9:45 am – 10:15 am Friday, September 16

Insurance and Neighborhood Opportunity Predict Adverse Events in Children with Acute Lymphoblastic Leukemia (217-1)

Our prior research uncovered potential socioeconomic (SE) risk factors for two adverse events that impact children hospitalized with acute lymphoblastic leukemia (ALL): hyperglycemia and severe sepsis. That research, however, was limited to only two measures of SE status, insurance source and median neighborhood income. Composite indices of neighborhood social and economic stability are useful in gleaning understanding of pathways between a child’s immediate environment and health outcomes. Yet, there is little reporting of the best way to measure these aspects of a child’s environment in pediatric oncology nursing research.

This study was a side-by-side comparison of three measures of SE status: insurance source, area deprivation and neighborhood child opportunity. The study goal was to determine each one’s utility as risk a predictor of hyperglycemia and serious infections, two outcomes our team has shown are potentially influenced by SE factors.

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5:00 pm – 5:30 pm Thursday, September 15

The Role of the Pediatric Clinical Research Nurse in the Management of Severe Aplastic Anemia (208-1)

Severe aplastic anemia (SAA) is a serious and life-threatening condition with an unknown etiology, involving improper production of stem cells due to damaged bone marrow. Without functional stem cells, the body is depleted of red blood cells, white blood cells, and/or platelets. With only 600 to 900 cases diagnosed each year in the U.S. alone, SAA is rare. Most patients are only provided supportive care measures: receiving blood transfusions to manage symptoms and adhere to complex medication regimens to limit complications; however, advancements in treatment of SAA are made possible through clinical research trials. The Clinical Research Nurse (CRN) must address the clinical needs of the research patient, but also be sensitive to the psychosocial and ethical issues of supporting pediatric research patients. This case study presents a 7-year old Mongolian patient, “M.B.”, with refractory SAA, who failed standard immunosuppressive therapy and failed to engraft from a previous expanded umbilical cord stem cell transplant. M.B. was enrolled in a clinical research protocol in which he underwent a haplo-identical transplantation using peripheral blood stem cells and post-transplant GVHD prophylaxis using Cyclophosphamide. M.B.’s complex clinical trajectory will unfold over the course of the case study, with the role of the Clinical Research Nurse highlighted. In addition to clinical complications, the COVID-19 pandemic added an additional layer of psychosocial and ethical complexities for M.B. and his family to navigate. Application of the Clinical Research Nurse Domain of Practice ensures that the bedside nurse addresses the holistic needs of the research patient and caregiver at the bedside, while also maintaining the integrity of the research protocol. Read more...
Speaker:
Alejandra Castillo MSN RN
CNE Hours
.50
3:45 pm – 4:45 pm Thursday, September 15

CBD, THC, GVH, MMJ: Practical Ways to Make Sense of the Alphabet Soup (203)

Many pediatric oncology patients report medical marijuana (MMJ) and hemp-based CBD use. Hemp is now federally legal under the Farm Bill since December 2018 and hemp-based cannabinoid products are widely available. Research focused on cannabis and its’ use in oncology, hematology, and bone marrow transplant is continuing to grow. A study in Israel looks at adding cannabis to the treatment of graft versus host disease following bone marrow transplant. Read more...
9:45 am – 10:45 am Friday, September 16

Using Their Own Words: AYA Cancer Patients as Influencers in COG Clinical Trials (C216)

Adolescent and young adult (AYA) cancer patients continue to be a conundrum for providers, researchers, and health care systems. Previous challenges for AYA oncology care have been identified as delayed diagnosis, lack of insurance, limited clinical trial availability and enrollment, tumor biology, unique toxicity profiles, distinct psychosocial issues, and more. While there has been advancement in the treatment of AYAs with cancer, there is a paucity of information about how that treatment impacts the AYA cancer patient’s life, both during treatment and beyond. Read more...
2:15 pm – 3:15 pm Saturday, September 17

What the HEC is MEC? Understanding Antiemetic Therapy for Moderately and Highly Emetogenic Chemotherapy (230)

Optimal chemotherapy induced nausea and vomiting (CINV) control has been shown to improve patient’s quality of life and decrease distress. Without good control, both physical and psychological complications can occur, including anorexia, malnutrition, and nutritional deficiency. But what is optimal CINV control? Nausea without vomiting? No nausea? No vomiting? Only vomiting a few times? This definition can mean something different to every patient, provider, and nurse. Read more...
4:15 pm – 5:15 pm Friday, September 16

You Deserve to Preserve: A Proposal to Offer Fertility Preservation to All Eligible Pediatric Oncology Patients (221)

Fertility preservation, the opportunity to preserve one’s ability to have genetically-related children prior to damaging or destroying the reproductive system, is a young but rapidly expanding field. Historically, fertility preservation has only been available to postpubertal male and female cancer patients via oocyte, embryo, and sperm cryopreservation. Read more...
9:45 am – 10:50 am Friday, September 16

Neurofibromatosis Therapeutics Program: Program Development, Tumor Treatment, and Side Effect Management (215)

The advanced practice provider is instrumental in designing, developing, and growing a program to treat tumors associated with Neurofibromatosis (NF) Type 1 and 2. Both NF1 and NF2 are autosomal dominant genetic disorders associated with the growth of both benign and malignant tumors of the peripheral and central nervous system. In the last two years selumetinib, a MEK inhibitor, gained FDA approval for treatment of plexiform neurofibromas in the children with NF. Read more...

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 are able to provide ongoing instruction and education to other registered nurses.

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