Introduction
The first successful hematopoietic stem cell transplant (HSCT) attempt was reported more than 50 years ago. Today more than 50,000 autologous (auto-SCT) and allogeneic (allo-SCT) stem cell transplants are performed annually for both malignant and non-malignant hematological disease. In the decades since that first report, advances in scientific understanding and process improvements in the transplant maneuver have resulted in increased numbers of long-term survivors and decreased adverse events.
Featured Content
• Mobilization with Chemotherapy-Based Regimens
• PBSC Collection for Optimal Results
• Poor Mobilization Prediction
• Stem Cell Mobilization Following Myelosuppressive Agents
• Pharmacoeconomic Considerations/Efficiency
• Effective Algorithms for Mobilization Agents
Editors
Steven M. Devine, MD, bio | Leona A. Holmberg, MD, PhD, bio | John M. McCarty, MD, bio | Peter A. McSweeney, MD, bio |
Ivana N.M. Micallef, MD, FRCP(C), bio | Jeffrey R. Schriber, MD, FRCP(C), bio
Media: Newsletter
Estimated time to complete activity: 1.5 hours |
Release date: March 8, 2010 | Expiration date: September 7, 2010
Statement of Need
A frequent approach to mobilizing stem cells for peripheral collection involves administering hematopoietic growth factors. Currently, granulocyte-colony-stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating factor (GM-CSF) are used in the autologous setting, while G-CSF is predominately used in the allogeneic setting. Growth factors are generally administered for 4-6 days prior to cell collection to allow adequate time for CD34+ cell mobilization from bone marrow to peripheral circulation. Chemotherapy administration prior to growth factor is a common approach that may increase peripheral blood stem cells (PBSC) 5-15 fold, but also introduces the risk of chemotherapy toxicity. In current clinical practice, patients who do not mobilize enough CD34+ cells for collection following multiple attempts at apheresis may require painful bone marrow harvest. Novel methods for obtaining the optimal dose of stem cells in the most efficient manner for transplant represents a significant medical need in autologous SCT. Furthermore, continuing clinical investigation in the allogeneic setting may demonstrate improved convenience for normal donors, and pharmacoeconomic analysis may indicate health-system cost savings. Healthcare professionals caring for patients requiring stem cell mobilization prior to SCT need to understand the basis for emerging therapeutic options, and the preclinical and clinical data supporting the development and integration of novel mobilization regimens into clinical practice. This educational program will address optimal integration of emerging therapeutic strategies regarding stem cell mobilization, describe the means of optimizing stem cell mobilization while minimizing adverse events, and provide a perspective of directions in stem cell mobilization.
Target Audience
The target audience for the program includes hematologists, hematologist-oncologists, medical oncologists, oncology specialty pharmacists, and stem cell collection personnel charged with the care of patients undergoing stem cell mobilization.
Learning Objectives
Upon completion of this educational program, participants should be better able to:
- Discuss challenges and opportunities for improvement with currently available techniques for stem cell mobilization such as role of chemotherapy-based mobilization regimens and optimal stem cell collection yield
- Prospectively predict patients at high risk for poor stem cell mobilization and determine appropriate timing for incorporation of novel stem cell mobilization strategies
- Develop treatment algorithm for the management of patients at risk for poor mobilization
- Consider pharmacoeconomic issues associated with stem cell mobilization and recommend techniques for improving efficiencies
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ACCREDITATION INFORMATION
PHYSICIAN CONTINUING EDUCATION
ACCREDITATION STATEMENT
Educational Concepts Group, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
CREDIT DESIGNATION STATEMENT
Educational Concepts Group, LLC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
| PHARMACIST CONTINUING EDUCATION |
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| Educational Concepts Group, LLC is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. |
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Type of Activity: Knowledge-based
Educational Concepts Group, LLC designates this continuing education activity for 1.5 contact hours (0.15 CEUs) (UAN 0199-0000-10-096-H01-P).
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METHOD OF PARTICIPATION
There are no fees for participating and receiving CME/CE credit for this activity. During the period March 8, 2010 through September 7, 2010, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the post-activity assessment.
CME/CE CREDIT
Physicians and pharmacists who complete the post-test with a score of 70% or better may view and print their credit letter or statement of credit via the website, www.educationalconcepts.net.
ACKNOWLEDGEMENT OF COMMERCIAL SUPPORT
This activity is supported by an educational grant from Genzyme Corporation.
ECG HAS DECLARED THE FOLLOWING FINANCIAL RELATIONSHIPS
ECG receives educational grants from pharmaceutical industry and other commercial sources. Planners, managers, and other staff members at ECG have no relevant financial relationships to disclose.
DISCLOSURE OF OFF-LABEL USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Educational Concepts Group, LLC (ECG) does not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity do not necessarily represent the views of ECG. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
None of the contents may be reproduced in any form without prior written permission from the publisher. This activity may be accessed at www.educationalconcepts.net.
CME/CE INQUIRIES
For further information, please contact
Educational Concepts Group, LLC
1300 Parkwood Circle SE
Suite 325
Atlanta, Georgia 30339
Phone: 1.770.933.1681
Fax: 1.770.933.1692
www.educationalconcepts.net |
FACULTY DISCLOSURE STATEMENT
All faculty participating in continuing education activities sponsored by ECG are expected to disclose to the audience any real or apparent commercial financial affiliations related to the content of their presentations/materials.
THE FOLLOWING FACULTY MEMBERS HAVE DECLARED RELEVANT FINANCIAL RELATIONSHIPS
Steven M. Devine, MD
Grants/Research Support
Genzyme Corporation
Honorarium
Millennium Pharmaceuticals, Inc.
Leona A. Holmberg, MD, PhD
Grants/Research Support
Celgene Corporation, Merck & Co., Inc., Millennium Pharmaceuticals, Inc.
Consultant Fees, Honorarium
Genzyme Corporation
John M. McCarty, MD
Grants/Research Support
Celgene Corporation, Genzyme Corporation, Seattle Genetics
Honorarium
Celgene Corporation, Genzyme Corporation
Speakers’ Bureau
Celgene Corporation, Genzyme Corporation
Peter A. McSweeney, MD
Grants/Research Support, Honorarium
Genzyme Corporation
Ivana N.M. Micallef, MD, FRCP(C)
Grants/Research Support
Genzyme Corporation
Jeffrey R. Schriber, MD, FRCP(C)
No relevant financial relationships to disclose
ACKNOWLEDGEMENT
The faculty wish to thank Maureen Haas, PharmD, BCPS, BCOP, a paid employee of ECG, for assistance in writing this document.
DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Please refer to the official prescribing information for each product or consult the Physicians’ Desk Reference for discussion of approved indications, contraindications, and warnings.
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