Articles & Insights

Patients Malignant Haematology

Waldenström Macroglobulinaemia

I recently reviewed a patient who was found to have an increased level of IgM kappa immunoglobulin, with an IgM paraprotein detected on serum protein electrophoresis. This was an incidental finding on routine blood testing, and the patient remains well. At present, he has no signs or symptoms to suggest an underlying lymphoma. However, the presence of an IgM paraprotein does carry an increased risk of progression over time to a blood cancer, most commonly a type of non-Hodgkin lymphoma called Waldenström macroglobulinaemia, also known as lymphoplasmacytic lymphoma. Much less commonly, an IgM paraprotein may be associated with multiple myeloma, which arises from plasma cells rather than lymphocytes. With this in mind, I have put together this patient-friendly article about Waldenström macroglobulinaemia: what it is, how it is diagnosed, when treatment is needed, and what modern treatment options are available.

Ivo Andrejco · 17 May 2026
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Patients From Clinics

What is Southeast Asian (SEA) Alpha Thalassaemia Trait?

Alpha thalassaemia is a genetic (inherited) blood condition that affects how your body makes haemoglobin—the protein in red blood cells that carries oxygen. In the Southeast Asian (SEA) type, two of the four alpha-globin genes are missing (deleted). This is sometimes written as: 👉 -- / αα

Ivo Andrejco · 24 Mar 2026
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Professionals Rare Diseases

When to Suspect VEXAS Syndrome: A Practical Guide for Clinicians

Since its discovery in 2020, VEXAS syndrome has rapidly emerged as an important cause of late-onset systemic inflammation associated with clonal hematopoiesis. The syndrome is increasingly recognised in patients previously labelled as having refractory autoimmune disease, relapsing polychondritis, or unexplained inflammatory syndromes with cytopenias.

Ivo Andrejco · 10 Mar 2026
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Professionals

Monoclonal B-cell lymphocytosis

Monoclonal B-cell lymphocytosis (MBL) is a blood disorder defined by a small, clonal expansion of B lymphocytes that lack features of leukemia or lymphoma. It is considered a precursor state to chronic lymphocytic leukemia (CLL) but is not itself a cancer. Most people with MBL remain asymptomatic and never progress to CLL.

Ivo Andrejco · 10 Mar 2026
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Professionals Non-malignant Haematology

Easy bruising

Easy bruising is a very common reason for referral to a haematologist that rarely results in the diagnosis of a serious underlying bleeding disorder

Ivo Andrejco · 10 Mar 2026
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Professionals Non-malignant Haematology

Erythrocytosis

The haemoglobin, haematocrit and red blood cell count reference ranges will vary depending on the age, gender and pregnancy status of the patient, as well as the laboratory performing the test. In general, a haemoglobin > 165 g/L in males and >145 g/L in females; and a haematocrit > 0.5 in males and > 0.44 in females is considered elevated. An elevated haematocrit should be demonstrated on more than one occasion to ensure the change is not artefactual.

Ivo Andrejco · 10 Mar 2026
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Professionals Non-malignant Haematology

FBC abnormalities in liver disease

Chronic liver disease is associated with a range of full blood count abnormalities. The mechanisms of these changes are multifactorial and can be related to portal hypertension with splenomegaly/ hypersplenism, marrow suppression from medication or alcohol use, reduced thrombopoietin production and chronic viral infections associated with liver disease (e.g. hepatitis C).

Ivo Andrejco · 10 Mar 2026
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Professionals Non-malignant Haematology

Leukocytosis

The white blood cell count reference range will vary depending on the age, gender and pregnancy status of the patient, as well as the laboratory performing the test. In general, the white blood cell count is considered elevated when it is above 11 x 109/L.

Ivo Andrejco · 10 Mar 2026
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