Immunogenetics

Module details

Title

Immunogenetics

Type

Specialist

Module code

SLS139

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.

This module will provide the trainee with the practical application of knowledge and skills relating to the scientific principles of molecular techniques available for HLA typing and their applications for different clinical conditions.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1,3	Competency Receive samples for HLA typing and enter onto laboratory IMS.	Action View
# 2	Learning outcome 1,2,3	Competency Extract and quantify DNA from samples according to local protocol.	Action View
# 3	Learning outcome 1,2,3,4	Competency Use local molecular based techniques in accordance with quality standards for intermediate resolution HLA typing.	Action View
# 4	Learning outcome 1,2,3,4,6,7	Competency Use local molecular based techniques in accordance with quality standards for High resolution typing.	Action View
# 5	Learning outcome 1,2,5,6,7	Competency Interpret data from HLA typing tests using current nomenclature and produce an HLA typing report for clinical colleagues.	Action View
# 6	Learning outcome 1,5,6,7	Competency Produce an interpretive genotyping report for a patient referred for disease association and pharmacogenetic reactions.	Action View
# 7	Learning outcome 8	Competency Work in partnership with other clinical specialisms in the investigation of disease association and pharmacogenetics and patients referred for transplantation and, where appropriate with service users and support staff.	Action View
# 8	Learning outcome 8	Competency Communicate effectively with the healthcare team recognising and responding appropriately to situations where it is necessary to share information to safeguard service users or the wider public.	Action View

Assessments

You must complete:

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

Prepare a blood sample for molecular HLA testing	DOPS
Quantify and assess DNA samples for purity	DOPS
Perform HLA typing using local molecular methods	DOPS
Prepare an interpretive HLA report	DOPS
Perform tests for a patient referred for disease association or pharmacogenetic reactions	DOPS
Attend a multidisciplinary review meeting at which laboratory results are presented and describe to colleagues what they mean.	OCE
Take a patient history	OCE

Learning outcomes

1. Select and perform HLA typing methods and HLA loci to be tested for solid organ and haematopoietic stem cell transplantation, associated diseases and pharmacogenetic reactions according to current practice.
2. Prepare good quality DNA template for HLA typing techniques.
3. Identify the correct specimen tubes for HLA typing and be able to troubleshoot issues around DNA extraction.
4. Perform all aspects of the current range of molecular techniques available for immunogenetic testing.
5. Report on the results from a range of current techniques available for immunogenetic testing.
6. Apply the specific accreditation standards governing the use of molecular techniques.
7. Select and perform the appropriate HLA typing resolution in accordance with relevant standards required for different clinical applications.
8. Work in partnership with other clinical specialisms in the investigation disease association and pharmacogenetics and patients referred for transplantation and, where appropriate with service users and support staff.

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

• Actively participate in multidisciplinary review meetings at which laboratory results are presented as part of the clinical record in patients awaiting or being monitored following haematopoietic stem cell transplantation. Identify how your experience will impact on your future practice as a clinical scientist.
• Review the case notes of a patient referred for disease association to gain an understanding of the care pathway of the patient from the initial consultation, investigations, follow-up appointment and treatment the patient may need, with the clinical team. Critically reflect on your learning and how it will affect your future practice
• Critically reflect on your own experience of supervision and mentoring and identify how you will use these in your learning training, supervising and mentoring of others.