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Appendix 2

SYLLABUS FOR TRAINING IN PAEDIATRIC HAEMATOLOGY/ONCOLOGY

Module 1 - Scientific Basis of Paediatric Haematology and Oncology

(suitable to be delivered by didactic course-based teaching on national/international basis)

Epidemiology of cancer and leukaemia
Biology of cancer and leukaemia
Genetics of cancer (cyto- and molecular) and gene therapy
Immunology of cancer
Imaging
Principles of surgery
Principles of chemotherapy, pharmacology, pharmacokinetics, new drug evaluation
Principles of radiotherapy, radiobiology
Emergencies
Supportive care: use of blood products, antibiotics, nutritional support, growth factors etc.

Psycho-social aspects
Epidemiology of non-malignant haematological diseases
Haemopoiesis
Coagulation, thrombosis, anticoagulation
Blood transfusion, tissue typing, transplantation immunology
Organisation of care
Statistics, incidence, survival
Clinical trial methodology
Research methodology and audit
Ethical Issues, consent, litigation, data protection

Module 2 - Generic Training in Practical Skills Required in Paediatric Haematology and Oncology

Optimal use of diagnostic services
Ensuring good clinical practice
Supportive care, including central lines
Care of adolescents
Long-term follow-up
Late effects
Palliative care, pain evaluation and treatment
Academic skills: research, audit, teaching, data reporting, trial documentation
Communication/counselling parents and patients
Psycho-social aspects
Organisation and managerial skills
Leadership of multidisciplinary team
Attendance at appropriate national and international meetings.

Module 3 - Laboratory Haematology


Blood transfusion
Bone marrow, blood, CSF cytology and morphology
(including to be able to report the results – training throughout the programme plus evaluation of skills required)
Flow cytometry
Cytogenetics
Immunophenotyping
Histo/cytochemistry
Coagulation
Thrombophilia and anticoagulation
Haemoglobin electrophoresis

Module 4 – Clinical non-malignant Paediatric Haematology


Anaemias including nutritional
Haemoglobin disorders (haemoglobinopathies, thalassaemia etc)
Haemolytic anaemias
Haemostatic disorders, platelet defects, thrombocytopenia, thrombophilia
Neutropenia
Bone marrow failure (aplastic anaemia)
Blood transfusion practice and safety
Neonatal haematology and immunology
Immunodeficiency disorders (congenital and acquired)
Haematological manifestations of systemic diseases including infections, e.g. malaria
Molecular diagnosis
Antenatal diagnosis and genetic counselling
Participation in clinico-pathological meetings

Module 5 – Clinical Malignant Haematology, (Leukaemia, Lymphoma Myelodysplasia, MDS)


Diagnosis, including cytology, morphology, cytogenetics and immunophenotyping (including being able to report the results)
In- and out-patient care
Emergencies
Risk stratification and choice of treatment
Ensuring appropriate samples and data are collected
Delivering treatment following clinical protocols
Response evaluation
Diagnosis and treatment of relapse
Late effects
Participation in clinico-pathological meetings

Module 6 - Bone Marrow Transplant/Stem Cell Transfusion (Clinical)

Indications for transplant/stem cell transfusion
Tissue typing
Donor selection
Donor counselling
Stem cell manipulation
Supportive care
Conditioning/immune suppression/transplant immunology
Graft versus host disease
Acute complications and late effects.

Module 7 - CNS Tumours (Clinical)

In conjunction with neuro-surgeon and radiotherapist, diagnosis, in- and out-patient care
Emergencies
Management of hydrocephalus
Investigation, imaging
Observation of operations for CNS tumours
Risk stratification and choice of treatment
Ensuring appropriate samples and data are collected
Delivering treatment following clinical protocols
Response evaluation
Rehabilitation
Management of neurological handicap, cognitive defects, endocrine dysfunction and other late effects
Diagnosis and treatment of relapse
Participation in Tumour Board Meetings including histopathology

Module 8 - Solid Tumours Outside the CNS (Clinical)

– including neuroblastoma, nephroblastoma, soft tissue and bone sarcomas, germ cell tumours, retinoblastoma, liver tumours, endocrine and epithelial tumours

In conjunction with paediatric surgical oncologists and paediatric radiotherapists, diagnosis, in- and out-patient care
Emergencies
Observations of operations for tumours
Staging, risk stratification and choice of treatment
Ensuring appropriate samples and data are collected
Delivering treatment following clinical protocols
Response evaluation
Rehabilitation
Management of handicaps, endocrine dysfunction, prostheses and other late effects
Diagnosis and treatment of relapse
Participation in Tumour Board Meetings including histopathology

Module 9 – Flexible

This may include further experience in aspects of any of the other 8 modules (for example, in laboratory haematology, tumour molecular biology or the care of children with coagulation disorders, haemoglobinopathies, leukaemia, CNS or other solid tumours) or time in research.

This experience may be gained in the trainee’s country or abroad.

A three month period in immunology might be chosen by some trainees, to include neonatal immunology, immunodeficiency disorders, transplantation immunology and immunomodulation.

Research must be undertaken under expert supervision in which the trainee learns to plan, conduct, evaluate, publish and present research projects but not more than 6 months may be spent in full time research.
Experience abroad will only be acceptable when undertaken in an institution considered suitable by the national body responsible for overseeing training.