Creating a Pediatric Hematology/Oncology Manuscript to Submit for Publication in a Nursing Journal (003)

3.25CNE  Increasing numbers of pediatric oncology nurses are completing advanced degrees, including the DNP and PhD. These nurses are advancing nursing discipline, science, evidence, and clinical practice by publishing their scholarly work. The experience of publishing in a professional nursing journal can be confusing and overwhelming to both novice and seasoned authors.
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2:15 – 3:15 pm Saturday, September 15

Are You an APN Searching for COG Supportive Care Guidelines? COG Guideline Development/Endorsement Process with Practical Applications (C234)

coglogo 1CNE Since the 1970s survival rates for most types of pediatric cancer have continued to improve, with about 80% of patients now expected to become long-term survivors. However, this incredible success requires intensive treatments that are often associated with significant acute and long-term side effects. These side effects of pediatric cancer therapy can negatively impact a patient’s symptom experience and quality of life. Lack of effective symptom management can potentially impact outcomes through delays in proven curative treatments, dose reductions, and patient nonadherence to the treatment plan.

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2:15 – 3:15 pm Saturday, September 15

Transfusions in Pediatric Hematology/Oncology Patients: As Easy As ABO (231)

1CNE  Transfusion of blood products is an essential part of caring for children with benign hematologic disorders, malignant diseases, and those undergoing hematopoietic stem cell transplants. One challenge in pediatric patients is the broad age range for patients that span from neonates to young adults. Recent studies have shown that there is a wide variability in practice among pediatric programs in the indications for transfusions, CMV prevention, and management of patients who become refractory to transfusions.

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11:30 am – 12:30 pm Saturday, September 15

COG Clinical Trials: Empowered Nurses the Key to their Success (C229)

coglogo1CNE  In pediatric oncology, clinical trials are conducted to improve survival rates, understand disease biology, and prevent or improve management of treatment-related acute and long-term side effects. The majority of children newly diagnosed with cancer in North America are treated on Children’s Oncology Group (COG) clinical trials. In the last 50 years clinical trials in pediatric oncology have increased the overall 5-year survival rate from under 10% to over 80% today. Nurses are an integral part of the success of these trials.

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11:30 am – 12:30 pm Saturday, September 15

Impact of Donor Selection in Hematopoietic Stem Cell Transplant Outcomes (224)

1CNE Hematopoietic stem cell transplant (HSCT) is an important therapeutic option for children with malignant and nonmalignant disease. Over the past 50 years, there has been an increasing number of indications for HSCT. Human leukocyte antigen (HLA) matched related donors offer the best outcome and frequently donors are siblings that are children. Haploidentical and unrelated donors have expanded the pool of donors. Improved HLA typing and posttransplant supportive care has improved the outcome of HSCT from alternative donors. The American Academy of Pediatrics published a statement regarding pediatric patients undergoing HSCT. The policy recommended new standards that had significant impact on both pediatric stem cell transplant physicians and parents. Choosing the appropriate donor depends on the patient and donor’s degree of HLA matching, sex, parity, blood type, CMV status, HLA directed antibodies, and the health of the donor.

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3:15 – 4:15 pm Friday, September 14

New Hope Through Clinical Trials in Low Grade Gliomas: From Diagnosis, Standard Treatment Modalities, to BRAF/MEK Inhibitors (221)

1CNE  Low grade gliomas (LGG) are the most common type of pediatric brain tumor (Jones et al., 2017). Depending upon tumor location, many patients undergo surgical resection. If a gross total resection is achieved, patients receive MRI imaging. However, patients who have an incomplete resection or a recurrence receive additional therapy. Young patients with developing brains receive chemotherapy. Older patients may receive radiation. There are multiple agents or combination of agents that are administered in patients with LGG. Standard frontline chemotherapies are either Carboplatin and Vincristine or TPCV (Thioguanine, Lomustine, Procarbazine, and Vincristine). Other traditional single-agent therapies include Temodar, Vinblastine, or Vinorelbine. BRAF/MEK inhibitors (trametinib, dabrafenib, vemurafenib, and selumetinib) are currently being used in clinical trials (Penman, Faulkner, Lowis, & Kurian, 2015).

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3:15 – 4:15 pm Friday, September 14

Never a Dull Moment: Latest and Greatest Clinical Pearls for the APN (218)

1CNE  Advanced practice providers (APP) are consistently challenged to have the most current information on diagnosis, treatment, therapy delivery strategies, adverse effects management, and nursing led research from throughout the trajectory of a disorder. The purpose of this session is to provide APP-specific education and networking related to the complexities of children diagnosed with a hematological or oncological disorder. First, a quick primer on how to read and interpret peripheral blood smears and bone marrow biopsies, which will help with initial diagnoses of hematology and liquid tumors. After an initial diagnosis is made, genomic profiling of both liquid and solid tumors is increasingly utilized to identify molecular targets. The role of the advanced practice nurse (APN) in the ordering and interpretation of these tests will be explained. Next, the intricate transition from identification of mutations to selection of mutational targets with current medications in brain tumors will be discussed. In addition, the monitoring and treatment of the complex side effect profiles will be reviewed.

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11:00 am – Noon Friday, September 14

High Risk Therapy Made Easy: Supporting High Risk Patients Through Complex Therapy (215)

1CNE  High risk (HR) pediatric oncology patients continue to undergo new and emerging treatment protocols, which have multiple complications that patients may encounter. Accurate assessment and early interventions is key to supporting patients through therapy. This session will focus on supportive cares for relapse leukemia and HR neuroblastoma patients; with special focus on the immunotherapy drugs blinatumomab and dinutuximab as well as infection prophylaxis. Most frequent serious adverse events noted in patients treated with blinatumomab are disorders of the nervous system and systemic cytokine release syndrome (CRS). Events are usually reversible and able to be managed with attentive supportive care. Most frequent side effects noted in patient treated with dinutuximab are pain, hypersensitivity reactions, CRS, capillary leak, fevers, and hypotension. We will use case studies of HR patients.

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11:00 am – Noon Friday, September 14

Managing Depression and Anxiety in Childhood Cancer (212)

1CNE  The period in which children are diagnosed with cancer and undergo treatment coincides with a time of critical physical, cognitive, behavioral, and social development. The mental health of children with cancer is particularly vulnerable due to the inherent uncertainties of the diagnosis, prognosis, therapy, and disruption of their daily lives. Psychiatric diagnoses such as anxiety and depression are often underdiagnosed, undertreated, and extend beyond the conclusion of cancer therapy. This presentation will address appropriate screening and assessment tools to enhance the pediatric oncology nurse’s comfort in identifying pathologic depression and anxiety, exploring treatment modalities such as psychotherapy, psychopharmacology (including appropriate dosing and monitoring), and when to refer patients for further care.

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4:45 – 5:45 pm Thursday, September 13

DNR, DNET, DNI: The Alphabet Soup of Resuscitation (208)

1CNE  Caring for infants, children, adolescents, and young adults through the end of life is challenging. "Getting the DNR" is terminology that many nurses are used to hearing; they may even be the ones asking for clarification of "code status" as their patients come closer to the end of their lives. This presentation will clarify definitions and abbreviations commonly used including DNR, AND, and DNET, and the meaning these terms have for the hematology/oncology team, patients, and families. How we talk with families will be reviewed, including discussions of data, what we are not going to do, and asking them to make impossible decisions. Finally, suggestions for discussing goals of care and recommendation and the role of hope will be discussed and practiced.

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