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Background: Recent research in febrile neutropaenia (FN) has focused on reducing the intensity of treatment for those thought to be at low risk of significant morbidity or mortality. This has not led to a reduced burden of treatment for either families or healthcare systems. An alternative approach is to discharge all patients who remain well after 48 hours of inpatient treatment, either with no ongoing treatment or with appropriate antibiotics if the cultures are positive. This paper aimed to demonstrate that this approach is safe.Methods: Patients treated according to this approach in a single centre were reviewed retrospectively, with a random selection of patients from a 4-year period. Data were collected according to the Predicting Infectious Complications of Neutropenic sepsis in Children with Cancer dataset. In addition, all septic deaths over a 10-year period were reviewed in the same manner.Results: 179 episodes of FN were reviewed from 47 patients. In 70% (125/179) of episodes, patients were discharged safely once 48-hour microbiology results were available, with only 5.6% (7/125) resulting in readmission in the 48 hours following discharge. There were no septic deaths in this cohort.There were 11 deaths due to FN over the 10-year study period. Almost all patients were identified as severely unwell in the early stages of their final presentation or had a prolonged final illness.Conclusion: This paper indicates that the policy described provides a balance between safety and acceptability. Further work is needed to demonstrate non-inferiority and cost-benefit. [ABSTRACT FROM AUTHOR]

Background: The National Institute for Health and Care Excellence (NICE) guidance for referral of children with suspected cancer was first published in 2005 and updated in 2015. The updated version relied on sparse primary care evidence and published without input from key stakeholders, for example, acute general paediatricians and paediatric haematologists/oncologists. This led to a document that fell short as a practical guide for referring physicians managing children with potentially life-threatening conditions. Following discussions between the Children's Cancer and Leukaemia Group (CCLG, the UK multidisciplinary professional body for healthcare professionals caring for children with cancer) and NICE, it was agreed that a practical supplement should be produced for the 2015 guidance. A prerequisite was evidence gathering from tertiary care to balance the existing primary care evidence, and a Delphi consensus method was therefore convened.Methods: A CCLG NICE Guidance Committee formulated 25 draft statements for review. The CCLG emailed its paediatric haematologist/oncologist membership (n=179) and 88 responded (49%). To achieve consensus, statements required ≥70% agreement from ≥60% of actual respondents, from the denominator (n=88).Results: Fifteen of 25 original statements were accepted at the first round of voting. Three of 25 statements where >50% did not support were rejected outright. One statement could not be revised without replicating a previously accepted statement. The six remaining statements were revised and a second round of voting undertaken; all six revised statements were accepted. Overall, 21 of 25 statements (84%) met consensus criteria.Conclusions: This expert opinion should help streamline suspected cancer referral in children and help optimise subsequent outcomes. [ABSTRACT FROM AUTHOR]

Avoiding errors in the histological interpretation of bone marrow trephine biopsy specimens requires an unprecedented degree of collaboration between histopathologists, haematologists, specimen requesters, specimen takers, laboratory technical staff and other scientific staff. A specimen of good quality, with full, relevant clinical information is the essential starting point. This must then be processed optimally and investigated appropriately, involving immunophenotyping and molecular testing when needed. A wide range of pathologies may involve bone marrow haemopoietic and stromal components, and a systematic approach to analysing each of the components in turn is required to avoid overlooking abnormalities; correlation with bone marrow cells aspirated in parallel is particularly important. Final interpretation should be a synthesis of the histological findings with information from such haematological and other investigations, interpreted with due regard to clinical context. [ABSTRACT FROM AUTHOR]

Reports the support of British doctors against the conviction and jail sentence of hematologist Jean-Pierre Allain in France. Failure of Allain to stop the distribution of factor VIII infected blood to patients; Career history of Allain; Criticisms on the ruling of the court of appeals.

Focuses on the appeal of Alexandra Hospital consultant hematologist Helen Zeitlin against dismissal from work in Great Britain. Involvement of the West Midlands Regional Health Authority; Basis for the appeal of Zeitlin; Background and context of the case.

The article presents an obituary for Alexander MacKenzie, former consultant and hematologist at Sunderland.

The article presents an obituary for U.S. haematologist Helen Ranney.

The article presents an obituary for Helen Howard, former staff haematologist in Liverpool, England.

The article presents an obituary for John Fairbourne Horley, former consultant haematologist at Royal Sussex County Hospital in Brighton, England.

Reports the reinstatement of consultant hematologist Helen Zeitlin following accusations of criticisms on nurse staffing levels of the hospital. Allegations made by the authority of the hospital; Claims of Zeitlin on the issue; Issuance of a draft by the Department of Health on whistle blowing.