Bloody Minded

It's a BONUS episode today as the Bloody Minded Crew are delighted to partner with the Thrombosis and Haemostasis Society of Australia and New Zealand (THANZ). After (correctly) exiling Nick to another country after he suggested yet more coagulation themed episodes, he's returned like Gandalf stronger and more powerful than ever. We cornered THANZ members at the International Society for Thrombosis and Haemostasis 2026 meeting to chat about what was keeping them interested.

Special thanks to Dr Danny Hsu, Dr Sara Ng, Dr George Mason, Dr Angela Huang, Dr Ibrahim Tohini-Esfahani, Dr Emily Powley, Dr Catherine Neal, Dr Marc Ellis, Dr Charithani Keragala, Hadley Bortz and Danielle Boyle for their contributions.

Check out the THANZ website (www.thanz.org.au) and consider signing up if you're an Australian based scientist, clinician, nurse or allied health professional with an interest in Thrombosis and Haemostasis.

There will be no show notes for this episode and our regular programming will continue as usual. 

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Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

Nick wanted to talk about buckets all episode. I’ve convinced him to at least let us get angry at iron polymaltose, hypophosphatemia and nangs all over again. You don’t think you need this episode but you’d be amazed how many consults come through to Haem thinking we’re the gatekeepers of iron in the building. Ironic, really.

TIMESTAMPS

0:56 - 1960s pop culture reference
3:20 - Episode overview
4:40 - Iron deficiency
6:28 - Pica chat
7:53 - Presentations of iron deficiency
8:36 - Causes of iron deficiency
11:10 - Taking a menstrual history
12:53 - Non-menstrual causes of iron deficiency
14:40 - Oral iron replacement
18:19 - IV iron replacement
25:01 - Folate deficiency
27:18 - Folate replacement
29:18 - B12 deficiency
31:19 - Causes of B12 deficiency
32:00 - Diagnosis of B12 deficiency
32:55 - B12 replacement
34:58 - Dealing with concurrent deficiencies
36:20 - Take home messages

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Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

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 Messages

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Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

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 messages

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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 Messages

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Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

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 messages

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Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

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 chitchat

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Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au

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 Messages 

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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 - Wrapup

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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 summary

Support the show

Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au