Baffled by blood? Confused by coags? Traumatised by TTP? Planning on quitting medical school because you've just finished haem block? Join the fellows of the Bloody Minded Crew as they tour the world of haematology one topic at at a time while procrastinating from their day jobs. Your time is precious, so to maximise your return we look at each topic at a variety of levels so you can tailor your learning. Check out more at www.bloodyminded.com.au
Episode 99 - It’s the B’s Knees | In The Lab : B12 and B9 (Folate) Testing
Two vitamins survived the great B-numbering cull to become the tests we order most and trust least. Meet the 80% of your B12 result your cells can't touch, and the antibody that sabotages the very test built to catch it. Join the Bloody Minded Crew as we come to the lab for a second time this season to learn how B12 and folate assays are performed. TIMESTAMPS 0:55 - The boys check out a new lab 2:25 - Episode overview 3:43 - Sample requirements 4:12 - B12 refresher 6:03 - Total B12 assays 9:36 - Caveats in interpretation 14:00 - Active B12 15:59 - MMA and Homocysteine 18:13 - Folate testing 22:18 - Take home messages Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 98 - Liver Storage World | Approach to Hyperferritinaemia
‘This bad boy can fit so much iron in it’ he said slapping the roof of a badly photoshopped molecule of apoferritin superimposed on a car. Is too much ferritin bad for you? Of course it is - too much is precisely the quantity that is in excess. But most of the time hyperferritinaemia has nothing to do with iron overload. Strap in to your 1992 Honda Civic as the Bloody Minded Crew learn all about ferritin, and why most of the time too much of it has nothing to do with your iron levels at all. Also join Cale specifically as he continues his vendetta against hepatology and their referrals. Timestamps 0:59 - Bashar visits the salon 2:03 - Hyperferritinaemia overview 3:13 - Ferritin vs Iron Overload 6:08 - Signs and Symptoms associated with Hyperferritinaemia 10:50 - Causes of Hyperferritinaemia w/o Iron Overload 16:59 - Hyperferritinaemia w/ Iron Overload 21:30 - Chelation 22:43 - Erythoferrone 24:16 - Summary Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
BONUS - BloodyMinded x THANZ go to ISTH2026
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. Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 97 - There's a Hole in My Bucket | Iron, B12 and Folate Deficiency in Clinic
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 Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 96 - On the Ning Nang Nongs | B12 and Folate Metabolism
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 Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 95 - Feeling Rusty? | In The Lab: Iron Studies
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 Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 94 - It should be a Fe-lony | Interpeting Iron Studies
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 Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 93 - The Silmaril-IRON | Iron Metabolism
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 Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 92 - On The Wards: A Practical Guide To Anticoagulants | Part 3 (Fancy Anticoagulants)
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 Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 91 - Have you tried turning it off and on again? | Allogeneic transplant in AML with Prof John Moore
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 Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 90 - GENEsis | In the Lab: NGS in AML with Dr Michael Krigstein
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 Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 89 - What is this, disease for ants? | MRD in AML with Dr Jad Othman
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
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 messages Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 87 - Flitting About | In The Lab: FLT3 and NPM1
“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 messages Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 86 - You Ugly | In The Lab: Bone Marrow Dysplasia
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 Messages Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 85 - Wake Me Up! | Acute Promyelocytic Leukaemia (APML)
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 Syndrome 41:04 - Treatment SEs 44:18 - Microgranular Variant 47:00 - Summary and Takehomes Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 84 - Chemotherapeutic Boogaloo | AML Part 2
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 - Summary Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 83 - On The Wards: The NBM Transplant Patient
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 summary Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 82 - MDS 102 | Much More on Myelodysplastic Syndrome
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 Messages Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
Episode 81 - In the Beginning... | Myeloid Precursor Conditions (CHIP, ICUS, CCUS)
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 messages Support the show Check out show notes, additional references and (sometimes) extra content at www.bloodyminded.com.au
