CME: Adult Acute Lymphoblastic Leukemia (ALL) in Adults: 2015 Overview
ACCREDITATION EXPIRED: June 30, 2017
Activity Description / Statement of Need:
In this online CME self-learning program:
Acute lymphoblastic leukemia (ALL) is one of a group of malignancies caused by cytogenetic DNA mutations of developing hematopoietic stem cell precursors and mostly common to children with peak incidence at 2-5 years of age. Although approximately 80% of ALL cases present in children, they also occur in adults. The symptoms of ALL are non-specific and similar to those of acute myelogenous leukemia (ALL), which patients usually have 1-3 months of complaints. These symptoms include: fatigue, malaise, or palpitations associated with anemia; fever with or without infection due to leukopenia or leukocytosis; and petechiae, and bleeding or bruising of the oral mucosa, skin, or gastrointestinal tract due to thrombocytopenia. Treatment goal in patients with ALL is to cure (which is defined as remission for at least 5 years), with children commonly responding to treatment with better than adults. Children may have a remission rate of 99% with a cure rate of about 90%, whereas adults have remission rates of only 60-85% with only 30-40% reaching 5-year disease-free survival. Treatments are categorized into five phases: remission induction with CNS prophylaxis, consolidation therapy, interim maintenance, delayed intensification, and maintenance therapy. Despite the high rate of cure in patients, possible complications and barriers to care in the treatment of ALL are adverse effects, expensive cost of treatment, or poor diagnosis. Dozens of agents that directly target biochemical pathways essential to neoplastic processes have been recently discovered and have been studied specifically in ALL, some of which are FDA-approved for ALL, others of which are presently in clinical trials. Helping the clinician discern the role of both cytotoxic and more novel therapies merits continuing education programming in ALL.
Agenda
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Epidemiology of ALL |
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ALL Morphology |
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WHO 2008 ALL Classification |
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Cytogenetic subtypes |
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Ph-like Precursor B-Cell ALL |
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ALL prognostic indicators |
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T-Cell ALL |
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ALL Management |
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Risk of CNS Disease |
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Immunotherapy of ALL |
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Relapsed/refractory ALL |
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Ph+ ALL |
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Future Directions |
Target Audience:
Healthcare professionals specializing in: hematology, oncology, pharmacy, and those who otherwise commonly care for patients with ALL.
Commercial Support Disclosure: This program is supported by educational grants from Sigma-Tau.
Release Date: June 30, 2015 -- Expiration Date: June 30, 2017
Faculty: Jonathan Kolitz, MD
Agenda
Learning Objectives
By the end of the session the participant will be able to:
- 1. Recognize factors affecting the diagnosis, staging, prognosis, and treatment of patients with ALL, including the Philadelphia chromosome-like signature.
- 2. Incorporate ALL treatment strategies based on the most up to date clinical trial findings.
- 3. Describe the risk-benefit calculus of ALL management strategies and apply them to patient cases taking into account the latest information from and about evidence-based medicine, disease stage, prior treatment, past medical history, and prognostic indicators, including the importance of minimal residual disease.
- 4. Describe the role of and, where applicable, apply to patient cases the following treatment strategies: TKIs and chemotherapy in Ph+ ALL, immunotherapy (CAR T cells, blinatumomab, immunotoxins), and Gamma secretase inhibition in T-ALL.
- 5. Describe salient differences in the treatment of adolescent and young adult (AYA) regimens in the treatment of ALL.
Accreditation
CME for this program is Expired.
Faculty Disclosure and Resolution of COI
As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.
Faculty Disclosure: Jonathan Kolitz, MD has no relevent financial disclosures.
Disclosures of Educational Planners: Charles Turck, PharmD is an officer and part owner of ScientiaCME, LLC.
Commercial Support Disclosure: This program is supported by educational grants from Sigma-Tau.
Instructions
- Read the learning objectives above
- Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
- View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
- Minimum participation threshold: Take the post-test. A score of 0% or higher is required to pass and proceed to the activity evaluation.
- Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.
System Requirements
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh
*Required to view Printable PDF Version
Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.