3:15 – 4:15 pm Friday, September 14

PTLD: What's That About? (220)

1CNE Post-transplant lymphoproliferative disease (PTLD) is a major complication of solid organ transplantation. PTLD occurs in 2–15% of pediatric solid organ transplant (SOT) patients, depending on the organ transplanted and the immunosuppression used (Llaurador, 2017). The incidence of transplantation in pediatrics is steadily rising making PTLD the most common form of lymphoproliferation in childhood (Llaurador, 2017). Features of PTLD are similar to an immune system malignancy with abnormal proliferation of lymphoid lineage cells, typically B cells, in the setting of immunosuppression and often associated with EBV infection (Dharnidharka, 2017). Presentation and treatment choice covers a wide spectrum. The goal is to preserve the transplanted organ/graft while eradicating the lymphoproliferative disease. Most often the first intervention is reduction of immunosuppression (Dharnidharka, 2017) and is generally managed by the transplant team. Oncology providers become a prominent member of the multidisciplinary team for patients with more aggressive or disseminated disease.

11:40 am – Noon pm Friday, September 14

Paper Presentation: Assessing Symptoms and Symptom Trajectories — Assessment Tools for Peripheral Neuorpathy in Pediatric Oncology Patients: A Systemic Review (216-3)

1CNE  Chemotherapy agents used for the treatment of pediatric cancer cause many side effects including peripheral neuropathy. Using appropriate assessment tools to accurately identify peripheral neuropathy is an important part of pediatric oncology care. A systematic review was performed to determine reliable assessment tools to identify peripheral neuropathy in children receiving vincristine.

Disclaimer: [1 CH] will be awarded for attending all three paper presentations presented during this timeslot. Partial credit is not available.

11:20 – 11:40 am Friday, September 14

Paper Presentation: Assessing Symptoms and Symptom Trajectories — Effect of Proton Therapy on Patient Reported Health-Related Quality of Life and Symptoms in Patients with Craniopharyngioma (216-2)

1CNE  Basis of inquiry: Craniopharyngioma is a brain tumor located near the hypothalamic-pituitary axis. Surgery and conventional photon-based radiation therapy result in long term tumor control; however, survivors are known to have disruptions in patient sleep, endocrine and neurocognitive function, as well as health related quality of life (HRQOL). Proton therapy is a newer form of radiation therapy. Little is known about its effect on patient–reported HRQOL and symptoms when used in the management of craniopharyngioma.

Purpose/Objectives: To describe patient-reported HRQOL and symptoms before and during proton therapy in patients with craniopharyngioma.

11:00 – 11:20 am Friday, September 14

Paper Presentation: Assessing Symptoms and Symptom Trajectories — Symptom Trajectories among Adolescents during Hematopoietic Stem Cell Transplantation (216-1)

1CNE  Basis of inquiry: Symptom management is major role of pediatric hematopoietic stem cell transplant (HSCT) nurses and a thorough understanding of symptom experiences is needed. Symptoms are complex and their frequency, severity, and distress change over time. Research is needed to identify symptoms over time (trajectories) among adolescents undergoing HSCT.

The aim of this study was to describe symptom trajectories including symptom frequency, severity, and distress among adolescents from pre-HSCT to 100 days post HSCT.

4:45 – 5:45 pm Thursday, September 13

Iron Overload: Implications in Hematology, Oncology, and HSCT Patients (207)

1CNE Iron is a vital mineral which is essential for life. Humans obtain iron through ingestion in foods where absorption is tightly regulated. Iron is bound to transferrin for transport due to the ability of labile plasma iron to cause oxidative damage to tissues and organs. Iron loss occurs through desquamation of the small intestine and menses in women and equals 1–2 mg Fe/day, similar to absorption. Blood transfusions are a lifesaving therapy for hematology patients as well as oncology and hematopoietic stem cell transplantation (HSCT) patients. Anemia, a common side effect of cancer and chemotherapy, used to be treated with erythropoietin stimulators until concerns were raised about their effect on tumor growth. Blood transfusions are a safe, readily available method to increase patient’s hemoglobin and can be done easily in the outpatient setting. However, each unit of blood contains 200–250 mg of iron which is released as the transfused blood cells break down.

3:30 – 4:30 pm Thursday, September 13

Going Viral: Review of Viral Illness and Antiviral Therapy in Hematopoietic Stem Cell Transplant Pediatric Patients (200)

1CNE  Hematopoietic stem cell transplant (HSCT) recipients are at significant risk for developing serious and sometimes fatal infectious complications. Common viral infections post-transplant occur from reactivation of a dormant virus, including herpes simplex (HSV), Varicella (VZV), cytomegalovirus (CMV), BK virus and Ebstein Barr Virus (EBV). Immunocompromised patients may also experience significant morbidity and mortality from common respiratory viruses, such as influenza, parainfluenza, adenovirus, and respiratory syncytial virus (RSV). Interventions vary greatly and can include prophylaxis, preemptive therapy or treatment of active infection. A variety of antiviral agents are now used including cellular immune therapy. A pharmacologic review will show that antiviral agents often have different dosage schemes, complex side effect profiles, and the need for supportive care.


Consulting, Arranging and Referring: How to Create the Connections Needed for a Successful CAR T Patient Experience (004)

3.25CNE  Leukemia is the number one cause of pediatric cancer mortality. In addition, there are poor outcomes for second and greater relapses of ALL, so there is a need for new novel therapies (Novartis, 2015). Chimeric antigen receptor-engineered T cells (CAR T cells) have yielded unprecedented efficacy in B cell malignancies, most remarkably in anti-CD19 CAR T cells for B cell acute lymphoblastic leukemia (B-ALL) with up to a 90% complete remission rate. (Wang, Wu Han, 2017). Because CAR-T therapy success can be contingent on factors such as disease burden and previous therapy, communication between referring and referral centers to facilitate rapid consultation is essential.

9:45 – 10:45 am Friday, September 14

General Session: Oral Medicine for Pediatric Hematology/Oncology Nursing (102)

1CNE  Pediatric hematology/oncology nurses are responsible for the comprehensive care of children with diverse and complex medical conditions, including both non-malignant and malignant diseases. For reasons related to both underlying disease pathology as well as treatment-related toxicities, this unique patient population is at risk of developing a wide spectrum of oral complications that can significantly impact patients.

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