VOL 2 ISSUE 2 Acute Leukemias
VOL 2 ISSUE 2Acute LeukemiasConversations with Oncology InvestigatorsBridging the Gap between Research and Patient CareFAC U LT Y I N T E R V I E W SMark Levis, MD, PhDFarhad Ravandi, MDEDITORNeil Love, MDSubscribe to Podcasts at ResearchToPractice.com/PodcastsFollow us at Facebook.com/ResearchToPracticeFollow us on Twitter @DrNeilLove
Acute LeukemiasEditorDirector, Clinical Content and CPD/CMENeil Love, MDKathryn Ault Ziel, PhDScientific DirectorRichard Kaderman, PhDEditorialClayton CampbellFelix M Chinea, MDMarilyn Fernandez, PhDAdam P HustadGloria Kelly, PhDKemi Obajimi, PhDCreative ManagerGraphic DesignersSenior Manager, Special ProjectsSenior Production EditorFernando RendinaJessica BenitezTamara DabneySilvana IzquierdoKirsten MillerAura HerrmannEditorial ManagersEllen BohnstengelKyriaki TsaganisCopy EditorsMegan BaileyRosemary HulcePat Morrissey/HavlinAlexis OnecaProduction ManagerAudio ProductionWeb MasterSenior Faculty and Operations ManagerContinuing Education Administrator for NursingContact InformationTracy PotterFrank CesaranoJohn RibeiroBrittany CaldwellKaren Gabel Speroni, BSN, MHSA, PhD, RNNeil Love, MDResearch To PracticeOne Biscayne Tower2 South Biscayne Boulevard, Suite 3600Miami, FL 33131Fax: (305) 377-9998Email: DrNeilLove@ResearchToPractice.comFor CME/CNE InformationEmail: CE@ResearchToPractice.comCopyright 2019 Research To Practice. All rights reserved.The compact disc, Internet content and accompanying printedmaterial are protected by copyright. No part of this programmay be reproduced or transmitted in any form or by anymeans, electronic or mechanical, including photocopying,recording or utilizing any information storage and retrievalsystem, without written permission from the copyright owner.The opinions expressed are those of the presenters and arenot to be construed as those of the publisher or grantors.Participants have an implied responsibility to use the newlyacquired information to enhance patient outcomes and theirown professional development. The information presented inthis activity is not meant to serve as a guideline for patientmanagement.Any procedures, medications or other courses of diagnosisor treatment discussed or suggested in this activity shouldnot be used by clinicians without evaluation of their patients’conditions and possible contraindications or dangers in use,review of any applicable manufacturer’s product informationand comparison with recommendations of other authorities.
Acute Leukemias UpdateA Continuing Medical Education Audio SeriesOVERVIEW OF ACTIVITYThe treatment of acute leukemias remains a challenge for many healthcare professionals and patients despite recentgains made in the management of this group of diseases. Determining which approach is most appropriate requirescareful consideration of patient and disease characteristics, physician expertise and available health-system resources.Published results from ongoing trials continually lead to the emergence of new therapeutic targets and regimens, therebyaltering management algorithms. In order to offer optimal patient care, including the option of clinical trial participation,the practicing medical oncologist must be well informed of these advances.To bridge the gap between research and patient care, this issue of Acute Leukemias Update features one-on-one discussions with leading hematology-oncology investigators. By providing information on the latest clinical developments in thecontext of expert perspectives, this CME activity assists medical oncologists, hematologists and hematology-oncologyfellows with the formulation of evidence-based and current therapeutic strategies.LEARNING OBJECTIVES Appraise current data on recent therapeutic advances and changing practice standards, including FDA approvals,in acute forms of leukemia, and integrate this information into clinical care. Recognize the clinical and prognostic significance of specific cytogenetic and molecular abnormalities, and usethis information to refine diagnostic algorithms for acute myeloid leukemia (AML). Consider patient age, performance status and other disease-related factors in the selection and sequencing oftherapy for AML. Understand the biologic rationale for and early efficacy and toxicity data with the use of chimeric antigen receptordirected T-cell therapy for patients with relapsed acute lymphoblastic leukemia, and, where appropriate, facilitatepatient access to this approach. Identify the mechanisms of action, efficacy and side effects of newly approved and investigational agents demonstrating promising activity in acute forms of leukemia, and refer appropriately selected patients for participation inclinical trials evaluating these approaches.AC C R ED I TAT I ON S TAT EMEN TResearch To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuingmedical education for physicians.C R ED I T DE SI G N AT I ON S TAT EMEN TResearch To Practice designates this enduring material for a maximum of 2.25 AMA PRA Category 1 Credits .Physicians should claim only the credit commensurate with the extent of their participation in the activity.A M E R I C A N B O A R D O F I N T E R N A L M E D I C I N E ( A B I M ) — M A I N T E N A N C E O F C E R T I F I C AT I O N ( M O C )Successful completion of this CME activity, which includes participation in the evaluation component, enables theparticipant to earn up to 2.25 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM)Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME creditsclaimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information toACCME for the purpose of granting ABIM MOC credit. Please note, this program has been specifically designed for thefollowing ABIM specialties: medical oncology and hematology. Personal information and data sharing: Research ToPractice aggregates deidentified user data for program-use analysis, program development, activity planning and siteimprovement. We may provide aggregate and deidentified data to third parties, including commercial supporters. We donot share or sell personally identifiable information to any unaffiliated third parties or commercial supporters.Please see our privacy policy at ResearchToPractice.com/Privacy-Policy for more information.HOW TO USE THIS CME ACTIVITYThis CME activity contains an audio component. To receive credit, the participant should review the CME information, listen to the audio tracks, complete the Post-test with a score of 80% or better and fill out the EducationalAssessment and Credit Form located in the back of this booklet or on our website at . The corresponding video program is available as an alternative at eo.This activity is supported by educational grants from AbbVie Inc, Amgen Inc, Astellas Pharma GlobalDevelopment Inc, Celgene Corporation, Daiichi Sankyo Inc, Genentech, Novartis and Takeda Oncology.Release date: April 2019; Expiration date: April 20203
CME INFORMATIONFA C U LT Y A F F I L I AT I O N SFarhad Ravandi, MDMark Levis, MD, PhDJaniece and Stephen A LasherProfessor of MedicineChief, Section of DevelopmentalTherapeuticsDepartment of LeukemiaThe University of TexasMD Anderson Cancer CenterHouston, TexasDirector, Adult Leukemia ProgramCo-Division DirectorHematologic MalignanciesProfessor of OncologyThe Sidney Kimmel ComprehensiveCancer CenterJohns Hopkins UniversityBaltimore, MarylandEDITORNeil Love, MDResearch To PracticeMiami, FloridaC O N T E N T VA L I D AT I O N A N D D I S C L O S U R E SResearch To Practice (RTP) is committed to providing its participants with high-quality, unbiased and stateof-the-art education. We assess conflicts of interest with faculty, planners and managers of CME activities.Conflicts of interest are identified and resolved through a conflict of interest resolution process. In addition, allactivity content is reviewed by both a member of the RTP scientific staff and an external, independent physicianreviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.FACULTY — The following faculty (and their spouses/partners) reported relevant conflicts of interest, whichhave been resolved through a conflict of interest resolution process: Dr Levis — Advisory Committee: AgiosPharmaceuticals Inc, Amgen Inc, Astellas Pharma Global Development Inc, Daiichi Sankyo Inc, FUJIFILMPharmaceuticals USA Inc, Novartis; Contracted Research: Astellas Pharma Global Development Inc, FUJIFILMPharmaceuticals USA Inc, Novartis; Data and Safety Monitoring Board/Committee: Axios Pharma. Dr Ravandi— Advisory Committee: Amgen Inc, Astellas Pharma Global Development Inc, Bristol-Myers Squibb Company,Jazz Pharmaceuticals Inc, MacroGenics Inc, Orsenix, Seattle Genetics, Xencor; Consulting Agreements:Amgen Inc, Astellas Pharma Global Development Inc, Bristol-Myers Squibb Company, Jazz PharmaceuticalsInc, Orsenix, Seattle Genetics, Xencor; Contracted Research: Amgen Inc, Bristol-Myers Squibb Company, JazzPharmaceuticals Inc, Orsenix, Xencor.EDITOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in theform of educational grants to develop CME activities from the following commercial interests: AbbVie Inc, AcertaPharma — A member of the AstraZeneca Group, Adaptive Biotechnologies, Agendia Inc, Agios PharmaceuticalsInc, Amgen Inc, Ariad Pharmaceuticals Inc, Array BioPharma Inc, Astellas Pharma Global Development Inc,AstraZeneca Pharmaceuticals LP, Bayer HealthCare Pharmaceuticals, Biodesix Inc, bioTheranostics Inc,Boehringer Ingelheim Pharmaceuticals Inc, Boston Biomedical Pharma Inc, Bristol-Myers Squibb Company,Celgene Corporation, Clovis Oncology, Daiichi Sankyo Inc, Dendreon Pharmaceuticals Inc, Eisai Inc, ExelixisInc, Foundation Medicine, Genentech, Genmab, Genomic Health Inc, Gilead Sciences Inc, Guardant Health,Halozyme Inc, ImmunoGen Inc, Incyte Corporation, Infinity Pharmaceuticals Inc, Ipsen BiopharmaceuticalsInc, Janssen Biotech Inc, administered by Janssen Scientific Affairs LLC, Jazz Pharmaceuticals Inc, KitePharma Inc, Lexicon Pharmaceuticals Inc, Lilly, Loxo Oncology, Merck, Merrimack Pharmaceuticals Inc,Myriad Genetic Laboratories Inc, Natera Inc, Novartis, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company,Prometheus Laboratories Inc, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Sandoz Inc, aNovartis Division, Sanofi Genzyme, Seattle Genetics, Sirtex Medical Ltd, Spectrum Pharmaceuticals Inc, TaihoOncology Inc, Takeda Oncology, Tesaro, Teva Oncology and Tokai Pharmaceuticals Inc.RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS —Planners, scientific staff and independent reviewers for Research To Practice have no relevant conflicts ofinterest to disclose.This educational activity contains discussion of published and/or investigational uses of agents that are notindicated by the Food and Drug Administration. Research To Practice does not recommend the use of anyagent outside of the labeled indications. Please refer to the official prescribing information for each product fordiscussion of approved indications, contraindications and warnings. The opinions expressed are those of thepresenters and are not to be construed as those of the publisher or grantors.If you would like to discontinue your complimentary subscription to Acute Leukemias Update, please emailus at Info@ResearchToPractice.com, call us at (800) 648-8654 or fax us at (305) 377-9998. Pleaseinclude your full name and address, and we will remove you from the mailing list.4
Interview with Mark Levis, MD, PhDTracks 1-24Molecular profiling in the diagnosisand treatment of acute myeloidleukemia (AML)Track 2Management of AML with p53mutationsTrack 3Efficacy of hypomethylating agentswith venetoclax in older patientswith AMLTrack 4Therapeutic options for patients withAML and FLT3 mutationsTrack 5Monitoring and management ofvenetoclax-associated tumor lysissyndromeTrack 6Case: A 62-year-old woman whopresents with fatigue and bleedinggums is diagnosed with AML withFLT3 and NPM1 mutationsTrack 7Role of the FLT3 pathway in myeloidcell development and types of FLT3mutationsTrack 8Impact of FLT3 mutations ontherapeutic decision-makingTrack 9Activity of midostaurin in newlydiagnosed AML with a FLT3 mutationTrack 10 BMT CTN 1506: A Phase III trial ofgilteritinib as maintenance therapyafter allogeneic transplant for patientswith AML and FLT3-ITD mutationsTrack 11 Case: A 60-year-old man with AMLand a FLT3-ITD mutation receivesgilteritinib with standard 7 3chemotherapy induction followedby allotransplant and maintenancegilteritinib on a clinical trialTrack 12 Similarities and differences amongmidostaurin, quizartinib and gilteritinibTrack 13 Case: A 63-year-old man withrefractory AML and an IDH2 mutationTrack 1Track 14Track 15Track 16Track 17Track 18Track 19Track 20Track 21Track 22Track 23Track 24receives enasidenib and developsdifferentiation syndromeBiologic rationale for targeting IDH1/2mutations and activity of ivosidenib orenasidenib in patients with relapsed/refractory AMLEfficacy and side effects of CPX-351(liposomal cytarabine/daunorubicin) inpatients with AMLCase: A 28-year-old obese man withacute lymphoblastic leukemia (ALL)and an MLL rearrangement developshepatic toxicity after treatmentwith the Berlin-Frankfurt-Munsterpediatric-inspired regimen containingL-asparaginaseMechanism of action, activity andtolerability of blinatumomab for ALLNeurologic side effects associatedwith blinatumomabUse of blinatumomab for minimalresidual disease-positive ALLOptimal use of tyrosine kinaseinhibitors in the management ofPhiladelphia chromosome-positiveALLCase: A 41-year-old woman receiveschimeric antigen receptor (CAR) T-celltherapy for relapsed ALLRole of CAR T-cell therapy in themanagement of ALLUse of the antibody-drug conjugatesgemtuzumab ozogamicin andinotuzumab ozogamicin for acuteleukemiasActivity of gemtuzumab ozogamicinin patients with high-risk acutepromyelocytic leukemia (APL)Interview with Farhad Ravandi, MDTracks 1-23Track 1Track 2Track 3Impact of genetic mutations andcytogenetic alterations on prognosisand therapy selection for patients withAMLInitial workup for patients with newlydiagnosed AMLBiologic rationale for, activity of andapproval of venetoclax in combination5Track 4Track 5with hypomethylating agents forpatients with AML who are 75 or olderor have comorbiditiesIntegration of venetoclax withhypomethylating agents into theclinical algorithm for AMLApproach to therapy for older patientswith AML and FLT3 mutations
Interview with Dr Ravandi (continued)Management of toxicities associatedwith venetoclax combined with ahypomethylating agentTrack 7RATIFY: Results of a Phase III trialevaluating midostaurin with 7 3induction and high-dose cytarabineconsolidation and as maintenancetherapy for patients with newlydiagnosed AML and FLT3 mutationsTrack 8Efficacy of sorafenib, quizartinib orgilteritinib for patients with AML andFLT3 mutationsTrack 9Side effects and spectrum ofactivity of gilteritinib, quizartinib andmidostaurinTrack 10 Case: A 70-year-old man with AMLand NPM1 and FLT3 mutationsreceives azacitidine in combinationwith venetoclax and sorafenib asthird-line therapyTrack 11 Case: A 44-year-old woman withAML and an IDH2 mutation receivesenasidenibTrack 12 Perspective on the potential useof enasidenib or ivosidenib in thefirst-line settingTrack 13 Mechanism of action and efficacyof CPX-351 in patients with therapyrelated AML or AML with myelodysplasia-related changesClinical experience with CPX-351Role of gemtuzumab ozogamicin inthe treatment of CD33-positive AMLTrack 16 Activity of the recently approvedhedgehog inhibitor glasdegib incombination with low-dose cytarabinefor newly diagnosed AML in patientsaged 75 or older or those withcomorbiditiesTrack 17 Case: A 75-year-old woman withAML and significant comorbidities isenrolled on a clinical trial of decitabinewith venetoclaxTrack 18 Case: A 76-year-old woman with ALLexperiences a complete remissionwith blinatumomab as second-linetherapyTrack 19 Mechanism of action and efficacy ofblinatumomab for ALLTrack 20 Activity and tolerability of CAR T-celltherapy for ALLTrack 21 Cytokine release syndrome andneurologic toxicities associated withCAR T-cell therapy and blinatumomabTrack 22 Perspective on the role of tyrosinekinase inhibitors in the treatment ofPhiladelphia chromosome-positiveALLTrack 23 Efficacy of gemtuzumab ozogamicinin patients with high-risk APLTrack 6Track 14Track 15Video ProgramView the corresponding video interviews with (from left) Drs Levis and Ravandiby Dr Love at /Video6
SELECT PUBLICATIONSAltman JK et al. Deep molecular response to gilteritinib to improve survival in FLT3mutation-positive relapsed/refractory acute myeloid leukemia. Proc ASCO 2017;Abstract 7003.Amadori S et al. Gemtuzumab ozogamicin versus best supportive care in older patients withnewly diagnosed acute myeloid leukemia unsuitable for intensive chemotherapy: Results ofthe randomized phase III EORTC-GIMEMA AML-19 trial. J Clin Oncol 2016;34(9):972-9.Boddu PC et al. Characteristics and outcomes of older patients with secondary acute myeloidleukemia according to treatment approach. Cancer 2017;123(16):3050-60.Cogle CR et al. Factors inf luencing first-line therapy of acute myeloid leukemia (AML)patients (pts) in the Connect MDS/AML Disease Registry. Proc ASCO 2018;Abstract 7037.Cortes JE et al. Glasdegib in combination with cytarabine and daunorubicin in patients withAML or high-risk MDS: Phase 2 study results. Am J Hematol 2018;93(11):1301-10.Cortes J et al. Quizartinib, an FLT3 inhibitor, as monotherapy in patients with relapsed orrefractory acute myeloid leukaemia: An open-label, multicentre, single-arm, phase 2 trial.Lancet Oncol 2018;19(7):889-903.Davids MS et al. Mitigation of tumor lysis syndrome (TLS) complications with venetoclax(VEN) in CLL. Proc ASCO 2018;Abstract 7526.DiNardo CD et al. Durable remissions with ivosidenib in IDH1-mutated relapsed or refractoryAML. N Engl J Med 2018;378(25):2386-98.DiNardo CD et al. Durable response with venetoclax in combination with decitabine orazacitidine in elderly patients with acute myeloid leukemia (AML). Proc ASCO 2018;Abstract7010.DiNardo CD et al. Safety and preliminary efficacy of venetoclax with decitabine orazacitidine in elderly patients with previously untreated acute myeloid leukaemia: Anon-randomised, open-label, phase 1b study. Lancet Oncol 2018;19(2):216-28.Jabbour E et al. Salvage chemoimmunotherapy with inotuzumab ozogamicin combined withmini-hyper-CVD for patients with relapsed or refractory Philadelphia chromosome-negativeacute lymphoblastic leukemia: A phase 2 clinical trial. JAMA Oncol 2018;4(2):230-4.Kantarjian H et al. Inotuzumab ozogamicin in combination with low-intensity chemotherapyfor older patients with Philadelphia chromosome-negative acute lymphoblastic leukaemia:A single-arm, phase 2 study. Lancet Oncol 2018;19(2):240-8.Kantarjian H et al. Blinatumomab versus chemotherapy for advanced acute lymphoblasticleukemia. N Engl J Med 2017;376(9):836-47.Lancet JE et al. CPX-351 (cytarabine and daunorubicin) liposome for injection versus conventional cytarabine plus daunorubicin in older patients with newly diagnosed secondary acutemyeloid leukemia. J Clin Oncol 2018;36(26):2684-92.Perl AE et al. Selective inhibition of FLT3 by gilteritinib in relapsed or refractory acutemyeloid leukaemia: A multicentre, first-in-human, open-label, phase 1-2 study. Lancet Oncol2017;18(8):1061-75.Pollyea DA, Jordan CT. Therapeutic targeting of acute myeloid leukemia stem cells. Blood2017;129(12):1627-35.Savona MR et al. Phase Ib study of glasdegib, a hedgehog pathway inhibitor, in combination with standard chemotherapy in patients with AML or high-risk MDS. Clin Cancer Res2018;24(10):2294-303.Shah BD et al. Outcomes of patients treated with prior blinatumomab in ZUMA-3: A studyof KTE-C19, an anti-CD19 chimeric antigen receptor (CAR) T cell therapy, in adult patientswith R/R ALL. Proc ASCO 2018;Abstract 7006.Stein EM et al. Molecular remission and response patterns in patients with mutant-IDH2acute myeloid leukemia treated with enasidenib. Blood 2019;133(7):676-87.Stein EM et al. Enasidenib in mutant IDH2 relapsed or refractory acute myeloid leukemia.Blood 2017;130(6):722-31.Stevens BM et al. Characterization and targeting of malignant stem cells in patients withadvanced myelodysplastic syndromes. Nat Commun 2018;9(1):3694.Stone RM et al. Midostaurin plus chemotherapy for acute myeloid leukemia with a FLT3mutation. N Engl J Med 2017;377(5):454-64.Zhu HH et al. Oral arsenic plus retinoic acid versus intravenous arsenic plus retinoic acid fornon-high-risk acute promyelocytic leukaemia: A non-inferiority, randomised phase 3 trial.Lancet Oncol 2018;19(7):871-9.7
P O S T-TE S TAcute Leukemias Update — Volume 2, Issue 2QUESTIONS (PLE ASE CIRCLE ANSWER):1. Which of the following statements is trueregarding venetoclax in combination with ahypomethylating agent for patients with AML?a. This therapy elicits a response rate(CR CRi) that is higher than 60%b. Responses are durablec. This therapy is approved for patientswith AML irrespective of age orperformance statusd. All of the abovee. Both a and bf. Both a and c6. Enasidenib is FDA approved for the treatment of relapsed or refractory AML with amutation in .a. IDH1b. IDH2c. Bcl-2d. FLT3e. Both a and b7. In the Phase III RATIFY trial the additionof midostaurin to standard chemotherapyresulted in a significant improvement inoverall survival for patients with newlydiagnosed AML and mutations.a. FLT3-ITDb. FLT3-TKDc. Both a and b2. The recently FDA-approved FLT3 inhibitor gilteritinib is effective in patients withrelapsed or refractory AML andmutations.a. FLT3-TKDb. FLT3-ITDc. Both FLT3-TKD and FLT3-ITD8. The antibody-drug conjugate gemtuzumabozogamicin provides the most benefit forpatients with CD33-positive AML who areat risk.a. Favorableb. Intermediatec. Poor3. Which of the following statements is trueregarding the agent CPX-351 in the treatment of therapy-related AML or AML withmyelodysplasia-related changes?a. CPX-351 is a liposomal formulationof cytarabine and daunorubicinencapsulated at a 5:1 molar ratiob. The efficacy of CPX-351 is similarto that of traditional cytarabine anddaunorubicin in terms of overall survivalc. Both a and b9. Patients with AML who have a FLT3mutation do not need to be retested atrelapse because a patient’s FLT3 mutationstatus does not change during the diseasecourse.a. Trueb. False4. The tyrosine kinase inhibitor ponatinibis effective in patients with Philadelphiachromosome-positive ALL and T315Imutations but has been associated withcardiovascular side effects and pancreatitis.a. Trueb. False10. is a hedgehog inhibitor thatwas recently FDA approved for use incombination with low-dose cytarabine forthe treatment of newly diagnosed AML inpatients who are aged 75 or older or whohave comorbidities that preclude intensiveinduction chemotherapy.a. Gemtuzumab ozogamicinb. Glasdegibc. Ivosidenibd. Gilteritinib5. Adverse events that have been associatedwith both the bispecific monoclonal antibodyblinatumomab and CAR T-cell therapyinclude .a. Cytokine release syndromeb. Neurologic toxicitiesc. Both a and b8
ED U C ATIO N A L A S SE S SMENT A ND CREDIT FO RMAcute Leukemias Update — Volume 2, Issue 2Research To Practice is committed to providing valuable continuing education for oncology clinicians, and yourinput is critical to helping us achieve this important goal. Please take the time to assess the activity you justcompleted, with the assurance that your answers and suggestions are strictly confidential.PA R T 1 — Please tell us about your experience with this educational activityHow would you characterize your level of knowledge on the following topics?4 Excellent3 Good2 Adequate1 SuboptimalBEFOREAFTERActivity and tolerability of approved and investigational FLT3 inhibitors inpatients with AML4 3 2 14 3 2 1Biologic rationale for and activity of CPX-351 (liposomal cytarabine/daunorubicin) for secondary AML4 3 2 14 3 2 1Differentiation syndrome associated with the IDH inhibitors enasideniband ivosidenib4 3 2 14 3 2 1Efficacy of venetoclax with a hypomethylating agent for previouslyuntreated AML4 3 2 14 3 2 1Mechanism of action, activity and tolerability of blinatumomab for ALL4 3 2 14 3 2 1Emerging data with and current clinical role of CAR T-cell therapy forpatients with relapsed ALL4 3 2 14 3 2 1Practice Setting:Academic center/medical schoolCommunity cancer center/hospitalGroup practiceSolo practiceGovernment (eg, VA)Other (please specify) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Approximately how many new patients with the following do you see per year?ALL . . . . . . . . . . . . AML. . . . . . . . . . . . . . . . . . APL . . . . . . . . . . . . . . . . . . . .Was the activity evidence based, fair, balanced and free from commercial bias?YesNoIf no, please explain: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Please identify how you will change your practice as a result of completing this activity (select all thatapply).This activity validated my current practiceCreate/revise protocols, policies and/or proceduresChange the management and/or treatment of my patientsOther (please explain): . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .If you intend to implement any changes in your practice, please provide 1 or more examples:.The content of this activity matched my current (or potential) scope of practice.YesNoIf no, please explain: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Please respond to the following learning objectives (LOs) by circling the appropriate selection:4 Yes 3 Will consider 2 No 1 Already doing N/M LO not met N/A Not applicableAs a result of this activity, I will be able to: Appraise current data on recent therapeutic advances and changing practicestandards, including FDA approvals, in acute forms of leukemia, and integratethis information into clinical care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1 N/M N/A Recognize the clinical and prognostic significance of specific cytogenetic andmolecular abnormalities, and use this information to refine diagnostic algorithmsfor acute myeloid leukemia (AML). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1 N/M N/A Consider patient age, performance status and other disease-related factors inthe selection and sequencing of therapy for AML. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1 N/M N/A9
ED U C ATIO N A L A S SE S SMENT A ND CREDIT FO RM (continued)As a result of this activity, I will be able to: Understand the biologic rationale for and early efficacy and toxicity data withthe use of chimeric antigen receptor-directed T-cell therapy for patientswith relapsed acute lymphoblastic leukemia, and, where appropriate, facilitatepatient access to this approach. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1 N/M N/A Identify the mechanisms of action, efficacy and side effects of newly approvedand investigational agents demonstrating promising activity in acute forms ofleukemia, and refer appropriately selected patients for participation in clinicaltrials evaluating these approaches. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 3 2 1 N/M N/APlease describe any clinical situations that you find difficult to manage or resolve that you would liketo see addressed in future educational activities:.Would you recommend this activity to a colleague?YesNoIf no, please explain: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .PA R T 2 — Please tell us about the faculty and editor for this educational activity4 ExcellentFaculty3 GoodMark Levis, MD, PhDFarhad Ravandi, MDEditor2 AdequateKnowledge of subject matter43214321Knowledge of subject matterNeil Love, MD43211 SuboptimalEffectiveness as an educator43214321Effectiveness as an educator4321R E Q U E S T F O R C R E D I T — Please print clearlyName: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Specialty: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Professional Designation:MDDOPharmDNPRNPAOther: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Street Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Box/Suite: . . . . . . . . . . . . . . . . . . . . . . . . . . . .City, State, Zip: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
in acute forms of leukemia, and integrate this information into clinical care. Recognize the clinical and prognostic significance of specific cytogenetic and molecular abnormalities, and use this information to refine diagnostic algorithms for acute myeloid leukemia (AML).
Menschen Pagina 20 Schritte international Neu Pagina 22 Motive Pagina 24 Akademie Deutsch Pagina 25 Starten wir! Pagina 26 Themen aktuell Pagina 28 em neu Pagina 29 Sicher! Pagina 30 Vol A1 1 Vol A1 Vol 1 Vol 1 2 Vol unico Vol 1 Volume 1 Volume 1 Vol 1 Vol 1 1 Vol A1 2 Vol 2 Vol 1 2 Vol A2 1 Vol A2 Vol 3 Vol
Akenson, Donald Harman Vol 8: 10 Alan, Radous, at Agincourt Vol 12: 1 Albert, King Vol 7: 45, 47 Albert, Prince Vol 12: 17; Vol 14: 1 Alden, John Vol 5: 34; Vol 9: 18 Alexander III Vol 13: 24 Aleyn, John, at Agincourt Vol 12: 1 Allen, Pat Vol 10: 44 Alling Vol 4: 26 Amore, Shirley Vol 12: 3 Anderson, Robert Vol 10: 46 Anderson, Virginia DeJohn .
Jul 07, 2020 · ACUTE TRIANGLE An acute triangle is a triangle in which all three angles are acute. An acute angle is an angle the measures less than 90 degrees. and are some examples of acute angles. In ; J K and L measure less than 90 degrees. All three angles are acute
active monitoring seguimiento activo Nota: De los casos o los contactos de estos. acute respiratory disease [ARD] enfermedad respiratoria aguda [ERA] Engloba acute respiratory distress, acute respiratory distress syndrome, acute respiratory failure y acute respirtaory infection, entre otros. acute respiratory distress [ARD]
chronic care needs that result in frequent transitions between their homes, acute, post-acute, and long-term care settings. In 2008, almost 40 percent (38.7%) of all Medicare beneficiaries discharged from acute-care hospitals received post-acute care. Of these beneficiaries, 15.5 percent were readmitted to the acute care hospital within 30 days 1
Acute pain management has seen many changes in the assessment and the available therapies. Acute pain is being identified as a problem in many patient populations. Beyond postoperative, traumatic and obstetric causes of pain, patients experience acute on-chronic pain, acute cancer pain or acute pain from medical conditions.
The acute oral toxicity, acute dermal toxicity, acute pulmonary, acute intravenous, primary eye irritation, primary dermal irritation, and delayed contact hypersensitivity test are acceptable. The acute pulmonary study showed no mortality and no ad
CHAPTER THREE Eight Problems 1. ACUTE DISSECTION GIVE N A TRIANGLE with one obtuse angle, is it possible to cut the triangle into smaller triangles, all of them acute? (An acute triangle is a triangle with three acute angles. A right angle is of cour,se neither acute nor obtuse
