84461 - Hematology

Course Unit Page

  • Teacher Elena Zamagni

  • Credits 3

  • SSD MED/15

  • Language English

  • Campus of Bologna

  • Degree Programme Single cycle degree programme (LMCU) in Medicine and Surgery (cod. 9210)

  • Course Timetable from Nov 16, 2021 to Dec 16, 2021

Academic Year 2021/2022

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

Depending on the global COVID-19 pandemic situation - and according to the provisions issued by the Ministry of Health and UNIBO - the exam of the integrated course of HEMATOLOGY and PATHOLOGICAL ANATOMY will take place either in remote oral test form (e.g., via Teams platform), or in the written form of multiple choice test.

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

The final mark will be the arithmetic average between the mark in Hematology (prof Zamagni) and the mark in Histopathology (prof. Piccaluga)

Exams dates (should be the same date as the histopathology exam):

to be defined

17/06, 06/07, 23/07

07/09, 22/09

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