3:30 – 4:30 pm Thursday, September 13

Management of Retinoblastoma in 2018: A Nursing Perspective (201)

1CNE  Retinoblastoma (RB) is the most common primary ocular malignancy of young children. Approximately 8,000 children are diagnosed with RB worldwide annually. If caught early RB can be cured, preserving life, vision, and the eye(s). At our institution, the treatment of retinoblastoma has evolved dramatically over the past decade. Utilization of focal therapies has transformed our treatment algorithms, patient outcomes and nursing care; our RB overall survival exceeds international rates. Localized treatments include chemotherapy administered directly into the eye via the ophthalmic artery or intra-vitreously, laser photocoagulation, cryotherapy, and, in cases of very advanced eyes, plaque brachytherapy or enucleation.

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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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2:15 – 3:15 pm Saturday, September 15

DSRCT: A Pediatric Oncology Rarity (230)

1CNE  Desmoplastic small round cell tumor (DSRCT) is one of the rarest pediatric tumors and was only recently classified in 1989. Categorized under sarcomas, DSRCT under the microscopic is a fusion of a both a wilms and ewing sarcoma gene. Although known as a mostly surgical tumor, chemotherapy, radiation, and new treatments like immunotherapy are vital in the battle against this fatal disease. DSRCT is known mostly in the adolescent and young adult population, where the rate of occurrence is predominantly in males. In a retrospective cohort analysis published in 2014 from the Journal of Cancer Epidemiology, the 5-year survival rate was found to be just 33.3% (Lettieri, Garcia-Filion, Hingorani, 2014). Factors impacting survival rate are the overall oncology role to treatment and management.

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12:10 – 12:30 pm Saturday, September 15

Paper Presentations: Clinical Care Issues — Improving Patient Identification Practices in a Central American Pediatric Cancer Hospital (228-3)

1CNE  Participants will identify the nurse’s unique role in promoting a culture of safety and continuous quality improvement through the implementation of a correct patient identification quality improvement project in a Central American pediatric cancer hospital.

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

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11:50 am – 12:10 pm Saturday, September 15

Paper Presentations: Clinical Care Issues — Implementation of an Inpatient Oncology Resource Nurse to Standardize and Improve Chemotherapy Admission Workflow (228-2)

1CNE  Basis of inquiry: Our 32-bed inpatient oncology unit identified delays in initiating chemotherapy for scheduled patients. With an increased census and tightened staffing ratios, the chemotherapy admission process became increasingly inefficient. These delays resulted in frustration for both patients and healthcare providers.

Purpose/Objectives: The aim of this project was to devise and evaluate a more efficient and consistent admission process through the use of a resource nurse. We sought to develop a workflow to deliver “on time” chemotherapy, defined as prior to shift change at 7 pm. This would reduce delays and increase satisfaction of patients, families, and providers.

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11:30 am – 11:50 am Saturday, September 15

Paper Presentations: Clinical Care Issues — Use of a Clinical Care Pathway for the Evaluation and Treatment of Children with Acute Chest Syndrome (228-1)

1CNE Acute chest syndrome is the leading cause of death and hospitalization among patients with sickle cell disease. Nurses have an important role in providing prompt evaluation and treatment of the child with acute chest syndrome. Evidence-based clinical care pathways are recommended to improve quality of care and to help reduce the length of hospitalization. This presentation will review the development of a standardized clinical care pathway which includes recommendations for management, diagnostic work up, and treatment strategies.

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

Therapeutic & Prognostic Impact of Medulloblastoma Molecular Subgroups (227)

1CNE  Medulloblastoma is an embryonal tumor of the central nervous system (CNS). It is the most common malignant CNS tumor in children with peak incidence between 5–9 years of age. Patients typically present with cerebellar deficits and headaches with vomiting, specifically in the mornings. Prognosis varies according to multiple factors including histology, age at diagnosis, and metastases. Medulloblastoma treatment is an intense, multi-modality therapy that can have many resulting late effects. Recent findings have shown medulloblastoma to be a heterogeneous disease which includes multiple subgroups.

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

Comprehensive Care for Thalassemia (226)

1CNE  Thalassemia is becoming a more common diagnosis seen in pediatric hematology/oncology centers. The term thalassemia describes a group of very complex diseases that requires thorough, comprehensive care to improve outcomes and quality of life for these patients. A complicating factor is that patients often are immigrants or refugees with language and cultural barriers and other socioeconomic issues. The care of these patients require a multidisciplinary approach and a strong understanding of the pathophysiology, specific complications, current treatments, and new and emerging therapies.

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3:15 – 4:15 pm Friday, September 14

Beyond the Cure: The Children’s Oncology Group’s Efforts to Improve Outcomes for Pediatric Cancer Patients Long after Treatment has Finished (C223)

coglogo1CNE  Childhood cancer survivors are living longer than ever before, with overall survival rates exceeding 80%. As a result, survivors also are living with chronic late health effects related to their curative treatments, with 40% of survivors experiencing a severe, disabling, and life-threatening or fatal late effect at 30 years post-treatment. Late effects may include second malignancies, endocrinopathies, cardiomyopathy, infertility, pulmonary function deficits, renal/ocular/auditory disorders, neurocognitive deficits, and metabolic syndrome. Recent studies report that cumulative incidence of late effects may be even higher than previously reported, with survivors having 3 to 5 treatment-related chronic health conditions by the age of 50.

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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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