Presentations
- Bruising
- Cytopenia
- Disseminated intravascular coagulation
- Eosinophilia
- Fatigue
- Febrile neutropenia
- Fevers
- Leucocytosis
- Pallor
- Polycythaemia
- Thrombocytosis
- Thromboembolism
- Tumour lysis syndrome
- Weakness
Conditions
- Acute myeloid leukaemia (AML)
- Clonal haematopoiesis
- Mastocytosis
- Myelodysplastic / myeloproliferative neoplasms:
- chronic myelomonocytic leukaemia
- Myelodysplastic neoplasms
- Myeloproliferative neoplasms:
- chronic myeloid leukaemia
- essential thrombocythaemia
- polycythaemia vera
- primary myelofibrosis
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- Bruising
- Fatigue
- Fevers
- Hypereosinophilia
- Hyperleucocytosis
- Pallor
- Weakness
Conditions
- Rare leukaemias
- Rare myeloproliferative neoplasms
- Rare myelodysplastic / myeloproliferative neoplasms
- VEXAS syndrome
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Classification of myeloid disorders, integrating:
- cytogenetics
- immunophenotyping
- molecular biology
- morphology
- Normal haematopoiesis and stem cell biology:
- hierarchical ordering of blood cell development from stem cell to mature blood cell
- intrinsic and extrinsic regulators of blood cell development
- Patterns of organ dysfunction directly or indirectly due to myeloid disorders or their complications
- Processes of normal marrow function, and how these processes are disrupted in myeloid disorders with clonal haematopoiesis
Investigations and management
- Clinical trials and appropriate procedures for patient participation
- Dose adjustment, and schedule and regimens of therapy, according
to organ dysfunction and comorbidities
- Induction, consolidation, and maintenance of cytotoxic chemotherapy,
including attendant side effects
- Prognostication, including genetic classification and risk assessment
- Treatment of myeloid disorders, such as:
- clinical trial agents
- hypomethylating agents
- indications for stem cell transplant
- supportive care
Procedures
- Bone marrow biopsy
- Calculation and prescription of appropriate doses of chemotherapy
and other anti-leukaemia therapies
- Lumbar puncture and intrathecal chemotherapy administration
- Monitoring and principles of measurable residual disease assessment,
including appropriate time points and interpretation
- Complications of myeloid disorders
- Familiarity with optimal care pathways
- Long-term side effects of treatment, and survivorship issues
- Maintain current knowledge in basic haematopoietic biology and
therapy, and impact on future therapies for acute leukaemia
- Outcomes of myeloid disorders according to classification, prognostic
indices, and treatment strategy
- Palliative modalities for patients with myeloid disorders
- Supportive care:
- appropriate use of analgesics, antiemetics, and haemostatic agents
- prevention and management of opportunistic infection
- use of blood components
- Treatment protocols in common use for major forms of myeloid
disorders, and major side effects associated with pertinent clinical,
cultural, financial, and social considerations in selection of therapeutic
options for patients
- Urgent management of:
- acute promyelocytic leukemia (APML)
- infections in immunocompromised patients, in particular febrile neutropenia
