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Accreditation/Credit Designation

Physicians' Education Resource®, LLC, is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Physicians' Education Resource®, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Acknowledgment of Commercial Support

This activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.

Oncology Briefings™: Updates in Rare Hematology: Advancing Care and Improving Outcomes for Patients with Aplastic Anemia

Release Date: August 31, 2017
Expiration Date: August 31, 2018
Media: Internet - based

 

Activity Overview

Oncology Briefings™ is an online interactive monograph that will include an overview of diagnostic guidelines and management strategies for treatment-associated adverse events, and a review of recent data regarding current and novel therapeutic approaches in aplastic anemia. A national thought leader will interpret presented data and provide key take-home points and pearls for practice that will place the content into perspective. Audio sidebars and tables will provide supporting evidence for this activity.

Acknowledgment of Commercial Support

This activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.

CME Activity Table of Contents

  • Background and Disease Biology of Aplastic Anemia
  • Diagnosis and Grading of Aplastic Anemia
  • Current Treatment Strategies for Aplastic Anemia
  • Emerging and Novel Treatments for Aplastic Anemia

Instructions for This Activity and Receiving Credit

  • You will need to log in to participate in the activity.
  • Each presentation may contain an interactive question(s). You may move forward through the presentation; however, you may not go back to change answers or review audio files/content until you finish the presentation.
  • At the end of the activity, "Educational Content/Audio Files" will be available for your reference.
  • In order to receive a CME certificate, participants must complete the activity.
  • Complete the Posttest and pass with a score of 70% or higher, complete the Evaluation, and then click on “Request for Credit.” Participants may immediately download a CME certificate upon completion of these steps.

Target Audience

This educational initiative is directed toward medical oncologists and hematologists who treat patients with hematologic malignancies. Nurse practitioners, nurses, physician assistants, pharmacists, researchers, fellows, and other healthcare professionals interested in the treatment of cancer also are invited to participate.

Learning Objectives

Upon completion of this activity, you should be better able to:

  1. Describe pathobiology of AA and evidence-based approaches for accurate diagnosis of patients with AA
  2. Outline first and second-line treatment strategies to optimize clinical outcomes in patients with AA
  3. Discuss potential treatment-associated adverse events and strategies to mitigate their occurrence and impact for patients with AA
  4. Evaluate recent clinical trial results and apply these findings in the context of an evolving treatment landscape for management of AA

Faculty, Staff, and Planners' Disclosures

Faculty

Danielle Townsley, MD, MSc
Hematologist
Bethesda, MD
 
 
 

Disclosure: No relevant financial relationships with commercial interest.

The staff of Physicians' Education Resource®, LLC have no relevant financial relationships with commercial interests to disclose.

Disclosure Policy and Resolution of Conflicts of Interest (COI)

As a sponsor accredited by the ACCME, it is the policy of PER® to ensure fair balance, independence, objectivity, and scientific rigor in all of its CME activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME activity to disclose all relevant financial relationships with commercial interests. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that creates a COI.

Additionally, PER® is required by ACCME to resolve all COI. PER® has identified and resolved all COI prior to the start of this activity by using a multistep process.

Off-Label Disclosure and Disclaimer

This CME activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing medical and nursing education purposes only, and is not meant to substitute for the independent clinical judgment of a physician relative to diagnostic or treatment options for a specific patient’s medical condition. The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER®.




PER Pulse™ Recap (1 of 3)
How to Identify Aplastic Anemia and Confirm Diagnosis

The online continuing medication education activity Oncology Briefings™: Updates in Rare Hematology: Advancing Care and Improving Outcomes for Patients With Aplastic Anemia provides oncologists and other health care providers with engaging instruction on how to identify aplastic anemia in their patients and current and evolving treatment standards in this rare blood disorder. Leading expert, Danielle Townsley, MD, MSc, a hematologist in Bethesda, Maryland, answers key questions, supported by the presentation of clinical science, about aplastic anemia. This first of 3 PER Pulse™ Recaps from this program focuses on the distinguishing features of aplastic anemia and how to properly diagnosis it.

Dr. Townsley discusses distinct symptoms patients may present with that suggest a diagnosis of aplastic anemia, as well as the necessary steps to take to confirm diagnosis and rule out alternative causes:

  • Aplastic anemia is characterized by a clinical presentation of pancytopenia in which 2 of the following must be present to confirm a diagnosis of severe disease: neutrophil levels: ˂0.5 x 109/L; platelet count: ˂20 x 109/L; and reticulocyte count: ˂60 x 109/L. In patients with very severe disease, neutrophil levels are even lower: ˂0.2 x 109/L.
  • Personal and family history should be taken, including comprehensive physical examination, to evaluate for an inherited syndrome. The main causes of inherited aplastic anemia include Fanconi anemia and dyskeratosis congenita (a condition of telomere syndrome), and less commonly, Shwachman-Diamond syndrome and congenital amegakaryocytic thrombocytopenia.
  • A bone marrow aspirate and trephine biopsy are both required for the confirmatory diagnosis of aplastic anemia. Myelodysplastic syndrome and leukemia must be ruled out via cytogenetic analysis and flow cytometry, respectively. Aplastic anemia can also occur in association with paroxysmal nocturnal hemoglobinuria, which is best evaluated by performing flow cytometry of peripheral blood for glycosylphosphatidylinositol-anchored proteins.

For additional information and commentary on this topic, as well as audio and supporting text, visit www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefingstrade-updates-in-rare-hematology-advancing-care-and-improving-outcomes-for-patients-with-aplastic-anemia.

For information on other topics, visit www.gotoper.com.




PER Pulse™ Recap (2 of 3)
How to Treat Aplastic Anemia

The online continuing medication education activity Oncology Briefings™: Updates in Rare Hematology: Advancing Care and Improving Outcomes for Patients With Aplastic Anemia provides oncologists and other health care providers with engaging instruction on how to identify aplastic anemia in their patients and current and evolving treatment standards in this rare blood disorder. Leading expert, Danielle Townsley, MD, MSc, a hematologist in Bethesda, Maryland, answers key questions, supported by the presentation of clinical science, about aplastic anemia. This second of 3 PER Pulse™ Recaps from this program focuses on current strategies to treat aplastic anemia.

 

Dr. Townsley details the sequencing strategies used to treat patients with aplastic anemia, as well as important considerations to make for age and other characteristics:

  • Definitive, potentially curative, therapy typically includes hematopoietic stem cell transplantation (HSCT) and immunosuppressive therapy (IST). Treatment is further striated based on patient characteristics, such as age, and disease characteristics, including grade and origin. Intolerability of treatment and increased risk of graft-versus-host disease following HSCT makes treatment for older patients more complex.
  • IST with horse antithymocyte globulin (ATG) and cyclosporine (CsA) is the recommended first-line treatment for patients with acquired severe or very severe aplastic anemia who lack a related human leukocyte antigen–matched donor, and for all older adults.
  • Rabbit ATG plus CsA is reserved for treatment of relapsed or refractory aplastic anemia.
  • Allogeneic HSCT is the only curative treatment for patients with inherited disease. This treatment is preferred for younger patients with histocompatible donors. Transplantation can become an option for patients 40 years or older who have failed to respond to first-line IST if a suitable donor, whether sibling or unrelated, is available.
  • Supportive care for aplastic anemia consists of careful monitoring of blood levels, appropriate red blood cell and platelet transfusions, antimicrobial prophylaxis to prevent infection, and iron chelation therapy in transfusion-dependent patients.

For additional information and commentary on this topic, as well as audio and supporting text, visit www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefingstrade-updates-in-rare-hematology-advancing-care-and-improving-outcomes-for-patients-with-aplastic-anemia.

For information on other topics, visit www.gotoper.com.




PER Pulse™ Recap (3 of 3)
Emerging Treatment Strategies for Aplastic Anemia

The online continuing medication education activity Oncology Briefings™: Updates in Rare Hematology: Advancing Care and Improving Outcomes for Patients With Aplastic Anemia provides oncologists and other health care providers with engaging instruction on how to identify aplastic anemia in their patients and current and evolving treatment standards in this rare blood disorder. Leading expert, Danielle Townsley, MD, MSc, a hematologist in Bethesda, Maryland, answers key questions, supported by the presentation of clinical science, about aplastic anemia. This third and final PER Pulse™ Recap from this program focuses on emerging strategies to treat aplastic anemia.

Dr. Townsley provides key information from recent and ongoing clinical trials that are examining novel compounds to treat patients with aplastic anemia, as well as guidance how these new agents fit into current strategies:

  • Eltrombopag, a thrombopoietin receptor agonist that was initially approved by the US Food and Drug Administration for the treatment of thrombocytopenia in patients with chronic immune (idiopathic) thrombocytopenic purpura, has been shown to increase platelet counts and a hematologic response in patients with aplastic anemia in phase I/II trials.
  • A more recent phase I/II nonrandomized, open-label trial evaluated eltrombopag in combination with standard immunosuppressive therapy for patients with newly diagnosed, severe aplastic anemia, from the National Heart, Lung, and Blood Institute, grouped 92 patients into 3 cohorts. The complete response (CR) rate at 6 months was 36% and the overall response rate (ORR) was 80%. Overall survival, with a median follow up of 2 years, was 97%.
  • In this trial, patients in the third cohort, who received eltrombopag plus antithymocyte globulin plus cyclosporine from day 1 of treatment through 6 months had the best responses. The CR in this group of patients was 58% and ORR was 94%.

For additional information and commentary on this topic, as well as audio and supporting text, visit www.gotoper.com/online-cme-activities/oncology-briefing/oncology-briefingstrade-updates-in-rare-hematology-advancing-care-and-improving-outcomes-for-patients-with-aplastic-anemia.

For information on other topics, visit www.gotoper.com.








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