Intended Audience
This educational activity is designed for hematologists/oncologists and medical oncologists within academic and community settings, oncology nurses, nurse practitioners, physicians assistants and pharmacists with a special interest in hematology or oncology.

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

• Discuss the pathophysiology of immune thrombocytopenic purpura (ITP) and emerging treatment modalities, including mechanisms of action, and assess results from the most recent clinical trials

• Define the role of erythropoiesis-stimulating agents in the management of anemia in hematologic disorders such as myelodysplastic syndrome and other malignancies and outline the new guidelines for their use

• Explain the mechanisms of action of CXCR4 antagonists, their role in stem cell mobilization, and their impact in the treatment of hematologic diseases

• Describe the role of colony-stimulating factors on chemotherapy-induced neutropenia and their effects on patients’ quality of life

Rationale and Purpose
Advances in the treatment of hematologic diseases such as thrombocytopenia, anemia, neutropenia, and blood-related malignancies serve to highlight the importance of addressing supportive care issues in patients with these disorders. As more potent chemotherapeutic regimens and targeted agents are developed in an aggressive effort to cure or treat cancer and prevent metastasis, more focused supportive care is needed to improve quality of life for patients undergoing such treatments. When supportive care issues are addressed, patients experience fewer delays in therapy, less reduction in chemotherapy dose intensity, and fewer or less severe side effects, greatly affecting their quality of life. The Annual Meeting of the American Society of Hematology is a forum that presents the latest data relevant for health care professionals treating patients with hematologic diseases and provides updates on reducing and treating adverse effects such as oral mucositis and treatment-induced cytopenias that are the unintended consequences of cancer-related treatments.

The purpose in providing this continuing education newsletter is to summarize and highlight information presented at ASH 2007 in an enduring format to an expanded target audience of physicians, nurses, and pharmacists who treat patients with hematologic diseases and those experiencing the adverse effects of chemotherapeutic and targeted therapies. Clinicians need to know the latest treatment approaches, as well as the potential risks and benefits of interventions in supportive care, so that they can use these agents in a compassionate but disciplined fashion. This continuing education newsletter will meet an important educational need of this audience.

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.

Physicians. The Meniscus Educational Institute is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Meniscus Educational Institute designates this educational activity for a maximum of  1.25 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Nurses. This activity for 1.3 contact hour(s) 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 1.3 contact hour(s).

Pharmacists. This educational activity is sponsored by the Meniscus Educational Institute. The Meniscus Educational Institute is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. The ACPE Universal Program Number assigned to this program, for 1 contact hour (.10 CEU), is 429-000-07-005-H04.

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.

Edmund K. Waller, MD, PhD, FACP, is a consultant or has an advisory role for and receives grant or research funding from Amgen, Bayer, Amorcyte, and Genzyme. Dr. Waller also receives honoraria from Amgen.

Mojtaba Akhtari, MD, has nothing to disclose.

Letitia O’Kicki, MD, has nothing to disclose.

Harleigh E. Willmott, PhD, has nothing to disclose.

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

Linda Pollio-Moriarity, RN, BSN, OCN, has nothing to disclose.

Beth Wilcox, RN, BS, OCN,  has nothing to disclose.

David Craig, PharmD,  has nothing to disclose.

Jodi Grabinski, PharmD, MS, BCOP,  has nothing to disclose.

Anne Frattali-Eder, MD, PhD,  has nothing to disclose.

Ellen Spremulli, MD,  has nothing to disclose.

Edward Sauter, MD, PhD,  has nothing to disclose.

Janice Dutcher, MD, is a consultant or serves on an advisory board for Wyeth, Bayer/Onyx Pharmaceuticals, Genentech Inc, Novartis Pharmaceuticals, Pfizer Inc, Medarex Inc, Bristol-Myers Squibb Company and Oxford BioMedica Inc, receives honoraria from Wyeth, Novartis Pharmaceuticals, Pfizer Inc, and Bayer/Onyx Pharmaceuticals, and receives grant or research funding from Novartis Pharmaceuticals, Genentech Inc, and
Pfizer Inc.

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.

Suzanne Fields Jones, PharmD, is a consultant or serves on an advisory board for Novartis Pharmaceuticals and Bristol-Myers Squibb Company.

Disclaimer
This activity has been designed to provide continuing education that is focused on specific objectives. In selecting educational activities, clinicians should pay special attention to the relevance of those objectives and the application to their particular needs. The intent of all Meniscus Educational Institute (MEI) educational opportunities is to provide evidence-based learning that will improve patient care. Clinicians are encouraged to reflect on this activity and if applicable to their own patient population, integrate this information into their clinical practice.

The opinions expressed in this activity are those of the faculty and reviewers and do not represent an endorsement by MEI or the companies providing educational grant support of any specific therapeutics or approaches to diagnosis or patient management.

Product Disclosure
Reflecting standard oncology practice, which often requires uses and dosages for therapeutic products that have not been approved by the US Food and Drug Administration, this educational activity includes information about many drugs. All faculty participating in continuing education activities are expected to disclose the approved or investigational status (related to the subject matter of this activity—supportive care in cancer) of all products and devices under discussion. This information, as of the time of printing, is briefly summarized below. In addition, primary references and full prescribing information should be consulted for complete information. Clinicians have the professional responsibility to ensure that drugs are prescribed and used appropriately, based on their own clinical judgment and accepted standards of care.

Agents discussed in this text approved by the US Food and Drug Adminis­tration include darbepoetin alfa, epoetin alfa, epoetin beta, G-CSF, GM-CSF, iron sulfate, sodium ferric gluconate, filgrastim, pegfilgrastim, and palifermin. The information presented does not include all possible uses, side effects, or interactions of these medications. Investigational agents mentioned in this text include AMG 531, eltrombopag, fms-like tyrosine kinase 3 ligand, plerixafor, rHuEPO, and velafermin.

Adapted from Drug Facts and Comparisons. St Louis, Mo: Facts & Comparisons; 2007.
US Food and Drug Administration Web site: http://www.fda.gov.

There is no fee for participating in this activity.

Release and Termination Dates
Release date: March 2008
CE available until: March 31, 2009