American Society of Hematology

Latin American Training Program

The 2017 application cycle is now closed.

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The purpose of the Latin American Training Program (LATP) is to help build hematology capacity in Latin America around specific priority areas for the region. The LATP provides funding for hematologists or hematology-related healthcare professionals in Latin America to receive up to twelve weeks of training in one of the following areas:

  • Flow Cytometry and Molecular Biology
    Faculdade de Medicina de Ribeirão Preto, Brazil
  • Adult Stem Cell Transplantation
    Hospital Maciel in Montevideo, Uruguay
  • Diagnosis and Treatment of Coagulopathies
    Instituto Estadual de Hematologia (HEMORIO) in Rio de Janeiro, Brazil
  • Thrombosis and Hemostasis
    Pontificia Universidad Catolica de Chile in Santiago, Chile
  • Pediatric Stem Cell Transplantation (Chile)
    Hospital Dr. Luis Calvo Mackenna in Santiago, Chile
  • Pediatric Stem Cell Transplantation (Mexico)
    National Institute of Pediatrics Mexico DF, Mexico

Specific information on each LATP training program is included below. Upon completion of the training, participants return to their home institutions to implement the skills and knowledge they have learned, ultimately helping advance hematology patient care across the region.

Program Benefits

  • The LATP award provided by ASH will fund approved costs for travel and living expenses throughout the duration of the training (applicants must submit a budget).
  • By implementing the training in their home institution, awardees will have the opportunity to increase hematology capacity for themselves and their colleagues, ultimately leading to improved patient care and/or research.
  • Through the 12 week program, personnel and institutions in Latin America will have the opportunity to create ongoing relationships and networks.
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Timeline

Applications availableDecember 23, 2016
Application deadlineMarch 17, 2017
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Eligibility Requirements

  • Physicians, scientists, and hematology laboratory staff working in a hospital or a research institution in one of the Latin American countries listed below:
    • Argentina
    • Brazil
    • Bolivia
    • Chile
    • Colombia
    • Costa Rica
    • Dominican Republic
    • Ecuador
    • El Salvador
    • Guatemala
    • Honduras
    • Mexico
    • Nicaragua
    • Panama
    • Paraguay
    • Peru
    • Uruguay
    • Venezuela
  • Applicants may be at any stage in their careers.
  • Applicants do not need to be ASH members.
  • English proficiency is not required, as the training may occur in Spanish or Portuguese.
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Training Programs

Non-Portuguese speaking candidates may apply.

This twelve week training program consists of hands-on activities with flow cytometry and molecular biology for the diagnosis of hematological malignancies. Trainees attend weekly meetings (every Thursday) to discuss the findings of morphological, immunophenotypic, genetic and histopathological analysis of cases sent to the Hematology Laboratory of the Medical School of Ribeirão Preto University Hospital and are trained on the following topics in flow cytometry and molecular biology:

Flow cytometry:

  1. Lab safety and sample handling
  2. Mononuclear cell isolation using Ficoll Hypaque gradient and whole-blood lysis
  3. Frequently used monoclonal antibody panels and relevant controls in daily practice
  4. Data acquisition
  5. Setting the Signal Intensity and Threshold of the cytometers
  6. Setting regions and gates
  7. Analysis of lymphoproliferative diseases
  8. Analysis of acute myeloid leukemia and myelodisplastic syndrome
  9. Analysis of acute lymphocytic leukemia
  10. Analysis of multiple myeloma
  11. Analysis of paroxysmal nocturnal hemoglobinuria
  12. Discussion of cases of minimal residual disease analysis in acute leukemias

Molecular biology techniques:

  1. DNA and RNA extraction and quantification
  2. Quality control of oligonucleotide samples
  3. Agarose gel preparation
  4. cDNA synthesis
  5. RT-PCR technique for PML/RARa, CBFbeta/MYH11, RUNX1/RUNX1T1 and FLT3-ITD detection
  6. RQ-PCR technique for PML/RARa
  7. RQ-PCR technique for JAK2 V617F mutations
  8. RQ-PCR for cyclin D1 quantification

Requirements for Candidates to this program:

  • The candidate must represent an institution that currently owns and operates a flow cytometer.
  • The candidate must present a support letter from his or her home institution signed by the candidate’s supervisor that verifies support of leave for training and confirms that the required equipment is available.
  • The candidate must meet all other eligibility requirements listed at the top of the LATP application.

During this twelve week training program, the trainee conducts all his or her daily clinical activities under the supervision of the SCT staff members in daily activities from 8 a.m. to 5 p.m. These activities as well as other objectives are as follows:

  • Clinical staff meetings for daily information updates about inpatients (Monday to Friday, 8:00 to 9:00 a.m.)
  • Clinical rounds at the Hematology Care Unit (8 weeks, Monday to Saturday, 9:00 a.m. to 12:00 midnight)
  • Clinical follow up of discharged outpatients at the daily Outpatients Clinic (4 weeks, Monday to Friday, 9:00 a.m. to 1:00 p.m.)
  • Two SCT Clinics / week (Tuesday at 2:00 p.m. and Thursday at 10:00 a.m.) for pre-SCT evaluation and long term follow up of transplanted patients
  • Participation in each step of the SCT procedure:
    • Stem cell mobilization
    • Stem cell timing counts at the Flow Cytometry Laboratory
    • Stem cell harvesting by leukapheresis at the Blood Bank Unit
    • Cell processing at the Cryopreservation Unit
    • Stem cell infusion
  • Active participation in regular scientific meetings (Thursday at 9:00 a.m.)
  • Participation at the weekly SCT staff meeting for discussion, planning and coordination of SCT procedures (every Tuesday at 11 a.m.)
  • Interaction with other Departments involved in the SCT Program:
    • Stem cells Donor Registry and HLA laboratory
    • Vascular Surgery
    • Blood Bank Unit and Cytapheresis Laboratory
    • Nutritional Support Unit
    • Infectious Diseases Unit
    • Psycosocial Medicine Unit
  • Training in quality management and application of quality model procedures
  • Interaction with the medical staff on duty at the Hematology Care Unit twice a week
  • Interaction with “Fundación PORSALEU”. From 2001, this volunteer foundation takes care of homing and social support of outpatients and families coming from outside the city during hospitalization (www.porsaleu.org)
  • Interaction with the Department Director and SCT staff in terms of applicability of the project at the home institution, setting up a transplant program, increasing capacities progressively and overcoming difficulties
  • Interaction with the Hospital Director who supports and promotes this action

Requirements for Candidates to this program:

  • The candidate must represent an institution that currently operates a SCT unit or department or is in the process of developing one and has the capabilities to implement the necessary procedures.
  • The candidate must present a support letter from his or her home institution signed by the candidate’s supervisor and relevant department head (hematology, SCT department), if applicable, that verifies support of leave for training and confirms that the required equipment is available to implement the training.
  • The candidate must meet all other eligibility requirements listed at the top of the LATP application.

This twelve-week program focuses on laboratory practices and test interpretation involved in the diagnosis of thrombosis and hemostasis disorders. Training areas include basic and advanced clotting tests, laboratory diagnosis of Von Willebrand Disease (VWD) phenotypes, platelet function testing, and thrombophilia diagnosis.

Training Program Schedule:

  • Global Laboratory function, theoretical updating on hemostasis process, including platelet function, clotting and fibrinolytic systems and natural anticoagulants. (Week 1)
  • Basic clotting tests, preparation of plasma pool control, quantitation of clotting factors, screening and identification of antibodies. Laboratory control of heparin and new anticoagulant drugs. Pre-analytical and analytical controls. Report of results. Internal and external quality control processes. (Weeks 2-4)
  • Training in VWD testing and diagnosis: VWF:Ag, VWF:RCo, VWF:CB, RIPA, FVIII binding to VWF, Multimeric analysis of VWF, ADAMTS 13 assay. Laboratory diagnostic criterium. (Weeks 5-6)
  • Training in platelet function testing: platelet aggregation and serotonin secretion, including diagnostic criteria; platelet procoagulant activity, detection of anti-platelet antibodies, diagnosis of platelet glycoprotein deficiencies and platelet compatibility testing by flow cytometry. (Weeks 7-9)
  • Inherited and acquired thrombophilia diagnosis: measurements of antithrombin and protein C by functional (coagulometric assay) and antigenic (ELISA assay); protein S antigen (ELISA), activated protein C resistance (coagulometric assay), diagnosis of FV Leiden and prothrombin C20210A mutation (PCR, lupus anticoagulant screening and confirmation assays. HIS diagnosis: anti-heparin-PF4 antibodies and serotonin release assay (by HPLC) (Weeks 10-12)

Trainees also attend weekly bibliography and research meetings as well as meetings to review, analyze, and interpret all tests performed on Wednesday and Friday each week. The trainee is asked to give a final seminar at the end of his or her stay.

If the trainee is a physician, he/she will have the chance to attend in- and out-patient specialized clinical practice and out-patient anticoagulant clinic during his/her last 6 weeks stay. During his/her entire stay, training supervisors explore realistic avenues of collaboration and continued improvement with the trainee and his/her home institution.


Requirements for Candidates to this program:

  • Applicants must accredit a title of MD, PhD, biochemist, or laboratory technician.
  • Applicants must direct or work in a Diagnostic or Research Thrombosis and Hemostasis Laboratory or in the Thrombosis and Hemostasis section of a Clinical Laboratory of a his or her hospital. The trainee’s laboratory must be equipped with automatic coagulometers and ELISA facilities. If not available, they must commit to develop in their center the study of platelet aggregometry and the molecular diagnosis of Factor V Leiden and G20210A prothrombin mutation. The trainee can get additional benefits if he/she has access to flow cytometry and molecular diagnosis at his/her home Institution.

Non-Portuguese speaking candidates may apply.

This twelve-week program covers the diagnosis and treatment of a wide range of coagulopathies including: hemophilia, von Willebrand disease, rare factor deficiencies and platelet disorders, and hereditary thrombopathies. Primary objectives include: understanding the principle clinical complications for these disorders; organizing a system for immediate treatment of hemorrhagic episodes; and laboratory diagnosis of hemophilia, von Willebrand disease and other coagulopathies.

Training Program Schedule:

  • Congenital coagulopathies outpatient follow-up care (Week 1)
  • Immediate care and coagulation factor infusion in the emergency room, with hemorrhagic or other disease-related complications (Week 2-3)
  • First screening and evaluation of suspected cases for diagnosis confirmation (Week 4)
  • Participation on patient training and education, including self-infusion (Week 5)
  • Participation at multidisciplinary rounds for congenital coagulopathies (Week 1-12)
  • Training on organization of dentistry and physical therapy care focused on coagulopathies (Week 6)
  • Training on storing and distributing coagulation factors concentrates, including traceability (Week 8-9)
  • Training at the coagulation reference lab (Week 10-12)

This 12 week program is intended for pediatric hemato-oncologists who are involved in the care of transplanted patients or are developing new transplant programs. The daily activities under HSCT Staff supervision will take place from 8 a.m to 5 p.m. Trainees will be exposed to the three major transplantation areas: pre-transplant, transplant procedure and post-transplant follow up. The trainees will have also the opportunity to discuss administrative issues with the staff.

BMT Unit rounds:

  • General round including medical staff, shift nurses, head nurses, education nurse, clinical pharmacist, social worker, psychologist (Monday at 8:15 a.m. and Friday at 12:30 p.m.)
  • Medical in-patient staff, trainee, fellows (Tuesday to Friday at 8:15 a.m.)
  • General round including medical staff, shift nurses, head nurses, clinical pharmacist (Monday to Thursday at 12:30 p.m.)
  • Medical in-patient staff, trainee, fellows and Pediatrics Residents (Monday to Friday at 4:00 p.m.)

Patients meetings:

  • Pre-transplantation round (Monday afternoon)
  • Post-transplantation round (Wednesday afternoon)
  • HLA and new patients review (Thursday afternoon)

General meetings:

  • Pediatrics Department general round (Wednesday morning)
  • Oncology-Hematology-BMT meeting (Friday morning)

Weekly Schedule

  1. Week 1-4: Pre-transplantation clinic and administrative issues:
    Pre-transplantation clinic
    • HSCT indications review
    • General candidates list
    • Patients summary review
    • HLA review, donor selection, stem cell sources
    • Clinical evaluation according to specific disease and HSCT protocols
    • Laboratory evaluation according to specific disease and HSCT protocols
    • Pre-transplantation evaluation planning: BM back-up, radiotherapy, conditioning regimen, CVC, final admission

    Administrative issues:
    • BMT Unit general structure
    • Physical requirements
    • Budget resources
    • Human resources
    • Hospital network: laboratories, assistant services and departments (Radiology, Pharmacy, Hematology, blood bank, etc.)
    • Planning and development
    • Evaluation Schedule
    • Accreditation
  2. Weeks 5-8: In-patient clinic
    • HSCT indications review
    • Patients summary review
    • Clinical evaluation according to specific disease and HSCT protocols
    • Laboratory evaluation according to specific disease and HSCT protocols
    • Transplantation planning: BM back-up, radiotherapy, conditioning regimen (myeloablative and RIC), immunosuppression, CVC.
    • Complications: Infectious complications, mucositis, pain, GvHD (diagnosis, scoring, staging and treatment), others (VOD, TMA, hemorrhagic cystitis, etc.)
    • Infusions and treatments: IVIG, antibiotics, antivirals, transfusions, hydration
    • Follow-up and therapeutic procedures: lumbar puncture, bone marrow aspirate and harvest and procurement, donor lymphocyte and HSCT infusions.
    • Laboratory procedures: stem cell apheresis, processing techniques (management of ABO incompatibilities, CB thawing, PB progenitors freezing and thawing, ex vivo TC depletion)
  3. Week 9-12: Post-transplantation outpatient clinic:
    Early post-transplantation follow-up: 3 weeks
    • Clinical evaluation according to specific disease and HSCT protocols
    • Laboratory evaluation according to specific disease and HSCT protocols
    • Infectious complications
    • Immunological complications/GvHD screening, scoring and treatment
    • Acute readmissions
    • Daily infusions and treatments: IVIG, antibiotics, antivirals, transfusions, hydration
    • Follow-up and therapeutic procedures: lumbar puncture, bone marrow aspirate, donor lymphocyte infusions.

    Long-term post-transplantation follow-up: 1 week
    • Clinical evaluation according to specific disease and HSCT protocols
    • Laboratory evaluation according to specific disease and HSCT protocols
    • Infectious complications
    • Immunological complications/GvHD screening, scoring and treatment
    • Long-term complications: endocrinological, metabolic, cardiovascular, respiratory, ophthalmological
    • Immune reconstitution and vaccination schedule
    • Social, family psychological evaluation
    • Transference to local health network

Requirements for Candidates to this program:

  • The candidate must meet all eligibility requirements listed at the top of the LATP application.
  • The Candidate must come from an institution that currently has a SCT unit or is in the process of developing one.
  • Paperwork required:
    • A support letter from the Director of his or her home institution. That letter must specify support for leave for training.
    • Curriculum vitae
    • Hepatitis B vaccine certification
    • International health insurance certificate
    • Valid professional certification
  • Successful candidates will be put in contact with the hospital academic department (UCAD) for further information and regulations according to international agreements from Chile and his or her country.

This 12 week program focuses on training for all phases of management of pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Trainees will learn the clinical and laboratory aspects of SCT necessary for the treatment of children. This program is designed for pediatric hemato-oncolologists or pediatric immunologists. Activities are scheduled from 7am to 7pm Monday through Friday and Saturday from 8am to 2pm. This program will feature the following components:

Didactic Education:

  • Daily Clinical Rounds in the Bone Marrow Unit with in-patients (7:00 a.m. to 9:00 a.m.)
  • Attendance at out-patient services Monday through Thursday (accompanied by a training supervisor) from 10:00 a.m. to 12:00 p.m.
  • Patient Review Conferences (every day at 2:00 p.m.)
  • Weekly Fellow Conference (Friday at 8:00 p.m.)
  • Cure4Kids Conference with Mexican SCT Group (every other Friday at 9:00 a.m.)
  • Weekly Tumor Board Conference (Fridays at 12:00 p.m.)
  • Weekly Journal Club (Wednesdays at 12:30 p.m.) and monthly Research Meeting (4th Tuesday of the month at 3:30 p.m.)
  • Visit to the Blood Center and Cell Therapy Laboratory
  • Quality standard session review weekly (Friday at 10:00 a.m.)

Training Schedule
Part One (Weeks 1-4)

  • Week 1:
    • Learn the biological features of hematopoietic stem cells (marrow, cord blood or blood derived) and their mobilization/collection.
    • Learn how human HLA antigens guide selection of allogeneic stem cell transplant donors
  • Week 2:
    • Learn how to manage stem cell infusions (Bone Marrow, Cord Blood, peripheral blood; thawing cord blood or peripheral blood)
    • Understand the pathophysiology and management of graft rejection
    • Learn how chimerism is utilized in the management of allogeneic HSCT (particularly in reduced intensity conditioning patients)
  • Week 3:
    • Learn how to assess immune recovery of HSCT
    • Diagnosis and treatment of infections early and their relationship with immune reconstitution
  • Week 4:
    • Management of patient from time of referral through initial consultation and decision(s) regarding type of transplant and conditioning/stem cell source
    • Coordination with referring physician and overseeing pre-HSCT evaluations.
    • Assessment of patients referred for HSCT and discussion of the procedure with the patient/family

Part Two (Weeks 5-10)

  • Week 5:
    • Learn the indications for autologous vs. allogeneic HSCT
    • Learn how to manage patients receiving high-dose chemotherapy and complications related to of mucositis, neutropenic fever and the need for blood product support
  • Week 6:
    • Diagnosis and treatment of acute infections and relationship with immune reconstitution of the patient.
  • Week 7:
    • Learn the features and pathophysiology of acute graft vs. host disease (GvHD)
    • Manage patients presenting with acute GvHD: assessment, appropriate biopsies, and therapeutic plan.
  • Week 8:
    • Learn the features and pathophysiology of chronic GvHD
    • Management of patients presenting with chronic GvHD: assessment, appropriate biopsies, and therapeutic plan
  • Week 9:
    • Learn the indications for reduced intensity allogeneic HSCT
    • Learn the types of Haploidentical Transplant with Cyclophosphamide and immuno-selection.
  • Week 10:
    • Follow-up of patients in the long term
    • Implementation of a quality program according to the FACT standards.
    • Participate in marrow harvests and observe the preparation of the stem cell product in the Stem Cell Laboratory.

Part Three: Research Rotations (Weeks 11 and 12)

  • Week 11:
    • Develop a hypothesis for a research project, review background publications and develop research plan
    • Review appropriate data sources, collect and collate data, initiate assessment and consider appropriateness/feasibility of plan
  • Week 12:
    • Complete data collection, extend analysis of data and present preliminary findings to HSCT team
    • Formalize presentation of data, conclusions and prepare manuscript related to project.

Requirements for Candidates to this Program:

  • The candidate must comply with the requirements established in the LATP application.
  • The candidate must be a pediatric hemato-oncologist or immunologist with interest in developing or extending services for HSCT in his or her own institution.
  • The candidate must come from an institution that currently has an SCT unit or is in process of developing one.
  • Curriculum Vitae with copy of professional certification.
  • International health insurance
  • Comply with the immigration requirements to enter Mexico
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Participant Program Evaluation

An integral aspect of the LATP is measuring the degree to which participants are able to implement the training they receive at their home institutions after the completion of their LATP experience. To do this, ASH has developed participant evaluation forms that must be completed by LATP awardees 30 days and 6 months after they have concluded their training. The purpose of the evaluation forms is to:

  • Give the participant an opportunity to provide feedback on their personal experiences with the program
  • Measure the scope of implementation of the training received at the participant's home institution
  • Allow the participant to express any issues that have arisen since returning to his or her home institution concerning the implementation of skills and procedures learned
  • Assess the impact of the program on the participant's professional career

It is important that you inform the International Programs Manager when you have completed your training at the host institution. You will receive an email with a link to the evaluation forms at the appropriate intervals following your training.

One Month Evaluation Form

Six Month Evaluation Form

One Year Evaluation Form

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Questions

If you have any questions or require any additional information regarding the ASH Latin American Training Program, please contact Chase Willett, International Programs Manager, at cwillett@hematology.org. back to top