Credit Hours: CME 1.00

Target Audience:

Faculty, residents, fellows, and community physicians in General Internal Medicine and subspecialties.

Educational Objectives:

Upon completion of this activity, participants should be able to:

Describe the various applications of Chimeric Antigen Receptor T-cell Therapy in Heme Malignancies.
Review new oral options for the treatment of MDS
Recommend using a personalized approach to the treatment of AML in the elderly.
Describe the mechanism of action of emicizumab and caplacizumab
Recognize the preferred choice of anticoagulation in antiphospholipid antibody syndrome.
Assess when a direct oral anticoagulant is an acceptable choice of anticoagulation for cancer-associated thrombosis.

Suggested Additional Reading:

Neelapu SS, Locke FL, Bartlett NL, et al. Axicabtagene Ciloleucel CAR T-Cell Therapy in Refractory Large B-Cell Lymphoma. N Engl J Med. 2017 Dec 28;377(26):2531-2544. doi: 10.1056/NEJMoa1707447. Epub 2017 Dec 10. PubMed PMID: 29226797.
Turtle CJ, Hay KA, Hanafi LA, et al. Durable Molecular Remissions in Chronic Lymphocytic Leukemia Treated with CD19-Specific Chimeric Antigen Receptor-Modified T Cells After Failure of Ibrutinib. J Clin Oncol. 2017 Sep 10;35(26):3010-3020.
Fenaux P1, Mufti GJ, Hellstrom-Lindberg E, Santini V, Finelli C, Giagounidis A, Schoch R, Gattermann N, Sanz G, List A, Gore SD, Seymour JF, Bennett JM, Byrd J, Backstrom J, Zimmerman L, McKenzie D, Beach C, Silverman LR; International Vidaza High-Risk MDS Survival Study Group. Lancet Oncol. 2009 Mar;10(3):223-32.
Mahlangu J, Oldenburg J, Paz-Priel I, et al. Emicizumab prophylaxis in patients who have hemophilia A without inhibitors. NEJM. 2018; 379: 811-822.
Scully M, Cataland SR, Peyvandi F, et al. Caplacizumab treatment for acquired thrombotic thrombocytopenic purpura. NEJM. 2019; 380: 335-346.
Pengo V, Denas G, Zoppellaro G, et al. Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome. Blood. 2018; 132: 1354-1371.
Raskob GE, van Es N, Verhamme P, et al. Edoxaban for the treatment of cancer-associated venous thromboembolism. NEJM. 2018; 378: 615-624.
Young AM, Marshall A, Thirlwall J, et al. Comparison of an oral factor Xa inhibitor with low molecular weight heparin in patients with cancer with venous thromboembolism; results of a randomized trial (SELECT-D). JCO. 2018; 36: 2017-2023.
McBane RD, Wysokinski WE, Le-Rademacher JG, et al. Apixaban and dalteparin in active malignancy-associated venous thromboembolism: the ADAM VTE trial. JTH. 2019; 00: 1-11.

Authors:

Craig Seaman, MD — Assistant Professor of Medicine, Division of Hematology/Oncology, University of Pittsburgh School of Medicine
Associate Director, Hemophilia Center of Western Pennsylvania
Dr. Seaman is a consultant with Bayer and Takeda.

Kathleen Dorritie, MD — Assistant Professor of Medicine, Division of Hematology/Oncology University of Pittsburgh School of Medicine
Dr. Dorritie receives grant/research support from Juno Therapeutics and Kite Pharma.

Liza Villaruz, MD — Associate Professor of Medicine, Division of Hematology/Oncology, University of Pittsburgh School of Medicine
Dr. Villarvz receives grant/research support from Exelixis, Incyte, Merck, RBN, Astrazeneca, Genentech, and is a consultant with Achilles Therapeutics.

No other members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships with any companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

This activity is approved for AMA PRA Category 1 Credit™

The University of Pittsburgh is an affirmative action, equal opportunity institution.