Manu Juneja

Allogeneic stem cell transplantation (alloSCT) is a potentially curative treatment for diseases including myelodysplastic syndrome, leukaemia and lymphoma. However, the cost and resource requirements of alloSCT is significant, totalling to in excess of $250,000USD in the United States [1, 2]. Poor graft function (PGF), defined as multilineage cytopenias in the presence of complete donor chimerism, is a significant complication of alloSCT [3].

With the guarantee of a training position and a pathway to consultancy, Australian medical trainees might have greater capacity to focus on clinical excellence and patient care, rather than competing in a qualifications arms race. I read with interest Dr Witter and Dr Hodge’s essay on the need for reform in vocational training and agree with their well argued contention that structural change is necessary to improve trainee wellbeing.

TO THE EDITOR: We read with interest the latest American Society of Hematology (ASH) guidelines addressing thrombophilia testing in patients with venous thromboembolism.1 Unfortunately, we believe the following 2 significant issues were not addressed: (1) the importance of paroxysmal nocturnal hemoglobinuria (PNH) screening in patients with atypical sites of thromboses (eg, splanchnic or cerebral venous sinus thrombosis) in which there may be evidence of hemolysis or cytopenias and (2) the...