Module - Haematopoietic Stem Cell Transplantation (SLS129)

STP

Aim of this module

This module will provide the trainee with a knowledge and understanding of stem cell donation, testing, harvesting and monitoring. They will understand a range of clinical conditions associated with stem cell transplantation requirements. They will gain experience of HLA typing in the matching of donors and suitable recipients. 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 Histocompatibility and Immunogenetics techniques applicable to haematopoietic stem cell transplantation.

 

Work-based learning outcomes


  1. Perform the clinical and laboratory investigation of patients being considered for HSCT including the interpretation and reporting of results in the correct clinical context.
  2. Select suitable donors for HSCT under supervision.
  3. Assess the suitability of potential related and unrelated (adult and cord blood) donors for HSCT.
  4. Perform clinical and laboratory monitoring of patients who have received haematopoietic stem cell transplantation.
  5. Work in partnership with other clinical specialisms in the investigation of haematopoietic stem cell transplantation and, where appropriate, with service users and support staff.

Work-based Competencies


Learning outcome Title Knowledge
1 1

Analyse family HLA results to produce pedigree data.

  • How to assure the quality of personal practice.
  • HLA haplotypes and inheritance.
  • Selection of extended family members for HLA typing.
  • Recombination events.
2 1,2

Review and select potential related  donors for HSCT, using local and national protocols.

  • How to assure the quality of personal practice.
  • Local and national protocols.
  • Types of HSCT donor including:
    • HLA matched related
    • Haplo-identical
    • Related/unrelated cord
    • Unrelated adult
  • Factors affecting HSCT donor selection.
  • National and international standards and legislation relating to haematopoietic stem cell transplantation.
  • Relevant advisory groups for donor selection.
  • Sources of stem cells and donor registries applicable to haematopoietic stem cell transplantation.
  • Local protocols for the clinical and laboratory work up of patients awaiting haematopoietic stem cell transplantation.
  • Impact of HLA antibodies in HSCT and donor selection.
  • Non-HLA factors relevant to donor selection.
  • The need to manage records and all other information in accordance with applicable legislation, protocols and guidelines.
3 1,2

Review and select potential unrelated adult donors for HSCT, using local and national protocols.

  • How to assure the quality of personal practice.
  • Local and national protocols.
  • Types of HSCT donor including:
    • HLA matched related
    • Haplo-identical
    • Related/unrelated cord
    • Unrelated adult
  • Factors affecting HSCT donor selection.
  • National and international standards and legislation relating to haematopoietic stem cell transplantation.
  • Relevant advisory groups for donor selection.
  • Sources of stem cells and donor registries applicable to haematopoietic stem cell transplantation.
  • Local protocols for the clinical and laboratory work up of patients awaiting haematopoietic stem cell transplantation.
  • Impact of HLA antibodies in HSCT and donor selection.
  • Non-HLA factors relevant to donor selection.
  • The need to manage records and all other information in accordance with applicable legislation, protocols and guidelines.
4 1,2

Review and select potential cord donors for HSCT, using local and national protocols.

  • How to assure the quality of personal practice.
  • Local and national protocols.
  • Types of HSCT donor including:
    • HLA matched related
    • Haplo-identical
    • Related/unrelated cord
    • Unrelated adult
  • Factors affecting HSCT donor selection.
  • National and international standards and legislation relating to haematopoietic stem cell transplantation.
  • Relevant advisory groups for donor selection.
  • Sources of stem cells and donor registries applicable to haematopoietic stem cell transplantation.
  • Local protocols for the clinical and laboratory work up of patients awaiting haematopoietic stem cell transplantation.
  • Impact of HLA antibodies in HSCT and donor selection.
  • Non-HLA factors relevant to donor selection.
  • The need to manage records and all other information in accordance with applicable legislation, protocols and guidelines.
5 1,2,3,5

Assess the suitability of potential related and unrelated (adult and cord blood) donors for HSCT, using local and national protocols

  • How to assure the quality of personal practice.
  • Local and national protocols.
  • Types of HSCT donor including:
    • HLA matched related
    • Haplo-identical
    • Related/unrelated cord
    • Unrelated adult
  • Factors affecting HSCT donor selection.
  • National and international standards and legislation relating to haematopoietic stem cell transplantation.
  • Relevant advisory groups for donor selection.
  • Sources of stem cells and donor registries applicable to haematopoietic stem cell transplantation.
  • Local protocols for the clinical and laboratory work up of patients awaiting haematopoietic stem cell transplantation.
  • Impact of HLA antibodies in HSCT and donor selection.
  • Non-HLA factors relevant to donor selection.
  • The need to manage records and all other information in accordance with applicable legislation, protocols and guidelines.
6 1,2,3,5

Produce an interpretive report of the suitability of potential related and unrelated (adult and cord blood) donors for HSCT for clinical colleagues.

  • How to assure the quality of personal practice.
  • Local and national protocols.
  • Types of HSCT donor including:
    • HLA matched related
    • Haplo-identical
    • Related/unrelated cord
    • Unrelated adult
  • Factors affecting HSCT donor selection.
  • National and international standards and legislation relating to haematopoietic stem cell transplantation.
  • Relevant advisory groups for donor selection.
  • Sources of stem cells and donor registries applicable to haematopoietic stem cell transplantation.
  • Local protocols for the clinical and laboratory work up of patients awaiting haematopoietic stem cell transplantation.
  • Impact of HLA antibodies in HSCT and donor selection.
  • Non-HLA factors relevant to donor selection.
  • The need to manage records and all other information in accordance with applicable legislation, protocols and guidelines.
7 1,4

Perform chimerism analysis to assess and monitor patients post HSCT.

  • How to assure the quality of personal practice.
  • HSC transplant complications including:
    • Acute graft versus host disease (GVHD)
    • Chronic GVHD
    • Graft failure, non-engraftment and delayed engraftment
    • Infection
    • Relapse in leukaemia, infertility, secondary malignancies
  • Local immunosuppression regimes and assessment as to whether immunosuppression is adequate.
  • Local protocols for the clinical and laboratory monitoring of patients who have received haematopoietic stem cell transplantation.
  • Conditioning regimens and applicability of chimaerism analysis.
  • Principles of methods employed for post transplant monitoring including:
    • Fluorescence in-situ hybridisation (FISH)
    • Minimal Residual Disease Monitoring
    • STR/microsatellite analysis
    • Real-time PCR
  • Relevance of Cell Lineage Analysis.
  • National guidelines for chimerism analysis.
  • The need to manage records and all other information in accordance with applicable legislation, protocols and guidelines.
8 1,4,5

Produce an interpretive chimerism report for clinical colleagues, using local and national protocols.

  • How to assure the quality of personal practice.
  • HSC transplant complications including:
    • Acute graft versus host disease (GVHD)
    • Chronic GVHD
    • Graft failure, non-engraftment and delayed engraftment
    • Infection
    • Relapse in leukaemia, infertility, secondary malignancies
  • Local immunosuppression regimes and assessment as to whether immunosuppression is adequate.
  • Local protocols for the clinical and laboratory monitoring of patients who have received haematopoietic stem cell transplantation.
  • Conditioning regimens and applicability of chimaerism analysis.
  • Principles of methods employed for post transplant monitoring including:
    • Fluorescence in-situ hybridisation (FISH)
    • Minimal Residual Disease Monitoring
    • STR/microsatellite analysis
    • Real-time PCR
  • Relevance of Cell Lineage Analysis.
  • National guidelines for chimerism analysis.
  • The need to manage records and all other information in accordance with applicable legislation, protocols and guidelines.
9 5

Work in partnership with other clinical specialisms in the investigation of haematopoietic stem cell transplantation and, where appropriate with service users and support staff.

  • The need to build and sustain professional relationships as both an independent practitioner and collaboratively as a member of a team.
  • Methods of effective communication.
10 5

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.

  • How communication skills affect assessment of, and engagement with, service users and how the means of communication should be modified to address and take account of factors such as age, capacity, learning ability and physical ability.
  • Situations where it is necessary to share information to safeguard service users or the wider public.

Work-based assessment


Complete 2 Case-Based Discussion(s)
Complete 2 of the following DOPS and/or OCEs
Type Title
DOPS Prepare an interpretive family pedigree report
DOPS Conduct a search for an unrelated stem cell donor
DOPS Conduct a search for an unrelated cord blood donor
DOPS Prepare an interpretive report of the suitability of potential related and unrelated donors
DOPS Perform tests to monitor post- transplant engraftment
DOPS Prepare an interpretive report for chimerism monitoring
OCE Attend ward rounds and/or clinics at which patients are being worked up for, or monitored following haematopoietic stem cell transplantation and describe to the patient the involvement of the Laboratory in their care
OCE Attend a multidisciplinary review meeting at which laboratory results are presented and describe to colleagues what they mean.
OCE Take a patient history