Final revision haematology

example of data security in LIMS

NHS synnovis cyber attack

Illumina

NGS, FL&RT, LP → CG → S → DA

example of Big data

CAR-T outcome in B-ALL response prediction

Example of AI drug discovery

Baricitinib, JAK inhibitor in RA and COVID, Autowise in molecular prediction @ JAK pathway

Liver cancer

Affect hepatocytes in erythropoietin func., Pro-inflamm. cytokines release, impair immune system

acute phase reactants in liver cancer

Hepcidin in downregulating ferroportin, maintain iron retention in cells

Serum ferritin elevation during infection, high iron absorption reduces iron for haemoglobin production

Pro inflamm. in liver cancer

TNF, IL-1, change emphasis of erthropoiesis to WBC development @ bone marrow

Immune system impairment in liver cancer

tumour associated macrophages facilitate tumour growth

Cisplatin

chemotherapy induced pancytopenia, bone marrow displacement, nephrotoxic reaction oxygen species

cisplatin thrombo/leucocytopenia

neutropenic sepsis, WBC/platelet count determines chemotherapy fit

nephrotoxic reaction oxygen species

FBC kidney function monitoring, EGFR

Leucoerythroblastic anaemia

Tumour growth displace bone marrow, blast/immature RBC present in peripheral blood film

Leucoerythroblastic anaemia vs haematological malignancy

immunophenotyping, polyclonal vs monoclonal

Haemolytic anaemia

in malignant patients, abnormal inflamm. system or drug induced by RBC bind blocking immune system destruction, WAIHA CAIHA, antiglobulin test

WAIHA

warm, Novel IgG antigen, complementary antibody triggers complement mediated destruction and splenic macrophage phagocytosis

Complement mediated destruction

complement cascade → membrane attack complex → cell destruction

Splenic macrophage phagocytosis

Destroys RBC cell structural integrity, returns to spheres

CAIHA

cold, cold-agglutinin disease and PCH

Cold-agglutinin disease

IgM antigen cause RBC agglutination, blood vessel blockage cause ischaemia

PCH

IgG antigen triggers DL antibody

Blood vessels in tumours

blood pooling, vessel looping, incomplete vessel, 10x permeable

permeable vessels in tumours

improper growth through VEGF imbalance and lack of connective tissue, increase chemotherapy bioavailability but allow fibrin deposition

Fibrin deposition

tissue factor binds with factor seven, activate extrinsic coagulation pathway, induce MAHA

Aplasia

severe pancytopenia, acquired immune vs non-immune mediated

Acquired immune mediated aplasia

associated with thymoma, antibody production vs erythroid pre-cursors

Non-immune mediated aplasia

Bone marrrow failure, chemotherapy therapeutic end-point

Parneoplastic syndrome

complications from abnormal inflamm. state of cancer instead of cancer itself, hepcidin elevation in liver, PNP-polycythaemia, Methotrexate

PNP-polycythaemia

tumour produce erythropoietin like peptides, stimulate excess RBC formation, JAK2 mutation differential

Methotrexate

Part of combination therapy, psuedo-folate deficiency by folate inhibition, cell swelling

Renal disease

impaired hepatocytic erythropoietin production

Dialysis

Anaemia before dialysis cuz of nitrogenous waste, novel antigen induce HTR, erythropoietin injections

Hepatic disease

Clotting defects, pancreatitis,vit K, F2,7,8,10, bile colipase lipase

Sepsis

systemic infection cause leukemoid infection, CML appearance, DIC complication

DIC

83% sepsis, full body → exhaustion, LPS virulence factor in gram neg, D-dimer