Hematological Malignancy

Module details

Title

Hematological Malignancy

Type

Specialist

Module code

SLS131

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 malignancy. 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 Perform a range of methods for diagnosing and monitoring treatment of haematological malignancy, including: morphology screening immunophenotyping by flow cytometry karyotyping fluorescence in-situ hybridisation panels molecular diagnostics, including: IgH gene rearrangement TCR gene rearrangement BCRABL JAK2 FLT3/NPMI minimal residual disease monitoring post-transplant chimera monitoring.	Action View
# 2	Learning outcome 2	Competency Interpret haematology data in order to aid the classification of haematological malignancies.	Action View
# 3	Learning outcome 2	Competency Interpret laboratory data in light of clinical details and authorise written reports under supervision on patients with lymphoid cell disorders, including: acute lymphoblastic leukaemia chronic lymphocytic leukaemia Hodgkin’s lymphomas non-Hodgkin’s lymphomas acute myeloid leukaemia chronic myeloid leukaemia myelomas.	Action View
# 4	Learning outcome 3	Competency Interpret laboratory data in patients for whom haemopoietic stem cell transplantation is the appropriate treatment.	Action View
# 5	Learning outcome 3	Competency Interpret and comply with appropriate national and international guidelines for the diagnosis and management of haematological malignancies.	Action View

Assessments

You must complete:

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

Demonstrate practical understanding of the principles of flow cytometry	DOPS
Review bone marrow films	DOPS
Describe the WHO classification system and other relevant systems guidelines	DOPS
Perform storage and processing of stem cells prior to transplantation	DOPS
Attend an outpatient clinic and take a case history from a recipient and donor	OCE
Attend an outpatient clinic and take a case history from a recipient and donor medium	OCE
Attend a haematology oncology ward round and take a patient history	OCE
Interpret data and prepare case study to illustrate how laboratory results link to clinical outcomes and explain the results to clinical colleagues	DOPS
Interpret data and present case at an MDT meeting	DOPS

Learning outcomes

1. Perform a range of laboratory and molecular testing techniques used in the workplace to diagnose and monitor treatment of haematological malignancy.
2. Perform laboratory investigations and outline the management of haematological malignancy in the correct clinical context, including the interpretation and reporting of results.
3. Interpret and comply with national and international guidance (e.g. NICE, WHO, BCSH) on the diagnosis and management of haematological cancer.

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. Describe and justify the importance and implementation of national (e.g. NICE) guidance on the diagnosis and management of haematological cancer.
6. Describe and justify 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 regimes
• 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
• IQC and EQA in haemato-oncology
• BCSH guidelines in haemato-oncology; NICE improved outcome guidance

Activities

• Observe a bone marrow aspiration and trephine to experience the importance to the patient of appropriate sample processing. Reflect on and discuss your experience in terms of patient care pathway.
• Observe peripheral blood collection in the outpatients’ clinic setting to gain knowledge of and report on patient experience.
• Prepare case study reports to illustrate how laboratory results link to clinical outcomes.
• Participate in multidisciplinary review meetings at which laboratory results are presented as part of the clinical record in patients with haematological malignancy. Prepare a portfolio of relevant cases, including learning points and clinical outcomes.
• Visit a histopathology and/or specialist laboratory and gain experience of the investigation and reporting of haematological malignancies. Reflect and report on the partnership between different laboratories and their impact on the quality of patient care.
• Attend ward rounds and/or clinics at which patients with haematological malignancy are being investigated and treated. Discuss and report on the process with regard to the role of ward rounds/clinics and their integration with laboratory investigation for patient care.
• Attend a centre where stem cells are processed and stored, and reflect on the procedures and storage conditions used and their importance in maintaining the quality of the cells