Clinical Sciences

Module Blood diseases

At the end of the course, students will be able to use the main diagnostic tools for the correct classification of hematological malignancies, including the execution and interpretation of morphological examinations of peripheral blood and bone marrow, complete blood count, coagulation tests, and the molecular determination of prognostic factors for the most common neoplastic and benign hematological diseases.

According to Regolamento di Ateneo.

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.

Teacher's slides and referral papers

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.

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.