YEREVAN STATE MEDICAL UNIVERSITY DEPARTMENT OF HEMATOLOGY COURSE DESCRIPTION HEMATOLOGY

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1 1. Module/unit Code II Module/unit Title Hematology 3. Subject Field Internal Diseases Group 4. Faculty/Department General Medicine, Department of Hematology 5. Programme(s) to which the Doctor of Medicine (MD) module/unit is attached 6. Level Year 4, Winter Semester (VIII) Year 6, Autumn Semester (XI) 7. ECTS Credits 1.5 each, 3 in total 8. Core or Optional Core (mandatory for all students) 9. Class Contact Time For each semester: Total Hours - 45 Distribution of Hours: Lectures - 10 h Practicals (group work) - 20 h 10. Guided Independent Study Time Total Hours: 15h 11. Duration of the Module/unit 2 weeks in total, divided in two parts: 1 week in VIII semester 1 week in XI semester 12. Campus Location Department of Hematology, Hematology Center after Prof. Yeolyan Nersisyan 7 str, Yerevan 13. Module/unit Co-ordinators Head of Department - Prof. S. Daghbasyan Assoc. Prof. Dr. A. Zakharyan 14. Brief Description of Module/unit. Lecture and laboratory course integrates theory with application of hematology and hemostasis diagnostic procedures, interpretation, problem solving and correlation of laboratory findings with disease states. Topics include hematopoiesis, cell morphology and hematologic evaluation of peripheral blood and bone marrow, anemias, thalassemias and hemoglobinopathies, myelodysplastic syndromes, lymphoproliferative and myeloproliferative disorders, immunoproliferative disorders, and malignant lymphomas. Overview of hemostasis provides studies in coagulation, platelet disorders and bleeding abnormalities. 15. Learning objectives: By the end of the class the student should be able to: 1. Report classification, etiology, pathogenesis, clinical features and basic principles of treatment of blood diseases 2. Explain lab. tests and instrumental investigation of blood diseases 3. Exam patients 4. Explain CBC, coagulation tests, bone marrow picture, histology and immunophenotyping of lymph. nodes 5. Differentiate blood diseases, transfuse blood components, prevent or treat adverse reactions after blood components transfusion 16. Readings: Mandatory: Course Handout, Lectures Further: Hoffman et al. Hematology, basic principles and practice, 6 th edition 17. Assessment: Written MCQ test (50 questions) at the end of each week. Grade passed / not passed (26 correct answers required to pass) 1

2 CURRICULUM WEEK 1 (Year 4, Semester VIII) ID Main Area Disease Lecture Practical 1. Stem Cell and Haemo Lymphopoiesis 2. Red cell disorders 2.1 Anaemia due to deficiency (iron, 1 3 B12, folates) 2.2 Thalassemia, Sickle cell, cell 1 3 membrane disorders and enzymopathies 2.3 Acquired immune-haemolytic anaemias 3. Bone marrow failure syndromes Aplastic anaemia, PNH 4. Thrombosis and Haemostasis 4.1 Pathophysiology and laboratory 1 1 screening 4.2 Platelet disorders (acquired and congenital) 4.3 Haemophilia and rare clotting disorders 4.4 Venous thromboembolism and thrombophilia (cong. & acq.) 4.5 Thrombo-haemorrhagic disorders (DIC, TTP, HUS) TOTAL

3 CURRICULUM WEEK 2 (Year 6, Semester XI) ID Main Area Disease Lecture Practical 1. Myeloid malignancies 1.1 Myeloproliferative disorders (Ph1 1 1 neg.) 1.2 Chronic myeloid leukaemia Myelodysplastic syndromes Acute Myeloid Leukaemia Lymphoid malignancies 2.1 Acute Lymphoblastic Leukaemia Non-Hodgkin s lymphoma, T-cell neoplasms 2.3 Hodgkin s lymphoma 2.4 CLL 2.5 Multiple Myeloma and Waldenstrom s Macroglobulinaemia Stem cell transplantation 3.1 Basic principles Allogeneic stem cell transplantation 3.3 Autologous stem cell transplantation Transfusion medicine 4.1 General principles of compatibility of transfusion 4.2 Blood component therapy: indications and complications TOTAL

4 SYLLABUS WEEK 1 (Year 4, Semester VIII) Session 1 Session 2 Session 3 Session 4 Stem Cell and Haemo-Lymphopoiesis 1. Introduction to stem cells 2. Hematopoietic stem cells biology, myelograms 3. Hematopoietic microenvironment 4. Hematopoietic cell trafficking and chemokines 5. Cell death 6. Biology of erythropoiesis, erythroid differentiation and maturation 7. Granulocytopoiesis and monocytopoiesis 8. Thrombocytopoiesis Red cell disorders 1. Pathobiology of the human erythrocyte and its hemoglobins 2. Definition and classification of anemias. Iron, vit.b12, folic acid deficiencies anemias. Causes, clinical aspects, differential diagnosis, laboratory evaluation, (CBC, indicators, bone marrow), management of anemias. Pathophysiology of iron homeostasis. Disorders of iron homeostasis: iron deficiency and overload. Anemia of chronic diseases. Megaloblastic anemias 3. Thalassemia syndromes 4. Pathobiology of sickle cell disease, clinical features and management 5. Red blood cell enzymopathies. Classification, etiology and pathogenesis, differential diagnosis, clinical aspects, laboratory evaluation, treatment. Management and outpatient observation. 6. Red blood cell membrane disorders. Immune and nonimmune hemolytic anemia. Inherited and acquired hemolytic anemia: classification, etiology and pathogenesis, differential diagnosis, clinical aspects, laboratory evaluation, treatment. Management and outpatient observation. Bone marrow failure syndromes 1. Aplastic anaemia. Classification, epidemiology, etiology and pathogenesis, laboratory evaluation, diagnosis, clinical features and treatment. 2. Paroxysmal Nocturnal Hemoglobinuria - Pathophysiology, Clinical features, laboratory evaluation, therapy Thrombosis and Haemostasis 1. Platelet disorders (acquired and congenital) 2. Haemophilia and rare clotting disorders 3. Venous thromboembolism and thrombophilia (cong. & acq.) 4. Thrombo-haemorrhagic disorders (DIC, TTP, HUS) 5. Hemostasis disorders. Classification. Inherited deficiencies of coagulation factors, hemophilia A & hemophilia B, prenatal diagnosis and carrier 4

5 detection, clinical and laboratory evaluation, treatment. Management and outpatient observation of hemophilia. 6. Immune thrombocytopenia, pathogenesis, clinical and laboratory evaluation, treatment. 7. Willebrand disease, differential diagnosis, lab. tests, management. Inherited and acquired qualitative defects of platelets, differential diagnosis, lab. tests, management. 8. Thrombocytopenic purpura - classification, clinical features, lab. tests, diagnosis, management. 5

6 SYLLABUS WEEK 2 (Year 6, Semester XI) Session 1 Session 2 Session 3 Session 4 Myeloid malignancies 1. Classification of myeloid neoplasms. Diagnostics. 2. Myeloproliferative neoplasms. 3. Acute myeloid leukemias. Pathobiology, clinical manifestations, treatment. 4. Myelodysplastic syndromes. Biology and treatment. 5. Chronic myeloid leukaemia. Etiology, pathophisiology, clinical features, treatment. Lymphoid malignancies 1. Acute Lymphoblastic Leukaemia. Etiology, diagnosis, clinical manifestations, therapy. 2. Non-Hogkin lymphoma. T-cell neoplasms. 3. Hodgkin lymphoma. Etiology, classification, diagnosis, management. 4. Chronic lymphocytic leukemia. Epidemiology, pathobiology, clinical manifestations, diagnosis and laboratory manifestations, treatment. 5. Multiple myeloma. Pathobiology, clinical manifestations, diagnosis and laboratory manifestations, treatment. 6. Waldenström macroglobulinemia. Pathobiology, clinical and laboratory manifestations, treatment. Stem cell transplantation Basic principles Allogeneic stem cell transplantation Autologous stem cell transplantation 1. Overview of hematopoietic stem cell transplantation 2. Allogenic stem cell transplantation 3. Indications and outcome of Allogenic hematopoietic stem cell transplantation 4. Autologous stem cell transplantation 5. Unrelated donor hematopoietic stem cell transplantation 6. Graft-versus-host disease and graft-versus-leukemia responses Transfusion medicine 1. Human blood group antigens and antibodies 2. Principles of transfusions of various blood components (RBC, WBC, platelets). 3. Blood component therapy: indications and complications 6