Pediatric Chemotherapy and Biotherapy Instructor Course (001)

The APHON Pediatric Chemotherapy and Biotherapy Instructor Course is designed for any nurse who has completed the provider course and meets the qualifications to be trained to teach the course. This course provides general instruction in adult education, guidance in the planning of lectures based on the APHON program content, and instruction in administering the provider exam. Upon successful completion, nurses return to their institutions as recognized APHON Pediatric Chemotherapy and Biotherapy Instructors who can provide ongoing instruction and education to other registered nurses.

Prerequisites are necessary to be accepted into this course*. This course is an extra-fee event that is open to nurses who: 

• is a licensed registered nurse
• is a current APHON Pediatric Chemotherapy and Biotherapy Provider
• is an APHON member*
• has two years of clinical experience
• is a current Certified Pediatric Oncology Nurse (CPON^®) or Certified Pediatric Hematology/Oncology Nurse (CPHON®)
• has a bachelor's degree or higher (preferred)

*Note that the eligibility of each registrant will be verified. APHON reserves the right to cancel the registration of any participant that does not meet the above criteria. APHON will issue a refund if a registrant does not meet all of the eligibility criteria. All registrations must be received by Monday, August 24, for this course. This course is limited to 75 participants. Applications will be handled on a first-come, first-served base. 

Opening Keynote: Unmasking Your Resiliency (101)

Broken Bone Marrow: Comparing and Contrasting Acquired Aplastic Anemia and Inherited Bone Marrow Failure Syndromes (200)

Bone marrow failure represents a diverse and rare group of hematologic disorders. Some patients have subtle findings that may go unrecognized for years, while others present with acute, severe cytopenias. As patients with an inherited disorder have increased risk of comorbidities and predisposition to malignancy, acquired aplastic anemia (AA) must be differentiated from inherited bone marrow failure syndromes (IBMFS) in order to provide appropriate treatment and surveillance.

Cancer Predisposition: Li-Fraumeni Syndrome in Pediatrics, Nurses Can Make A Difference in Quality of Life and Long-Term Survival Through Screening and Education (201-1)

Oncology nurses provide care for patients and families with multiple early-onset cancers. This session will review Li-Fraumeni Syndrome (LFS), a genetic cancer predisposition syndrome. It is recognized as a mutation in the TP53 gene, the most frequently mutated gene in sporadic cancers. LFS is defined as any germline mutation in the TP53 tumor suppressor gene that is passed down in an autosomal dominant pattern.

Rolling the DICER1 (201-2)

Are multiple malignancies in one patient just bad luck? Do different malignancies within the same family signal a cancer predisposition syndrome? Understanding of the human genome demonstrates that many cancers are more than just a bad roll of genetic dice. Benign and malignant conditions that are not seemingly related may be the result of one abhorrent gene.

What Every Nurse Needs to Know About Drug Shortages (202)

Shortages of essential drugs can have a significant impact on the health of children worldwide. In pediatric oncology, drug shortages are particularly impactful. Childhood cancer treatment relies heavily on the use of sterile injectable generic agents, which make up the majority of scarce medications.

First Victim, Second Victim.....Do No Harm (203-1)

In November 1999, the Institute of Medicine released its landmark report "To Err is Human," which outlined the looming patient safety crisis affecting healthcare facilities. It was suggested in this report that up to 98,000 patients per year were the victims of medical errors.

Reducing Preventable Harm: Quality Improvement Strategies to Reduce Chemotherapy/Biotherapy Medication Administration Errors (203-2)

Medication administration errors (MAE) are among the most common adverse events causing patients during treatment. These events are nearly always preventable. Although any MAE is problematic, patients treated with chemotherapy and biotherapy agents are at risk for significant harm due to the inherent hazards of the medications and the complexity of treatment protocols.

Promoting Well-Being and Resilience for Pediatric Oncology Advanced Practice Nurses: An Evidence-Based Approach (204)

Occupational burnout adversely impacts the delivery of high-quality, compassionate care. Pediatric oncology advanced practice nurses (APNs) are at increased risk for burnout attributed to a high-stress environment, and the complexity of patient/family conditions. In 2019, the World Health Organization recognized burnout as an occupational phenomenon in the 11th revision of the International Classification of Diseases.

Enhancing Patient/Family Education with Children’s Oncology Group Tools and Resources (C205)

When a child is newly diagnosed with cancer, a consistent theme reported by parents is feeling overwhelmed with the amount of medical information that they must process in order to safely care for their child at home.

Solid and CNS Tumors at Relapse: Creativity and Challenges for the APN (206)

Advanced practice providers are consistently challenged to help provide and deliver new and innovative therapies at the time of relapse. Solid and central nervous system tumors rarely have well-proven, successful treatments at the time of relapse or progression on therapy.

Sickle Cell Disease - New Treatments for Patients (Finally!) (207)

There have been very few new treatments developed for patients with sickle cell disease since Hydroxyurea was first introduced in the early 1980s. Essentially in isolation, Endari (L-glutamine), indicated to reduce acute complications of sickle cell disease, became available to patients approximately 2 years ago.

Same Chorus, Different Tune: Interactive Teaching Techniques for Chemotherapy-Biotherapy Instructors (208)

The Chemotherapy/Biotherapy Provider Program Committee is committed to the ongoing support of more than 550-course instructors as they continue to adapt to the content and lectures of the 4th edition curriculum.

Paper Presentation: Symptoms Across the Cancer Continuum—Time Will Tell? Symptom Clusters, Physical Activity, and Quality of Life During Maintenance Therapy in Children with Acute Lymphocytic Leukemia (209-1)

Children undergoing treatment for acute lymphocytic leukemia (ALL) report co-occurring symptoms of fatigue, sleep disturbances, and depression as a symptom cluster. Physical activity (PA) is essential for development and may influence symptom severity. Nurses often advise patients and families that if they are experiencing distressing symptoms, these will improve with time during the less intensive maintenance phase of therapy.

Paper Presentation: Symptoms Across the Cancer Continuum—Symptoms and Quality of Life of Children and Adolescents Receiving Cellular Therapies (209-2)

Hematopoietic stem cell transplantation (HSCT) and chimeric antigen receptor (CAR) T-cell therapy are potentially curative therapies for children with life-threatening conditions but can result in a high symptom burden and poor quality of life (QoL).

Paper Presentation: Symptoms Across the Cancer Continuum— Comparison of Symptom Reports Among Children with Advanced Cancer and Their Parents (209-3)

Using patient-reported outcomes to elicit a child’s symptom experience is the gold standard; however, little empirical evidence exists demonstrating consistent integration of self-report of physical and psychological symptoms across clinical settings. Additionally, studies have revealed discordance among children and parents for symptom reporting during cancer treatment.

Less is More in Childhood B-ALL: Targeted immunotherapies, MRD by HTS, and De-escalation of Therapy in COG Trials AALL1731/AALL1732 (C210)

While survival rates in childhood B-lymphoblastic leukemia (B-ALL) have improved significantly, relapse among this population is still common, and for relapsed patients, 5-year overall survival (OS) is approximately 38%. Interventions that reduce B-ALL relapses remain a priority as an intensification of conventional chemotherapy has proven unsuccessful.

Targeting the RAS/MAPK Pathway in Neurofibromatosis Type 1, Plexiform Neurofibromas, and Optic Pathway Gliomas: Improving Patient Outcomes With an Innovative Therapeutic Approach (SY1)

Join us for this PeerView educational activity on neurofibromatosis type 1 (NF-1) and plexiform neurofibromas (PNs). An expert panel will provide insight into the expanding landscape of targeted therapies and will discuss optimal clinical decision-making for patients with NF-1 and NF-1─related PNs that are based on the latest evidence, best practice recommendations, and effective interdisciplinary collaboration. 

APHON thanks Astra Zeneca for their generous support of this event. 

General Session: Pediatric Oncology Nursing Research: Transforming Practice Through Science Together (102)

Endocrinopathies Related to Cancer Therapy (211)

Due to the remarkable improvements in the care of childhood cancer patients, the 5-year survival rate now exceeds 80%. Long-term survivors of childhood and adolescent cancers may experience a range of adverse outcomes that occur due to treatment-specific factors including chemotherapy and radiation therapy.

HLH: Navigating to Safe Harbor Through the Cytokine Storm (212)

Hemophagocytic lymphohistiocytosis (HLH) is a rapidly progressive and life-threatening syndrome of pathologic immune activation that results in uncontrolled cytokine release and tissue destruction. HLH may be due to an underlying genetic defect or be triggered by infection, malignancy, or autoimmune disorders.

Caring for Pediatric Patients with Malignant Bone Tumors: The Advanced Practice Nurse’s Perspective (213)

Children, adolescents, and young adults with malignant bone tumors require expert and specialized care beginning at diagnosis and continuing throughout therapy and beyond. Each patient’s treatment plan is likely to include systemic chemotherapy plus radiation and/or surgery to achieve local tumor control.

Paper Presentation: Supporting Patient Well-Being and Quality of Life—The Effect of Integrative Therapies on Pediatric Hematology/Oncology/Hematopoietic Stem Cell Transplant Patients (214-1)

This session will discuss the significance of providing nonpharmacological interventions to patients using integrative therapies. The literature indicates integrative therapies are gaining popularity in hospital settings and have positive effects on patients. Understanding the impact of integrative therapies will inspire nurses to incorporate integrative principles into their own nursing practices.

Paper Presentation: Supporting Patient Well-Being and Quality of Life—The Influence of Health Seeking Behavior on the Health Literacy of Adolescents with Sickle Cell Disease (214-2)

Between 94% and 98% of children with sickle cell disease (SCD) are living to age 18 years and beyond. However, patients with SCD experience significant morbidity and mortality after they transfer from pediatric care to adult care. One hypothesis is that health literacy plays a role in the transition of children with SCD from pediatric care to adult care.

Paper Presentation: Supporting Patient Well-Being and Quality of Life—Psychosocial interventions to improve social health of adolescents and young adults with cancer: A review (214-3)

The incidence of cancer diagnosis in the adolescent and young adult (AYA) population has been increasing, and more frequently these patients are being cared for at pediatric institutions. The AYA population has a set of psychosocial needs that differ from other age groups. Failure to tend to these needs leads to a host of negative health outcomes from cancer and therapy and negatively impacts the quality of life.

Cancer Control and Supportive Care in the Children’s Oncology Group: Nursing Roles and Recent Results (C215)

Survival rates for many pediatric cancers have improved over time, although children and adolescents continue to experience acute and delayed toxicities related to their disease and treatment. This session will review the purpose and research domains within the Children’s Oncology Group (COG) Cancer Control (CCL) Committee.

Precision Health Care: Pharmacogenetics and Next Generation Sequencing Through the Lens of Pediatric Oncology (216)

Newly diagnosed patients and their families are offered numerous genetic and genomic testing options including predictive and diagnostic screening. Screening provides guidance for inpatient care based on patient classification, medication management, disease susceptibility, and potential understanding of disease etiology.

Marijuana, Hemp, and the Child with Cancer (217)

Many pediatric oncology patients report medical marijuana (MMJ) and hemp-based CBD use. Over 4,000 children are registered users of marijuana in Colorado, the first state to legalize recreational marijuana. Eleven states and Washington, DC have legalized marijuana for recreational use for adults older than 21.

Neurofibromatosis type 1 Diagnostic Updates and Plexiform Neurofibroma Treatment Options (218)

Neurofibromatosis (NF) 1 is a progressive autosomal dominant disorder that results from a germline mutation of a protein called neurofibromin that occurs in one out of every 3500 births (AANS, 2019). The clinical diagnosis of NF1 is based on the presence of two or more cardinal symptoms identified in the 1988 National Institute of Health (NIH) Diagnostic Criteria.

Communication Pearls for Navigating Difficult Conversations (219)

Communication is the root of many conflicts in health care and the cause of up to 60% of all hospital adverse events according to the Joint Commission (Mueller et al, 2018). The nurse’s role is inherently different from the physician’s role in regard to delivering difficult news, but the nurse is often left to answer the questions that arise from these conversations.

Paper Presenation: Global Health—POINTE: A Novel Way of Spreading Global Pediatric Oncology Nursing Knowledge (220-1)

Well-trained nurses are vital for optimal outcomes in pediatric oncology. One of the most significant barriers to adequately treating children with cancer in resource-constrained settings is a lack of healthcare workers in general and even fewer with specialty training in pediatric oncology.

Paper Presentations: Global Health — WHO Global Childhood Cancer Initiative: Relevance for Nursing Immigrant and Vulnerable Families Facing Childhood Cancer in the United States (220-2)

In 2017, the WHO World Health Assembly passed the Cancer Prevention and Control through an Integrated Approach (WHA70.12) resolution under a wide agreement that cancer is an increasing public health issue. In 2018, WHO created the Global Initiative for Childhood Cancer (GICC) to galvanize the Ministries of Health to prioritize childhood cancer in low- and middle-income countries (L&MIC).

Paper Presentation: Global Health—Long-Distance Coaching for a Quality Improvement Initiative to Improve Nursing Assessment and Management of Nausea and Vomiting in Marrakech, Morocco (220-3)

Quality improvement (QI) in health care consists of systematic and continuous actions that lead to measurable improvements in the patient experience. While QI methodology has long been included as a core component of nursing education and professional development in institutions in the United States, QI methodology is novel in many low- and middle-income countries.

Reproductive Health: from Diagnosis through Survivorship – Resources and Perspectives from the Children’s Oncology Group (C221)

Puberty and sexual and reproductive health are normal parts of human growth and development. Adolescence and young adulthood are developmental times of exploration of sexual identity and planning for the future, which may include parenting goals. A cancer diagnosis does not preclude a patient or their family from concern about sexual and reproductive health.

Town Hall: APHON Pediatric Chemotherapy and Biotherapy Instructors (TH1)

Town Hall: Global Nursing (TH2)

Town Hall: Economic Roadblocks for Patients and Challenges for Nurses (TH3)

Town Hall: Trauma Diorama (TH4)

Town Hall: Adolescent Decision Making and Adherence (TH5)

Town Hall: Zone Training and LGBTQ+ Inclusive Care (TH6)

Town Hall: Transplant (TH7)

Town Hall: Palliative Care (TH8)

Town Hall: Managers and Administrators (TH9)

Town Hall: Educators (TH10)

Recognition Session for Certified Oncology Nurses: Having a Ball: Including a Healthy Dose of Music, Laughter and Patient Inspiration (RB)

"Oncology nurses are the backbone and heart of a cancer patient’s experience – playing the most critical roles for their patients - doing everything from administering chemo, warding off side-effects, comforting on the bad days and celebrating the victories. They are a trusted confidante and tender caregiver. In addition, nurses are increasingly being charged with taking larger leadership roles as well. They are truly the superheroes of health care (carrying magic wands that seem to fix everything!) for their patients.

General Session: Gene Therapy and Gene Editing as a Treatment Option for Patients with Hemoglobinopathies (103)

Sickle cell disease is one of the most common inherited diseases in the Unites States, with a homozygous frequency of 1 in 400 African American births. The disease is associated with multiple complications including infections, veno-occlusive pain crisis, acute chest syndrome, and cerebrovascular accidents.

Clinical Pearls of Pediatric Brain Tumors for the Advanced Practice Nurse (222)

While progress has been made in research to find cures for many pediatric cancers, brain tumors remain the leading cause of cancer-related death in children. This means that further research is needed to push forward for more cures and better treatments for these patients.

Protect Your Professional Life: Beware of Predatory Publishers and Conferences (223)

Can you spot a “fake” journal or conference? The publishers of predatory journals are motivated by self-interests which are primarily financial.1 They are characterized by: a) false or misleading information; b) deviation from best editorial and publication practices: c) a lack of transparency, and/or d) the use of aggressive and indiscriminate solicitation practices.”

Adopt, Adapt, Advance: Utilizing Evidence Based Practice, Quality Improvement and Nursing Research to Transform Pediatric Hematology/Oncology Nursing Practice (224)

Nursing research (NR), evidence-based practice (EBP), and quality improvement (QI) are principal methods of clinical inquiry and provide unique contributions to the science of pediatric hematology oncology nursing. Each of these methodologies have distinct similarities and differences. Due to their complexity, differentiating between the three can be challenging.

Paper Presentation: Outcomes of Serious Illness on Nurses, Patients, and Families—Keeping a Positive Outlook – Strategies, Threats, and Outcomes for Parents of Children with Cancer and Other Serious Illness (225-1)

Parents who make end-of-life decisions for their seriously ill children do so according to their individual definitions of ‘being a good parent’ to their seriously ill child. This pediatric cancer nursing concept, developed by Pamela Hinds, has been applied to parents of critically ill children but has potential relevance for other pediatric contexts.

Paper Presentation: Outcomes of Serious Illness on Nurses, Patients, and Families—Inpatient Deaths of Children with Cancer: DNAR and CPR Events in Children Who Don’t Survive to Hospital Discharge (225-2)

Death in children with malignancy may result from refractory disease or acute complications during therapy. In this population, little is known about the medical interventions received in the last week of life from the overall cohort of children who die from cancer or related complications as inpatients. Perceptions of under- or over-treatment can cause distress among families and staff, yet the prevalence of do not attempt resuscitation (DNAR) orders, use of CPR, and other supportive therapies remains poorly described.

Paper Presentation: Outcomes of Serious Illness on Nurses, Patients, and Families—Posttraumatic Stress Disorder (PTSD) in Nurses: An Integrative Review (225-3)

"Post-traumatic stress disorder (PTSD) is a psychiatric disorder that can occur from direct or indirect exposure to traumatic events. Nurses are at risk of developing PTSD due to their indirect and/or direct exposure to traumatic situations while providing care to vulnerable patient populations.

High Risk Neuroblastoma in the new decade: Incorporating targeted therapies to maximize impact in current Children’s Oncology Group trials (C226)

While the overall cure rate for childhood cancer is approaching 80%, the prognosis for long-term survival for children with high risk neuroblastoma lags considerably behind, at 50%–60%. Upfront standard treatment for high-risk neuroblastoma protocols within the Children’s Oncology Group (COG) has historically utilized all available modalities of cancer treatment including chemotherapy, surgery, myeloablative chemotherapy with stem cell rescue, radiation therapy, differentiating agents, and most recently biologic therapy with anti-GD2 antibody (dinutuximab) used post consolidation in ANBL0032.

This is Awkward...  Having Difficult Conversations about AYA Sexual Health (227)

Sexual and reproductive health (SRH) is a key aspect of physical health, emotional health, and quality of life in adolescents and young adults (AYAs) with cancer and blood disorders both during and after treatment. AYAs increasingly identify concerns with sexual function, contraception, fertility, and psychosexual adjustment and report conversations on these topics rarely take place with providers.

What works in ITP - Voodoo to what's NEW! (228-1)

Immune thrombocytopenia can present a multitude of clinical challenges for providers, patients, and families. In 2011, the American Society of Hematology released guideline recommendations for the management of this challenging pediatric condition.

Update on Hemophilia - The A's, the B's and the C's (228-2)

Hemophilia A (Factor VIII deficiency) and Hemophilia B (Factor IX) are bleeding disorders in which a specific protein in the blood is absent or low, resulting in an inability to form an adequate fibrin clot. These disorders, while rare, can occur spontaneously, be inherited, or be acquired.

Below the Surface:  Applying Evidence-Based Practice in Skin Care Management with the Hematopoietic Cell Transplant Patient (229)

Children and adolescents undergoing hematopoietic cell transplant (HCT) are at high risk for developing skin complications. Nurses play a vital role in the assessment, prevention, and management of skin issues in this population where multiple factors lead to skin complications.

Preparing Patients and Families for the Off-Therapy Transition (230)

Completion of cancer-directed therapy can be an exciting time for patients and their families but may also be anxiety provoking as they face a new set of challenges and a “new normal.” Patients may be returning to school with new needs for academic accommodations or returning to the care of their primary care provider, who may have limited experience with childhood cancer survivors.

Paper Presentation: Symptom Reporting Strategies—Examining Self-Reported Pain of School-Age Children Undergoing Treatment for Cancer Using a Game-Based App (231-1)

The goal of this presentation is to describe the daily pain experiences reported by 19 school-age children with cancer participating in a trial of a game-based symptom assessment app. We will discuss the prevalence of pain and how participants elected to communicate their pain within the app, using child-centric rating scales, an avatar to localize pain, and free-text responses.

Paper Presentation: Symptom Reporting Strategies—Perceived Usefulness and User Satisfaction of Electronic and Paper-and-Pencil Symptom Tracking Diaries for Young Children with Cancer: Parent Perspectives (231-2)

"Because much of the cancer care for young children occurs in the outpatient setting, parents have the responsibility of identifying and responding to the child’s symptoms at home. Having a tool that parents could use to record their child's daily symptoms could help to provide insight into the symptoms the child is experiencing. Although multiple resources have been developed to support symptom tracking, ensuring usability is key.

Paper Presentation: Symptom Reporting Strategies—Patient and Parent Experiences of Cancer Symptoms as Assessed by the Memorial Symptom Assessment Scale for Children (231-3)

Treatment for childhood cancer is associated with symptoms that contribute to poorer psychological and physical functioning and decreased quality of life. Symptom assessment scales have been used to identify the prevalence, severity, and distress related to cancer treatment.

How to Return Research Results to Patients and Families? The Children’s Oncology Group Experience (C232)

In North America, the majority of children with cancer will enroll in a clinical trial at some point during their treatment. Clinical research is rooted in the premise that the quantity and quality of human lives will be improved by carefully conducted clinical and basic research.