Clinical Sciences
Module Blood diseases

Academic Year 2025/2026 - Teacher: ALESSANDRA ROMANO

Expected Learning Outcomes

Expected Learning Outcomes (Dublin Descriptors)
Upon completion of the course, the expected learning outcomes, structured according to the five Dublin descriptors, are as follows:
1. Knowledge and Understanding
By the end of the course, the student must demonstrate the acquisition of a solid theoretical foundation regarding:
The pathophysiological principles of major hematological malignancies and benign blood disorders.
WHO classification criteria (morphological and molecular) for hematological diseases.
The clinical and biological significance of complete blood count (CBC) parameters and coagulation tests.
The methodological basis of molecular biology techniques applied to diagnostics and prognosis.
2. Applying Knowledge and Understanding
Students will be able to transition from theory to clinical practice through:
Morphological Diagnostics: Technical execution and critical interpretation of peripheral blood smears and bone marrow aspirates.
Data Interpretation: Correct analysis of CBC results and coagulation screenings to guide diagnostic suspicion.
Prognostic Assessment: Utilization of molecular markers to define disease progression and personalize patient management.
3. Making Judgements
The training program aims to develop the ability to:
Integrate morphological, clinical, and molecular data to formulate an accurate differential diagnosis.
Critically evaluate the relevance of various prognostic factors within the specific context of each patient.
Identify discrepancies between laboratory results and the observed clinical picture.
4. Communication Skills
Students must develop competence in:
Presenting diagnostic conclusions clearly, using appropriate scientific terminology.
Interacting effectively within a multidisciplinary team (hematologists, pathologists, geneticists).
Translating complex technical concepts (such as molecular mutations) into information that is understandable for patients or non-specialist colleagues.
5. Learning Skills
The course provides the tools to:
Consult and comprehend updated scientific literature and international clinical guidelines.
Maintain independent updates on the evolution of diagnostic techniques and new biomarkers.
Independently explore the molecular basis of rare or emerging pathologies.

Course Structure

Interactive lessons about topics described in the Program tab

Required Prerequisites

According to Regolamento di Ateneo.

Attendance of Lessons

Mandatory for frontal lessons

Detailed Course Content

After a general overview of the mechanisms that regulate normal and pathological hematopoiesis, the student will be introduced to the definition and pathophysiology of the main diseases affecting red blood cells, white blood cells and platelets. A special attention will be paid to the most common forms of anemia and the most frequent hematological neoplasms. Priority will be given to the notions providing a general framework of the hematological patient and the current prospects for cure or control of the disease, with a special mention for the most modern therapeutic strategies used in hematology, including the basics of cellular therapy and bone marrow transplantation. 

Four lectures are planned on the following topics:

1- Complete blood count, morphological characterization of blood cells. Use of the blood cell counter and flow cytometry to determine phenotypes of clinical interest.

2- Separation of blood cells to identify the main prognostic factors in acute and chronic myeloid disease, with particular emphasis on qualitative and quantitative expression of PML-RARalpha, JAK2, CALR, MPL, and cKIT mutational status using digital drop PCR; NGS, and RT-PCR. Comparison of method sensitivity.

3- Overview of chronic lymphoid disease, reactive and neoplastic lymphoproliferative processes. Identification of prognostic markers using flow cytometry and immunohistochemistry, with particular emphasis on Bcl-2, Bcl-6, and IRF-4.

 

Characterization of minimal residual disease in major hematological diseases. Definition and technologies for NGF vs. NGS determination in multiple myeloma, chronic lymphocytic leukemia, and acute myeloid leukemia.

4- Overview of the use of cell therapy (autologous, allogeneic, CAR-T) in hematologic oncology. HLA system. Criteria for allogeneic donor selection. Advantages of CAR-T design. Overview of the use of bispecific drugs using the therapeutic approach to myeloma as a paradigm.

Textbook Information

Teacher's slides and referral papers

Ematologia per medicina, scienze biologiche, biotecnologie mediche di N. Giuliani, A. Olivieri - Idelson-Gnocchi

Course Planning

 SubjectsText References
1Morphological and functional aspects of blood elementsSlides and teacher's documents
2Alterations of the signal transduction pathway in the pathogenesis of myeloproliferative processesSlides and teacher's documents
3Alterations of the signal transduction pathway in the germinal center reaction in the pathogenesis of lymphoproliferative processesSlides and teacher's documents
4Cellular manipulation in the treatment of hematological malignancies: autologous and allogeneic hematopoietic stem cell transplantation, haploidentical transplantation. In vitro and ex vivo manipulation for the development of cell therapy strategies: bispecific drugs and CAR-TSlides and teacher's documents

Learning Assessment

Learning Assessment Procedures

At the end of the course, students will be asked to write a paper on one or more strategies for addressing resistance to one of the cell therapies covered in the course. This paper will be the subject of an oral exam.

Examples of frequently asked questions and / or exercises

Discussion of an essay for the search for a biomarker in a specific clinical context, illustrating the pathophysiological characteristics of the hematological disease, the molecular characteristics to be looked for, the pre-analytical and analytical evaluation phases, and an example of test reporting.

VERSIONE IN ITALIANO