Intro to B12
7:49 - B12 Absorption
12:55 - Role of B12
15:07 - MMA + Homocysteine
16:40 - Causes of B12 Deficiency
20:04 - Nangs - Again
23:18 - Intro to Folate
25:32 - Folate Absorption
27:03 - Folate Deficiency
30:00 - Concurrent B12 + Folate Deficiency
32:18 - Take Home MessagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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Heal with steel? Absolutely not - There’s no alloys or for that matter surgeons allowed in the safe space of the laboratory. Join us on another wonderful lab adventure as Bashar, Cale and Nick head down to the biochemistry lab to work out exactly how our iron studies are performed in the lab before you throw the serum iron in the bin.
TIMESTAMPS
0:53 - An early etymological diversion
2:53 - Serum iron
9:43 - UIBC
11:22 - TIBC
13:34 - Transferrin
15:45 - Transferrin saturation
17:25 - Ferritin
20:42 - Example of how the numbers work
23:31 - The iron stain
25:02 - Take home messagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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Missing episodes?
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Taunted by transferrin? Befuddled by ferritin? Scratching your head at why we throw the serum iron results directly into the confidential waste bin, which is a more dignified burial than it deserves? Come along as the boys discuss the interpretation of iron studies in a definitely tight, definitely 20ish minute episode.
Timestamps
00:54 - Just Iron Studies with No Nonsense
02:21 - Overview of Iron Stuides
03:42 - Serum Iron
05:35 - Transferrin
07:32 - TIBC
08:35 - UIBC
10:47 - Transferrin Saturation (TSat)
12:38 - Ferritin
14:34 - Soluble Transferrin Receptor (sTfR)
15:45 - Invasive Iron Studies
16:52 - Rapid Fire Case Studies ft. Geraldine
22:25 - Summary & Take Home MessagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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One molecule to rule them all, one molecule to find them. One molecule to bring them all, and in the liver bind them. Hepcidin is the key to understanding iron metabolism and we examine how iron gets into, around and out of the body. We promise not to be too Celebrimbor-ing as you join Nick, Cale and Bashar for this discussion of the basic science of iron handling in preparation for our journey into the building blocks of blood. Welcome to Lord of the Haematinics.
TIMESTAMPS
0:56 - The next arc of the Bloody Minded Cinematic Universe
3:23 - Series overview
6:21 - Basic iron metabolism
7:54 - The three main player groups in iron metabolism
8:44 - Iron binding molecules: Heme
13:22 - Non-heme iron
14:05 - Iron binding molecules: Ferritin
17:12 - Iron binding molecules: Transferrin
20:44 - Iron transporters: DMT1
25:02 - Iron transporters: ferroportin
28:21 - Iron transporters: Hephaestin
29:28 - Iron flux
33:24 - Hepcidin: Master Regulator and The One Ring
39:04 - Non-hepcidin regulation of Ferroportin and IREs
41:32 - Take home messagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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Has your ward team been hit with HITT? Is Jane the only Fonda you know? Is BAD an 80s hit and not a trio of anti-coagulation infusions (Bivalirudin, Argatroban and Danaparoid). Is Alison showing her age? Never fear; join Alison, Bashar, Nick and Cale as they aim to de-mystify less commonly used anticoagulation that may come up on the wards.
TIMESTAMPS
0:56 - It's Fancypants Wednesday!
2:15 - Episode overview
4:37 - Fondaparinux
9:07 - When to use fonda
12:35 - Argatroban
17:25 - When to use argatroban
18:02 - Bivalirudin
19:11 - Mandatory historical diversion
22:50 - Back to bivali business
25:59 - Danaparoid
30:21 - When to use danaparoid
32:45 - Quick summary
34:13 - Dalteparin
38:02 - A bit of nonsense chitchatSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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Join us in our third straight week of incredibly nice and incredibly talented haematology gurus as Professor John Moore joins us as an expert guest to discuss stem cell transplant in the myeloid disease setting.
TIMESTAMPS
1:00 – HYTTIOAOA
1:47 – Introducing Professor John Moore
8:06 – Advice to RMOs on the Allo Term
11:02 – The history of allogeneic transplantation
18:26 – Modern morbidity/mortality from alloSCT for AML
23:05 – Use of transplant scoring systems
27:29 – The role of MRD in transplant decisions
30:04 – MAC vs. RIC – Choice of Conditioning
38:15 – The role of PTCy
40:17 – Second allogeneic transplants
42:02 – DLI
43:08 – Biallelic TP53 – no good options
45:29 – Free rein in the trials space
49:11 – AlloSCT/CAR-T for autoimmune disease
55:05 – Take Home MessagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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This week we continue the pattern of guests who are really really ridiculously good at haematology and also really really ridiculously nice people as well. We are very excited to be joined by Dr Michael Krigstein who many of you would know as the a molecular haematology guru who has gotten countless patients through their diagnoses and countless haematology trainees through their exams.
Timestamps:
01:30 - Introducing Dr Michael Krigstein
04:23 - Getting into Lab Haem
08:30 - The Mechanics of NGS
16:57 - Learning to report - RCPA Modules
19:58 - After the NGS - Curation
24:14 - NGS - Not a panacea
28:45 - Why NGS is bad at ITDs
32:42 - Panel Design
36:37 - RNA vs DNA Panels
39:16 - The future of NGS in haematology
46:56 - A standout case
53:36 - WrapupSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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What happens when you take someone who is really really ridiculously good at haematology and also a really really ridiculously nice person as well? You get Dr Jad Othman, consultant Haematologist and Haematopathologist at Royal North Shore Hospital in Sydney who will be joining us today to discuss the use of measurable residual disease in acute myeloid leukaemia.
Dr Othman is well suited to this topic, having written his doctoral thesis on molecular disease assessment in AML, sitting on the European LeukaemiaNet (ELN)-DAVID MRD Working Group as well as numerous ALLG AML and MDS working groups. We're delighted to have him field the Bloody Minded Crew's questions today.
Timestamps
01:00 - The boys making outdated millenial references
02:50 - Getting to know Dr Jad Othman
09:50 - The concept of MRD
11:55 - Lab techniques for MRD
17:59 - Why doesn't everyone have an MRD marker?
20:51 - What makes a good MRD assay?
24:14 - Patients without a molecular MRD marker
26:21 - Clinical case
30:30 - What we do with MRD results
31:47 - The NPM1/FLT3 PB/BM situation
35:31 - Why MRD is actually helpful
39:40 - Why single agent treatment in AML is challenging
44:33 - The 2025 ELN DAVID update
48:44 - Does doing MRD improve OS?
52:21 - The INTERCEPT study
55:41 - Wrap up and summarySupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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Here’s a question, what do CD123, CD4 and CD56 have in common? Other than pleasing The Count on Sesame Street. Sorry, another question perhaps - what happens if you cross a plasma cell and a dendritic cell? The answers to these questions can be found on a most enigmatic myeloid cell - the plasmacytoid dendritic cell. And what happens when these rare beasts become neoplastic - why BPDCN of course. Embark on a journey into this weird and not so wonderful (but highly examinable) neoplasm with the Bloody Minded Crew
TIMESTAMPS
0:57 – A glimpse into Cale's psyche
2:39 – Intro to BPDCN
6:56 – What IS a plasmacytoid dendritic cell?
10:24 – Pathological PDCs in BPDCN
11:42 – Clinical presentation – lots of rash talk
15:23 – Morphology in BPDCN
17:48 – Immunophenotype
21:16 – Karyotypic and molecular features
22:44 – Treatment of BPDCN
24:00 – A bit on prognostic markers
25:03 – Transplant
25:28 – Tagraxofusp
29:15 – Other treatment options
31:33 – Take home messagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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“It’s pronounced nuc-ul-ophosmin” “Nucleophosmin”. “Noo-clee-o-phosmin”. FLT3-ITD got you In The Dumps? Have a Total Knowledge Deficit about TKD mutations? Struggling with the A-B-Cs of NPM1 mutations? Want to know how a cat sarcoma is somehow related to AML? Join the Bloody Minded Crew as they flit about the laboratory looking at the structure of FLT3 and NPM1, what these proteins usually do and how we test for mutations in the advanced myeloid episode.
== Edit 6/5/26 = We've been made aware that strictly speaking the current MANE approved transcript for NPM1.1 has only 11 exons and therefore the mutations are best to be considered in Exon 11 as opposed to exon 12 - in contrast to what we said. ==
Timestamps
0:52 - Bloody Minded issues a formal apology
2:40 - Introducing molecular chaperones
5:05 - What even NPM1?
9:30 - Functions of NPM1
10:55 - Molecular biology of NPM1 in disease
15:42 - Why the subtypes are important
19:53 - NPM1 prognosis
21:35 - MRD testing in NPM1
25:52 - NPM1 summary
27:13 - Intro to FLT3
28:30 - Mandatory FLT3 history
36:28 - FLT3 pathogenesis
37:37 - FLT3 structure, ITD vs TKD
41:16 - The juxtamembrane domain
42:53 - Prognostic features in FLT3
44:17 - TKD mutations
46:26 - FLT3 in the lab
50:30 - Take home messagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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U-G-L-Y, you ain't got no alibi, you dysplastic yeah yeah you dysplastic. Apologies to all the ring sideroblasts out there, but this week the Bloody Minded crew is doing a Mean Girls and judging cells by their morphology. For now we’re deciding to ignore those that would argue that it’s what’s on the inside that counts (i.e. judging by NGS… that’ll come later).
TIMESTAMPS
2:28 - For some reason, an audio podcast on visual dysplasia
5:05 - Normal erythroid morphology
7:17 - Dysplastic erythroid morphology
17:32 - Normal granulocyte morphology
20:00 - Dysplastic granulocyte morphology
28:33 - Monocyte morphology - dysplastic at baseline
30:33 - Normal megakaryocyte morphology
32:24 - Dysplastic megakaryocyte morphology
35:02 - Take Home MessagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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What do arsenic, acne tablets and Jodi Picoult have in common? Why, it must be a deep dive with Nick, Bashar and Cale on acute promyelocytic leukaemia. From buzzwords to brain bleeds, the sweetest of translocations to the cruellest of coagulopathies... The yield is almost as high as the survival rates.
TIMESTAMPS
00:57 - Bloody Minded Poetry Jam & Jodi Picoult
06:25 - APML Starts Here
08:02 - APML - Where does it fit in AML?
10:02 - Morphology & Flow
12:12 - PML::RARA - t(15;17) and rare variants
16:58 - Lab Summary
17:50 - Clinical Presentation
21:02 - APML Coagulopathy
26:46 - Treatment and Risk Stratification
33:53 - High Risk Aside
36:58 - Differentiation Syndrome41:04 - Treatment SEs
44:18 - Microgranular Variant
47:00 - Summary and TakehomesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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After our initial intro to AML back in ep 79, we are back to dig deeper into AML this week, from pathophysiology through to treatment overview. The boys are joined by final year registrar Dr Georgina Calov who is here to cut through our nonsense and deliver some actual high yield content. And thank goodness for that, otherwise it'd be an hour of us making bad April Fool's day jokes.
Timestamps
2:09 - Introducing Dr Georgina Calov
3:34 - AML Refresher
7:12 - AML defined by recurrent genetic abnormalities
15:39 - AML defined by differentiation (aka whats with the M numbers)
18:14 - MN-pCT
19:03 - Prognostication - ELN Classification
21:58 - Diagnosing AML - Clinical
24:16 - Diagnosing AML - Lab
31:39 - New AML Workup
35:50 - Intro to Treatment - Induction in "Fit" patients
41:40 - Treatment - Consolidation & MRD
45:15 - Treatment - "Unfit"
48:02 - Treatment - Supportive
50:16 - Treatment - Relapse/Refractory
55:19 - SummarySupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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Cat got your tongue? Or in this case - mucositis? Does converting the acute allogeneic transplant patient who can no longer eat's medications to IV fill you with dread? In this practical for once episode join consultant haematologist Dr Alison Chandler as well as haematology pharmacists Andriana Colic & Ariana McCauley as they take us through the how to of this challenging, but very common, clinical scenario.
Timestamps
0:58 - Nick's literal nightmare
2:18 - Today's outline
3:38 - Let's meet the A-team!
11:14 - What do you wish the haem doctors knew?
13:38 - Introducing the NBM transplant patient
15:18 - Tacrolimus
17:37 - Mycophenolate
19:51 - Ciclosporine (or cyclosporine or CsA or CyA, whatevs)
22:20 - Hot tip on TDM
23:47 - Antifungals
24:23 - Posaconazole
26:06 - Voriconazole
27:29 - Isavuconazole
28:45 - Echinocandins - mica/anidula
30:52 - Antivirals
33:27 - CMV treatment
37:41 - Antibacterials - PJP prophylaxis
39:22 - The NBM APML patient
43:35 - Antiepileptics
46:24 - TLS prophylaxis
47:53 - Wrap up time!
50:18 - Episode summarySupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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Was episode 79 too light on MDS for you? “Amateurs” you said, adjusting your sellotaped glasses. If so, you’re in the right place today as we prepare to look at classification, risk stratification and treatment of myelodysplastic syndrome. You also should seek out psychiatric attention, or perhaps just go outside. But in the meantime, enjoy this episode where we’ll dig deeper into the nitty gritty of MDS! We’ve got a lot to cover so we float about between intermediate and advanced for this episode.
TIMESTAMPS
1:11 - A Very Unhinged Intro
3:34 - Actual Content Starts Here
5:52 - Differentials for dysplasia
7:54 - Presentations of MDS
12:36 - MDS Subtypes
14:23 - MDS with del(5q)
18:29 - Lenalidomide in del(5q)
25:03 - MDS with SF3B1
29:05 - MDS with biallelic TP53 inactivation
30:26 - Bonus cytogenetic abnormalities that pop up
31:43 - Germline mutations that predispose to MDS and AML
37:14 - MDS with low blasts
38:08 - Ogata Score
39:26 - Hypoplastic MDS
44:03 - MDS with increased blasts
44:58 - MDS with increased blasts and fibrosis
46:22 - Breaking News - Blasts Should Now Be Counted By Flow
48:30 - Prognostic models for MDS
53:36 - Treatments for MDS
1:04:39 - Take Home MessagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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What if the prequel had a prequel? Join Bashar, Nick and Cale as they attempt to unpack the newfangled world of clonal haematopoeisis. Find out how CHIPs can kill and no, it’s not due to eating too many of them too fast. Though that might do it too. We’ve had one spectrum, but what about a second. We need to go deeper.
TIMESTAMPS
0:56 - A classic chippy mixup
2:56 - Episode overview
3:54 - Where CHIP sits in haem
5:15 - Clonal haematopoiesis
11:21 - What genes acquire CH?
13:42 - CHIP
20:09 - Clinical implications of CHIP
24:24 - Increased mortality in CHIP
28:54 - ICUS
32:40 - CCUS
35:42 - Take home messagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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If we’re going to truly understand myeloid disease, we must dispense with the ward and journey to the dystopian heart that beats at the centre of each dysplastic cell. Learn what is valid and in-valid as we swim across an ocean of concepts - past the basic principles of DNA and RNA, Polymerase Chain Reaction and its many many variants, Fragment Analysis and Next Generation Sequencing. Just save a little something for the swim back to clinic next week.
PS The Extra T is for TYOTT
Timestamps
0:55 - Back in the lab, baby!
2:08 - Today's outline
6:24 - What IS molecular testing?
8:13 - The central dogma of molecular biology
14:46 - Types of genetic mutations
20:05 - Nomenclature for gene variants (advanced)
23:52 - Samples for testing
27:42 - What comes after DNA extraction
30:11 - What is PCR and how did we discover it?
38:45 - What we do post PCR
41:27 - Quantitative and RT-PCR
46:54 - Asking the RIGHT question
48:55 - Digital droplet PCR
50:44 - Electrophoresis
52:35 - Fragment analysis and melt curve analysis
54:33 - NGS
1:00:02 - What is a VAF?
1:05:23 - Lab governance (for haem ATs)
1:09:32 - Take home messagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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Happy marrows are all alike; every unhappy marrow is unhappy in its own way. When haematopoiesis behaves itself, it’s frankly quite boring. When it goes rogue, it can get very creative. Join Cale, Bash and Nick as they attempt to walk through how this process goes off the rails, how MDS and AML are best understood and how dysplasia, cytopenias, blasts and clones all fit together.
TIMESTAMPS
0:55 - Our serious introduction to counterbalance last week
1:58 - Episode overview
2:50 - Introducing MDS
7:12 - Risk factors for MDS
8:53 - MDS progression
11:13 - Complications of MDS
13:10 - Leukaemic transformation
15:37 - MDS epidemiology
16:27 - Diagnosing MDS
21:19 - What is dysplasia?
26:44 - What we test on marrow
35:13 - Clonality assessment in MDS
42:29 - Caveats in diagnosing MDS
43:18 - MDS summary (finally)
44:09 - MDS treatment in brief
45:37 - Intro to AML
51:32 - Episode summarySupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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What’s a CHIP and why is it so delicious? Why do we still abbreviate myeodysplastic neoplasm to MDS? How did Bashar get his hands on the Necronomicon? These are questions that every budding haematologist asks themselves at some point and we will answer at least some of them here! Join us today for a birds-eye overview of the myeloid family of disorders before we dig into them more over the coming weeks.
TIMESTAMPS
0:57 - Does anyone know a good priest?
3:17 - Myeloid conditions in bucket form
5:30 - Acute vs chronic in haematological diseases
7:35 - Myeloid precursor lesions
10:33 - Myeloproliferative neoplasms
15:23 - Myelodysplastic syndromes
18:50 - MDS/MPN Overlap Syndromes
22:29 - Mastocytosis
26:02 - Acute myeloid leukaemia
28:23 - (Acute promyelocytic leukaemia)
29:36 - Histiocytic/dendritic cell disorders
31:14 - Take Home MessagesSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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Hi-ho, Hi-ho, it's off the myeloid factory we go. Grab your fastest belt, a spare inserter and all the iron plates you can get your hands on as the Bloody Minded Crew embark on their nerdiest references yet and learn all about the basic science behind myelopoiesis. You’d better hop on a train, because the only main bus here goes straight from the marrow out to the periphery carrying all sorts of myeloid cells. And some blue circuits.
0:52 - New year same us
2:44 - Season overview: myeloid time, baby!
5:15 - What is the myeloid compartment?
7:29 - Myelopoiesis
12:49 - Stem cell destiny... does free will exist?
14:28 - The myeloid progenitor
16:30 - Red cells and platelets
17:46 - White cell maturation
19:34 - Hormonal control of myelopoiesis
21:25 - Historical diversion into GCSF
23:19 - Clinical use of stimulating factors
26:39 - GCSF Bone Pain
28:15 - Emergency Myelopoiesis
30:08 - Wrap UpSupport the show
Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
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