Intended Audience
This continuing education activity is designed for nurses and nurse practitioners who care for patients with myelodysplastic syndromes (MDS), chronic lymphocytic leukemia (CLL), and multiple myeloma (MM) and their families. It also includes interested nurses who may care for this population in the future.

Learning Objectives
At the completion of this activity, participants should be better able to

• Outline current standards of care for patients with MDS, CLL, and MM

• Relate results of recent studies on the use of US Food and Drug Administration (FDA)–approved and investigational agents for the treatment of MDS, CLL, and MM to the changing standards of care

• Describe adverse effects (toxicities) associated with the current drugs used for MDS, CLL, and MM and approaches to managing these effects

• Formulate plans of patient care designed to optimize treatment outcomes and quality of life for patients

Rationale and Purpose
The rapid development of novel antineoplastic agents has significantly expanded therapeutic options for patients with MDS, CLL, and MM. Advances in our understanding of molecular biology, cytogenetics, signaling pathways, and pathobiology of these hematologic malignancies have spurred the emergence of new agents and regimens—including monoclonal antibodies, immunomodulatory drugs, proteasome inhibitors, and antimetabolites—to replace the traditional standard of care.

MDS represents a group of clonal stem cell disorders that, for a variety of reasons, have become increasingly more common in oncology practices during the last few years. Within a 2-year period, the FDA approved 3 new active agents for MDS, shifting the focus of existing guidelines from best supportive care to active treatment. The revised guidelines include detailed diagnostic and risk evaluation to promote selection of the best available therapy for each patient. They also incorporate supplemental therapies for iron chelation and updated recommendations for the use of erythropoietin-stimulating hormones.

CLL is a malignant low-grade disorder arising from B cells. Currently, no standard treatment results in cure, and patients generally develop resistance to the commonly used purine analog. For relapsed disease, the existing agents are effective but may cause severe immunosuppression. Recent clinical trials examining flavopiridol (cyclin-dependent kinase inhibitor), lenalidomide (immunomodulatory agent that modifies or regulates functioning of the immune system), and bendamustine (novel alkylating agent that attacks cancer cells) look especially promising.

MM is an increasingly common malignant plasma cell disorder currently diagnosed in nearly 15,000 Americans annually. The introduction of newer drugs, such as lenalidomide, thalidomide, and bortezomib, has begun to change the therapeutic paradigm for MM and offers patients new hope for improved rates of complete response and extended overall survival.

The purpose of this activity is to enhance the quality of care provided by oncology nurses involved in the management of patients with MDS, CLL, and MM by providing them with the latest clinical trial findings and their implications for clinical practice.

Continuing Education
Participants who successfully complete this activity (including scoring at least 70% on the learning assessment and completing and submitting the evaluation form) will be issued a statement of credit via e-mail or US mail within 4 weeks.

Nurses. This activity for 1.6 contact hours is provided by the Meniscus Educational Institute. The Meniscus Educational Institute is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Accreditation refers to recognition of educational activities only and does not imply approval or endorsement by the Meniscus Educational Institute or the American Nurses Credentialing Center’s Commission on Accreditation of any product mentioned.

Provider approved by the California Board of Registered Nursing, Provider No. 13164, for
1.6 contact hours.

This program has been approved for 1.5 contact hours of continuing education by the American Academy of Nurse Practitioners. Program ID 0807345.

ANCC Accreditation Feedback Line

1-866-262-9730

The Accreditation Program of the American Nurses Credentialing Center is interested in the opinions and perspectives of the participants in accredited continuing nursing education activities, particularly perspectives related to the presence of perceived bias* in an activity. For this reason, we provide a toll-free telephone number, which participants may call at any time to tell us about:

·   Any noted bias or conflict of interest in the education

·   Any concerns, compliments, or opinions

·   A great experience

·   An unpleasant experience

·   Your thoughts on the process

Just call and tell us!

1-866-262-9730

*Bias is defined as: preferential influence that causes a distortion of opinion or of facts. Commercial bias may occur when an educational activity promotes one or more product(s) (drugs, devices, services, software, hardware, etc). This definition is not all inclusive and participants may use their own interpretation in deciding if a presentation is biased.

NOTE: Statements of commercial support and/or conflict of interest disclosures do not represent bias. Such statements inform the learner that the provider has implemented a mechanism to identify and resolve all conflicts of interest prior to delivery of the educational material.

Financial Disclosures

All individuals in positions to control the content of this program (eg, planners, faculty, content reviewers) are expected to disclose all financial relationships with commercial interests that may have a direct bearing on the subject matter of this continuing education activity. Participants have the responsibility to assess the impact (if any) of the disclosed information on the educational value of the activity. All faculty have been offered a modest honorarium from the accredited provider for their participation in this activity.

Sandra E. Kurtin, RN, MS, AOCN, ANP
Celgene Corporation, Amgen Inc, sanofi-aventis, Novartis, MGI Pharma, Inc,
and Bristol-Myers Squibb Company.                   

Daruka Mahadevan, MD, PhD, is a consultant or has an advisory role with Astex Therapeutics Ltd; receives
honoraria from Celgene Corporation, Alexion Pharmaceuticals, and MGI Pharma, Inc; and receives grant or
research funding from Avila Therapeutics, Inc, Astex Therapeutics Ltd, and Pfizer Inc.           

Kena Miller, RN, MSN, FNP, has an advisory role with and receives honoraria from Celgene Corporation, Millennium Pharmaceuticals, Inc, and Kyphon, Inc.

Beth Faiman, RN, MSN, CNP, AOCN, is employed or holds a leadership role with, is a consultant or has an advisory role with, and receives honoraria from Celgene Corporation, Millennium Pharmaceuticals, Inc, and Kyphon, Inc.

Karen Abbas, RN, MS, AOCN, has nothing to disclose.

Jennifer Seiler, MSN, FNP, AOCNP, has nothing to disclose.

Sylvia Wood, RN, MS, ANPC, has nothing to disclose.

Marilyn Haas, PhD, ANP-C, is a consultant or serves on an advisory board for and receives honoraria from Cytogen Corporation, PharmaWrite LLC, and Center of Medical Knowledge LLC.