Module - Hematological Malignancy (SLS131)

STP

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.

Work-based 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.

Work-based Competencies

Learning outcome Title Knowledge
1 1

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.
  • The principles underlying the methods listed.
  • Understanding of BCSH guidelines for selection of appropriate tests.
  • Relevant white cell morphology (bone marrow and peripheral blood).
  • Cytogenetic abnormalities commonly associated with haematological disease.
  • A minimum of two molecular tests from the following list:
    • IgH gene rearrangement
    • TCR gene rearrangement
    • BCRABL
    • JAK2
    • FLT3/NPMI
    • minimal residual disease monitoring
    • post-transplant chimera monitoring.
  • The need for internal and external quality assessment and how to remedy poor performance.
2 2

Interpret haematology data in order to aid the classification of haematological malignancies.
  • WHO classification system and other relevant systems/guidelines.
3 2

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.
  • Correct timing of patient samples prior to and during investigation.
  • Correct interpretation of haematological results relative to reference data.
  • Requirements of interpretive reports.
  • Responsibility and level of authority for production and authorisation of reports.
4 3

Interpret laboratory data in patients for whom haemopoietic stem cell transplantation is the appropriate treatment.
  • Knowledge of the clinical indications appropriate for stem cell transplantation.
  • Types of donor and donor registry.
5 3

Interpret and comply with appropriate national and international guidelines for the diagnosis and management of haematological malignancies.
  •  Appropriate national and international guidelines (e.g. NICE) for the diagnosis and management of haematological malignancies.

Work-based assessment

Complete 2 Case-Based Discussion(s)
Complete 2 of the following DOPS and/or OCEs
Type Title
DOPS 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
OCE 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
DOPS 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