84461 - Hematology

Learning outcomes

Describe the clinical manifestations, etiology, epidemiology, risk factors, natural history, diagnosis, staging, prognostic indicators and management of the major blood diseases, with emphasis on those most commonly encountered in the clinical practice. Identify the major diagnostic and therapeutic options for each encountered clinical scenario, and discuss their benefits and limitations. Summarize decision-making algorithms for a correct differential diagnosis, prognosis, and treatment choice. Present and critically analyze clinical cases, discuss the differential diagnosis, and formulate appropriate diagnostic and therapeutic strategies for each case (Problem-Based Learning).

Course contents

• LEARNING OUTCOMES AND SKILLS TO BE ACHIEVED:

Recognize and interpret the main diseases of the blood and lymphatic system, both neoplastic and non-neoplastic. In particular, at the end of the course the student will be able to:

• interpret the signs, symptoms and laboratory data that characterize anemia; acute myeloid and lymphoid leukemias; chronic myeloproliferative syndromes; lympho-immuno-proliferative syndromes; platelets and coagulation diseases;
• manage with the main ways of application of autologous and allogeneic stem cell transplantation (ASCT and allo-SCT)

HEMATOLOGY EXAMINATION PROGRAM:

- Hematopoiesis: hierarchical organization. Stem cells. Marrow microenvironment and growth factors.

- Erythropoiesis and erythropoietin.

- Anemias. Pathogenetic classification. Diagnosis, clinical symptoms and signs, main laboratory tests, blood count test.

- Reduced erythroblastogenesis anemia.

- Reduced erythrocytogenesis anemia. Ineffective erythropoiesis. Vitamin B12 and folic acid/folate metabolism. Megaloblastic anemias: clinical and laboratory pictures, hints of therapy.

- Reduced hemoglobin synthesis anemia. Thalassaemias, with particular reference to beta-thalassaemias: clinical and laboratory pictures, hints of therapy. Beta-thalassaemias minor. Cooley's disease. Generalities on alpha-thalassaemias and hemoglobinopathies (sickle-cell anemia).

- Iron metabolism. Iron shortage and sideropenic anemia: clinical and laboratory pictures, hints of therapy.

- Physiological and pathological hemolysis: causes, clinical and laboratory pictures. Spherocytosis. Paroxysmal nocturnal hemoglobinuria. Hemolytic anemia due to enzymatic deficits. Immune hemolytic anemias.

- Leukemias: etiopathogenesis and molecular bases. Acute and chronic leukemias.

- Acute myeloid leukemias: cytological features, genetic-molecular alterations, clinical and laboratory frameworks, hints of therapy.

- Acute lymphoid leukemias: cytological and immunophenotypical characteristics, genetic-molecular alterations, clinical and laboratory pictures, hints of therapy.

- Myelodysplastic syndromes.

- Chronic myeloproliferative syndromes (Chronic myeloid leukemia. Polycythemia vera. Essential thrombocythemia. Myelofibrosis with spleno-hepatic myeloid metaplasia): genetic-molecular alterations, clinical and laboratory pictures, hints of therapy.

- Chronic lymphoproliferative syndromes, with particular reference to chronic lymphatic leukemia: immunophenotypic features, clinical and laboratory pictures, hints of therapy. Prolymphocytic leukemia and scalp cell leukemia.

- Monoclonal gammopathies. Monoclonal gammopathy of indeterminate significance (MGUS) and multiple myeloma: genetic-molecular alterations, clinical and laboratory pictures, hints of therapy. Waldenstrom's Macroglobulinemia.

- Nodal and extranodal lymphomas: WHO classification.

- Hodgkin's lymphoma: epidemiology and etiopathogenesis, clinical pictures, hints of therapy.

- Non-Hodgkin's lymphomas, nodal and extranodal, high degree and low degree of aggressiveness: clinical and laboratory pictures, hints of therapy.

- Megakaryocytopoiesis and Platelet disorders: pathogenetic classification, diagnosis, clinical symptoms and signs, main laboratory tests, hints of therapy. Immune thrombocytopenic purpura (Werlhof's disease).

- Congenital coagulopathies: Hemophilia A and B, von Willebrand's disease.

- Acquired coagulopathies: defects of liver synthesis, disseminated intravascular coagulation.

- Allogeneic and autologous stem cell transplantation: general principles and clinical applications.

Readings/Bibliography

S. Tura, Cavo M, Zinzani PL, Hematology, ESCULAPIO publishing company

Harrison, Principles of Internal Medicine (related chapters)

Teaching methods

Lessons supported by teacher explanation and slides

Assessment methods

The exam of the integrated course of HEMATOLOGY and PATHOLOGICAL ANATOMY will take place in the written form of multiple choice test (24 questions for hematology, 8 for pathology).

Exam commission: Elena Zamagni, Fausto Castagnetti (assistant professor), Alessandro Broccoli (assistant professor), Pierpaolo Piccaluga

The exam is passed only if at least 4 pathology questions and at least 12 hematology questions are correct. 30L with 31 or 32 correct answers. then 30 and below corresponding to the number of correct answers.

Exams dates:

26 january 2023 3 pm

22 february 2023 3 pm

12 april 20233 pm

21 june 2023 3 pm

12 july 2023 3 pm

20 september 2023 3 pm

Teaching tools

-Slides will be uploaded  in the teacher website immediately before or after the lesson, grouped by 2-4 lessons, during the course. At the end of the course all the lessons will be available

Office hours

See the website of Elena Zamagni