Faculty: Susmita Chakrabarty

Course Name : Advanced Hematology

Code(Credit) : CUTM1727 (3-1-0)

Course Objectives

• The overall aims are that the student should obtain advanced knowledge of the most common hematologic diseases & understanding the concept of Blood cells and other blood components.
• Demonstrate an understanding of the components of human blood and characteristics, functions, and abnormalities and disease states of each.
• Demonstrate proficiency in the skills necessary to perform blood cell counts, and evaluation of blood elements within stated limits of accuracy.
• Determine suitability of hematology specimens and dispose of them in the appropriate bio-hazard containers.

Learning Outcomes

• Differentiate various hematological procedures and the use of basic equipment essential to working in a Hematology Laboratory.
• Discuss differences between Quality control, Quality Assurance, and Continuing Quality Improvement principles as used in the Hematology Laboratory.
• Categorize various hematology analyses , operational principles of various hematology instruments, and troubleshooting of various instruments.
• Explain the principles and theories utilized in a variety of problem-solving situations.
• Compare and contrast hematology values under normal and abnormal conditions.

Course Syllabus

Module-1 ( 8 Hrs)
Quality assurance in hematology: Internal and external quality control including reference preparation
Routine quality assurance, Protocol, Statistical analysis i.e. Standard deviation, Co-efficient variation,
accuracy and precision, Safety precautions in hematology. Basic concepts of automation in hematology
with special reference to: Blood cell counter, Coagulometer.
Practice: Collection of blood from different body parts. Data and record Maintain, Handling
hematological equipments.
 

Module-2 ( 12 Hrs)
 
Bone marrow examination:
1. Composition and functions, Aspiration of bone marrow (Adults and children), Processing of aspirated bone marrow (Preparation & staining of smear)
2. Brief knowledge about examination of aspirated bone marrow (differential cell counts and cellular ratios) .Special Stain for Bone Marrow -Periodic Acid Schiff, Sudan Black
3. Leukemia: Classification, Blood Picture, Differentiation of BlastCells. Laboratory diagnosis of leukaemias , Processing and staining of trephine biopsy specimens.
Practice: Method of aspiration bone marrow, method of Processing and staining of trephine biopsy.
 

Module-3 ( 10 Hrs)
 
L.E. cell phenomenon

1. Definition of L.E. cell,  Demonstration of L.E. cell by various methods , Clinicals Physiological variations in Hb, PCV, TLC and Platelets. Investigations of a case suffering from bleeding disorders.

2. Quantitative assay of coagulation factors - a. Principle b. Procedure c. Mechanism d. Tests
3. Biomedical waste management in hematology laboratory (Other than Radioactive material)
Practice-: Demonstration of functional aspect of blood cell counter
Study the RBCs abnormal morphological form -a. Variation in size, shape and staining
Character, b. Red cell inclusion, c. Identify morphologically the- Immature Erythroid series of cells
d. Immature Myeloid ad other WBCs series of cells

Module-4 ( 10 Hrs)
Demonstration of various parts of centrifuge; its functioning and care, Cleaning and drying of glass and plastic ware, Cleaning of glass, syringes and its sterilization. Preparation of various anticoagulants, Preparation of buffers, Preparation of the stains and other reagents.
Practice: Use centrifuge machine to separate serum & plasma from whole blood cells, Sterilization, Buffer & stain preparation.

Suggested Readings:

1. Textbook of Medical Laboratory Technology P.B Gotkar Mumbai, Bhalani Publishing House
2. Text book of Medical Laboratory Technology by Paraful B. Godkar, Publisher Bhalani
3. Text book of Medical Laboratory Technology (2nd edition) by V.H Talib, Publisher CBS
4. Atlas of hematology (5th edition) by G.A. McDonald, Publisher Churchill Livingstone
5. Medical Laboratory Technology By K.L Mukharjee, Publisher McGraw Hill education pvtlimited
6. Text book of Medical Laboratory Technology (6th edition) by Ramnik Sood,Jaypee Publication.
7. Ebook link-https://www.pdfdrive.com/hematology-basic-principles-and-practice-e176384006.html
8. Ebook link-https://www.pdfdrive.com/hematology-basic-principles-and-practice-expert-consult-online-and-print-expert-consult-title-online-print-5th-edition-e186195241.html
9. Ebook link-
   https://books.google.co.in/books?id=6sfacydDNsUC&printsec=frontcover&dq=hematology&hl=en&sa=X&ved=2ahUKEwja9-ve3I7qAhUwzTgGHSMUDekQ6wEwAHoECAQQAQ#v=onepage&q=hematology&f=false
10. Ebook link-
    https://books.google.co.in/books?id=QQcYAAAAYAAJ&printsec=frontcover&dq=hematology&hl=en&sa=X&ved=2ahUKEwja9-ve3I7qAhUwzTgGHSMUDekQ6wEwAnoECAIQAQ#v=onepage&q=hematology&f=false

Simulation links for labs: 
All the practice components can be performed by simulation as well as virtual labs. Amrita Vlab (https://www.youtube.com/channel/UC1ouqR_dIY_WPDPSZo0e8Wg),
labsforlife (http://labsforlife.in/)
Online Source: Udemy, Coursera, article library, NCBI,Study.com, You tube, Slide share, Frontier, Febs, unacademy, academia,

Session Plan

Session 1

Topic: Quality assurance in hematology: Internal and external quality control including reference preparation
Study Materials:
Slide share- https://www.slideshare.net/IshwarBihana/quality-assurance-in-haematology-87797108
Video- https://www.youtube.com/watch?v=xYaMO3k1F9I
https://www.youtube.com/watch?v=kmh2rq5iajI
Routine quality assurance & Protocol Discussion- https://www.docsity.com/en/quality-assurance-in-haematology-introduction-to-hematology-lecture-slides/221648/

Session Plan

Session 2

Practice session:
Topic: Collection and preservation of blood: different methods of collection
Study Materials:
Slide share-https://www.slideshare.net/globalsoin/blood-collection-and-preservation
Video- https://www.youtube.com/watch?v=8-NVVSOBUu8
https://www.youtube.com/watch?v=ibU5PYOF2qg
https://www.youtube.com/watch?v=r8n2O1GIqQg
https://www.youtube.com/watch?v=7NSEFVbzTAU

Session 3

Practice session:
Topic: Data & Record Maintenance
Study Materials:
Discussion- https://www.icontracts.com/managing-documents-records-laboratory/
Do's and Don'ts-https://techtransfer.cancer.gov/intellectualproperty/inventions/inventor-guidance/guide-keeping-laboratory-records-dos-dont
Topic: Hematological Equipment Handling
Discussion- https://www.biologydiscussion.com/hematology-2/laboratory-hematology-2/equipments-used-in-hematology-laboratory-hematology-biology/80370

Session 4

Topic: Safety precautions in hematology
Study Materials:
Discussion- http://biologydiscussion.com/hematology-2/laboratory-hematology-2/safety-measures-to-prevent-laboratory-hazards-hematology/80388
Description- https://oncohemakey.com/safety-in-the-hematology-laboratory/

Session 5

Topic: Statistical analysis i.e. Standard deviation, Co-efficient variation,accuracy and precision
Study Materials:
Video- https://www.investopedia.com/terms/c/coefficientofvariation.asp

Session 6

Topic: Basic concepts of automation in hematology with special reference to: Blood cell counter, Coagulometer
Study Materials:
Slide share- https://www.slideshare.net/saikat1607/automated-cell-counter-its-quality-control-36198989
Article of Coagulometer- https://www.who.int/medical_devices/innovation/whole_blood_coagulation_analyzer.pdf?ua=1
Article of Blood cell counter- https://pubmed.ncbi.nlm.nih.gov/18550479/
Slide share of Blood cell counter- https://www.slideshare.net/SADAF519/automated-cell-counters-91056262

Session 7

Topic: Bone marrow examination: Composition and functions
Study Materials:
Discussion- https://medcaretips.com/bone-marrow/
Notes- https://microbenotes.com/bone-marrow-types-structure-and-functions/
https://spark.adobe.com/page/mMDF7W1XtTG48/

Session 8

Topic: Bone marrow examination
Study Materials:
Video- https://www.youtube.com/watch?v=tI7m2y_secI
Notes- https://spark.adobe.com/page/XCoKNRcH2T4sa/

Session 9

Topic: Aspiration of bone marrow (Adults and children)
Study Materials:
Discussion- https://www.chp.edu/our-services/cancer/resources/patient-procedures/bone-marrow-biopsy
Description- https://www.chp.edu/our-services/cancer/resources/patient-procedures/bone-marrow-biopsy#:~:text=Bone%20marrow%20aspirations%20and%20bone,into%20your%20child's%20hip%20bone.
Guidelines- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2532899/

Session 10

Practice Session:
Topic: Bone marrow aspiration and Biopsy
Study Materials:
Video- https://www.youtube.com/watch?v=NkdsLHBCreI
Discussion- https://labtestsonline.org/tests/bone-marrow-aspiration-and-biopsy
Notes- https://www.healthline.com/health/bone-marrow-biopsy

Session 11

Topic:
method of
Processing and staining of trephine
biopsy

Study Materials:
Slide share- https://www.slideshare.net/kanwalpreet15/processing-of-bone-marrow-trephine-biopsy

Session 12

Practice Session:
Topic: Bone marrow Preparation: smear & stain
Study Materials:
Video- https://www.youtube.com/watch?v=0ZTGoPmCV1w
Notes-https://www.labce.com/spg448397_manual_staining_of_bone_marrow_preparations_wright.aspx#:~:text=Wright's%20or%20
Wright%2DGiemsa%20stains,contact%20time%20for%20adequate%20staining.
Descriptions-https://clinicalgate.com/preparation-and-staining-methods-for-blood-and-bone-marrow-films/

Session 13

Topic: Processing of aspirated bone marrow (Preparation & staining of smear)
Study Materials:
Notes- https://labmonk.com/preparation-staining-bone-marrow-smear
Description- https://clinicalgate.com/preparation-and-staining-methods-for-blood-and-bone-marrow-films/

Session 14

Topic: Brief knowledge about examination of aspirated bone marrow (differential cell counts and cellular ratios)
Study Materials: 
Procedure-https://labtestsonline.org/tests/bone-marrow-aspiration-and-biopsy

Session 15

Practice session:
Topic: Special Stain for Bone Marrow-Periodic Acid Schiff
Study Materials:
Video- https://www.youtube.com/watch?v=W56K4ISNfgA
Protocol- http://www.ihcworld.com/_protocols/special_stains/pas.htm
Application- https://www.labce.com/spg949466_periodic_acid_schiff_pas_diagnostic_applications.aspx

Session 16

Practice session:
Topic: Special Stain for Bone Marrow:Sudan Black
Study Materials:
Procedure- http://laboratorytests.org/sudan-black-b-stain/
PDF- https://webpath.med.utah.edu/HISTHTML/MANUALS/SUDANF.PDF

Session 17

Practice session:
Topic: Processing and staining of trephine biopsy specimens
Study Materials:
Slide share- https://www.slideshare.net/kanwalpreet15/processing-of-bone-marrow-trephine-biopsy

Session 18

Topic: Leukemia: Classification, Blood Picture
Study materials:
Discussion- https://www.mayoclinic.org/diseases-conditions/leukemia/symptoms-causes/syc-20374373
Description-https://webpath.med.utah.edu/HISTHTML/MANUALS/SUDANF.PDF
Notes- https://my.clevelandclinic.org/health/diseases/4365-leukemia

Session 19

Topic: Differentiation of BlastCells
Study Materials:
Discussion- https://www.sciencedirect.com/topics/immunology-and-microbiology/blast-cell
Notes- https://www.verywellhealth.com/overview-of-blast-cells-4114662#:~:text=In%20the%20myeloid%20cell%20line,basophils%20and%20monocytes%2C%20and%20macrophages.

Session 20

Topic- L.E.cell phenomenon-Definition of L.E.cell
Study Materials:
Discussion- https://www.labpedia.net/le-cell-phenomenon-lupus-erythematosus-cell/
Notes- https://askhematologist.com/lupus-erythematosus-le-cells/
Slide share- https://www.slideshare.net/8056933252/demonstration-of-le-cells

Session 21

Topic: Demonstration of L.E.cell by various methods
Study Materials:
Slide share- https://www.slideshare.net/8056933255/demonstration-of-le-cells

Session 22

Topic: Clinical Physiological variations in Hb, PCV, TLC and Platelets
Study Materials:
Slide Share- https://www.slideshare.net/himanshuguptadr/blood-and-blood-cells-57679867
Article- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3422383/
https://www.hindawi.com/journals/physiology/2013/283814/

Session 23

Practice:
Topic: Blood cell Counter (Manual)
Study Materials:
Video- https://www.youtube.com/watch?v=HfqZdiqTSUQ

Session 24

Topic: Red Cell Inclusion
Study Materials:
Video: https://www.youtube.com/watch?v=Klcx1ZgFsmw
Discussion- https://theartofmed.wordpress.com/2015/09/07/inclusion-bodies-of-red-blood-cells/#:~:text=Typically%2C%20inclusion%20bodies%20are%20nuclear,within%20a%20red%20blood%20cell.

Session 25

Topic: Immature Erythrocyte Series or Erythrocyte maturation
Study Materials:
Video- https://www.youtube.com/watch?v=cATQFej6oAc

Session 26

Topic: Immature Lymphoid & Myeloid and other WBC Series
Study Materials:
Video- https://www.cancer.gov/publications/dictionaries/cancer-terms/def/white-blood-cell
Slide share-https://www.slideshare.net/P-Z0-3/white-blood-cells-39413127
https://en.wikivet.net/Leukopoiesis

Session 27

Topic: Investigations of a case suffering from bleeding disorders
Study Materials:
Slide Share- https://www.slideshare.net/supreetmvj/bleeding-disorders-44901153

Session 28

Topic: Quantitative assay of coagulation factors - a. Principle b. Procedure
Study Materials: 
Discussion-  https://labtestsonline.org/tests/coagulation-factors
Book Reference- Ramnik Sood pg:375

Session 29

Practice session:


Topic: Coagulation Factors Mechanism & Test


Study Materials:


Discussion-
https://medlineplus.gov/lab-tests/coagulation-factor-tests/
https://www.ncbi.nlm.nih.gov/books/NBK507850/
Procedure- https://www.healthline.com/health/coagulation-tests

Session 30

Topic: Biomedical waste management in hematology laboratory (Other than Radioactive material )
Study Materials:
Slide Share- https://www.slideshare.net/arunbabunb/laboratory-safety-biomedical-waste

Session 31

Topic: Demonstration of various parts of centrifuge; its functioning and care
Study Materials:
Slide share https://slideplayer.com/slide/10501557/

Session 32

Topic: Cleaning and drying of glass and plastic ware
Study Materials:
Video- https://www.youtube.com/watch?v=W0oacysFTko

Session 33

Topic: Cleaning of glass, syringes and its sterilization
Study Materials:
Video- https://www.youtube.com/watch?v=9pfjcsIeG74

Session 34

Practice session:
Topic: Uses and function of various anticoagulants
Study Materials:
Video- https://www.youtube.com/watch?v=jrWD83b8hkA&t=4s
About-http://www.pathlabs.org/healthcare-providers/clinical-testing/clinical-tube-types.aspx
Slide share- https://www.slideshare.net/JananiMathialagan1/blood-collection-and-anticoagulants

Session 35

Topic: Preparation of buffers
Study Materials:
Video- https://www.youtube.com/watch?v=kdhmryQACz8
Procedure-https://www.shimadzu.com/an/hplc/support/lib/lctalk/38/38lab.html#:~:text=When%20an%20acetic%20acid%20(sodium,
buffer%20action%20can%20be%20obtained.

Session 36

Topic: Preparation of the stains and other reagents
Study Materials:
Slide share- https://www.slideshare.net/DrSHAHIDRaza/special-and-routine-stains-in-haematology-1

Session 37

Practice session:
Topic: Use centrifuge machine to separate serum & plasma from whole blood cells
Study Materials:
Video- https://www.youtube.com/watch?v=IhJNFGfsUus
https://www.youtube.com/watch?v=nX0NNfV8nWw

Session 38

Practice session:
Topic: Sterilization(Dry Sterilization & Moist Sterilization)
Study Materials:
Video- https://www.youtube.com/watch?v=yEsDVJQf4io
https://www.youtube.com/watch?v=KRL7Bt3F38k
https://www.youtube.com/watch?v=ckuZg1gPl1Y
https://www.youtube.com/watch?v=6YVqwnWnGdo
https://www.youtube.com/watch?v=j23s_cxwxSE

Case Studies

Case Studies