Hematology

Background While going through the literatures, I came across two landmark articles on the evolution of Monoclonal Gammopathy of Unknown Significance (MGUS) and Smoldering Multiple Myeloma (SMM) by the Mayo Clinic Group headed by Dr Robert Kyle. These articles described the evolution of MGUS and SMM into symptomatic myeloma by reporting cumulative proportion of developing symptomatic myeloma in a population based follow up study. The following figure depicts the progression of MGUS into symptomatic myeloma

Background Recently, I was presenting approach to Thrombotic Microangiopathy in hospital. I made the following notes, which I feel will be beneficial for the residents. Introduction TMA are of diverse etiologies but have unified manifestation a. MAHA (Coombs negative, increased LDH, schistocytes) b. Thrombocytopenia c. Organ injury (ischemic) TMA has unified pathogenesis a. Endothelial dysfunction b. Microinfarcts Approach to treatment a. Primary TMA syndromes (ADAMTS deficiency, HUS): treatment to be of the cause