Haematological Malignancies and Transplantation

Module details

Title

Haematological Malignancies and Transplantation

Type

Specialist

Module code

SLS127

Credits

10

Requirement

Compulsory

Aim of this module

This module will provide the trainee with knowledge and understanding of the pathophysiology, clinical presentation and management of patients with haematological malignancies, transplantation and appropriate investigations. In the work-based module they will be expected to apply this knowledge as they learn to perform relevant laboratory methods and gain experience of the interpretation of patient results in a variety of clinical settings.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1	Competency Select the appropriate immunological assay to investigate the immune system of a patient with a haematological malignancy for all of the following: chronic lymphocytic leukaemia acute leukaemia lymphomas multiple myeloma Waldenström’s macroglobulinaemia post-bone marrow transplantation lymphocyte levels (immune reconstitution).	Action View
# 2	Learning outcome 1,2	Competency Perform the appropriate immunological investigations, to include the following: flow cytometry morphological assays relevant molecular techniques electrophoresis free light chains immunoglobulin measurement.	Action View
# 3	Learning outcome 3	Competency Interpret data from  immunological investigations. To include the following: flow cytometry morphological assays relevant molecular techniques electrophoresis free light chains immunoglobulin measurement.	Action View
# 4	Learning outcome 3,4	Competency Interpret immunological data in light of clinical details and be aware of the process of authorising written reports of patients with a variety of haematological malignancies.	Action View
# 5	Learning outcome 3,4	Competency Assist with the clinical laboratory work-up of patients awaiting haemopoietic stem cell transplantation.	Action View

Assessments

You must complete:

• 2 case-based discussion(s)
• 2 of the following DOPS/ OCEs:

Perform the correct staining procedure on a tissue biopsy taken from patient with suspected haematological malignancy	DOPS
Perform serum electrophoresis and or capillary electrophoresis on patients suspected of haematological malignancies	DOPS
Perform the Serum free lite chain assay	DOPS
Demonstrate that you can prepare an interpretive report on a haematological malignancy such as CLL	DOPS
Prepare an interpretive report on a haematological malignancy such as myeloma	DOPS
Prepare an interpretive report on a haematological malignancy such as an acute leukaemia	DOPS
Perform flow cytometric immunophenotyping on a patient suspected of acute leukemia	DOPS
Perform flow cytometric immunophenotyping on a patient suspected of lymphoma	DOPS
Prepare DNA from a patient with a suspected haematological malignancy	DOPS
Attend an adult haematology clinic where haematological patients with myeloma may or may not have secondary immunodeficency and specifically note the types of laboratory assays that may be requested to assist in their management	OCE
Attend an adult haematology clinic where haematological patients with CLL may have may not have secondary immunodeficency and specifically note the types of laboratory assays that may be requested to assist in their management	OCE
Attend a paediatric haematology clinic where haematological patients with acute leukaemias will be assessed and specifically note the types of laboratory assays that may be requested to assist in their management	OCE
Attend an adult haematology clinic where haematological patients with lymphomas are being assessed and specifically note the types of laboratory assays that may be requested to assist in their management	OCE
Obtain a patient history from a normal volunteer or typical patient referred to your service and present the findings to a colleague or peer.	OCE

Learning outcomes

1. Select and perform laboratory tests for haematological malignancies and data analysis.
2. Undertake the clinical laboratory work-up of patients awaiting haemopoetic stem cell transplantation.
3. Interpret results of investigations for haematological malignancies and transplantation in the correct clinical context.
4. Work in partnership with other clinical specialisms in the investigation of haematological malignancies and transplantation.

Learning outcomes

1. Explain the classification, aetiology and genetics of haematological malignancy.
2. Describe the design, operation and performance of laboratory and molecular techniques used in the investigation and management of haematological malignancy.
3. Discuss the principles of bone marrow and stem cell harvests and their role in transplantation programmes.
4. Discuss the principles and mechanisms of chemotherapy, immunotherapy and radiotherapy and their use in haematological malignancy.
5. Explain the importance and implementation of national (e.g. NICE) guidance on the diagnosis and management of haematological cancer.
6. Discuss the importance of integrated diagnosis of haematological malignancy.
7. Describe the partnership between the haematology laboratory and other clinical specialisms in the investigation of haematological malignancy and patient care.

Indicative content

Current concepts on the aetiology, pathogenesis and molecular mechanisms involved in:

• Myeloid malignancy
• Lymphoid leukaemia
• Lymphoma
• Myeloma and plasma cell disorders
• Myelodysplastic syndromes
• Diagnosis and management of the above
• Myeloproliferative disorders and their diagnosis and management
• Bone marrow failure syndromes
• Blood and bone marrow transplantation regimens
• Principles of chemo- and radiotherapy and the rationale behind Medical Research Council (MRC) acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL) trials
• Survival rates in haematological malignancy
• Internal quality control (IQC) and external quality assessment (EQA) in haemato-oncology
• BCSH guidelines in haemato-oncology; NICE improved outcome guidance

Activities

• Prepare case reports on newly diagnosed patients and follow-up patients in a haematological malignancy outpatient clinic and critically appraise the process of diagnosis, treatment and management.
• Prepare for and contribute to multidisciplinary review meetings where immunology results are presented as part of the clinical record in patients with haematological malignancies, and reflect on your contribution, identifying areas that went well and those that could be improved for future meetings.
• Attend clinics at which patients are being investigated for haematological malignancies.
• Critically appraise the internal quality control and external quality assessment performance of the different methods used in the diagnosis of haematological malignancies.
• Contribute to multidisciplinary team meetings for haematological malignancies.