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
5:30 pm – 6:00 pm Thursday, September 15

Onco-Critical Care 101 (209-2)

Pediatric Oncology nurses are frequently exposed to patients with oncologic emergencies and who become critically ill requiring transfer to the PICU. They are familiar with conditions requiring transfer but happens to these patients while they are in the PICU? When the patient is transferred back to the regular oncology floor or presents back in clinic, it is helpful for the nurse to know what happened to their patient in the PICU. Common oncology critical care interventions such as CRRT, vasopressors, respiratory support, ect are largely unfamiliar to oncology nurses but can be helpful to understand for post PICU care and in situations where care must be initiated by the nurse on the floor. This presentation will cover the basics of Oncology Critical Care including recognizing oncologic emergencies that should trigger transfer to PICU and how these conditions are treated once the patient is in the PICU. Read more...
Speaker:
Katie Gardner MSN APRN CPNP-AC
CNE Hours
.50
5:00 pm – 5:30 pm Thursday, September 15

Neuro 911: Managing Neurologic Complications in Pediatric Oncology Patients (209-1)

Neurologic complications are common in pediatric patients with all types of malignancies. These complications can arise from the disease process itself or as a result of one of our therapies. Oncology nurses care for patients receiving multi-modal therapy with chemotherapy, surgery and radiation. It is important to recognize these complications quickly and correctly. Initiating treatment quickly may reduce pain, may prevent further progression and permanent deficits. Read more...
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...
3:45 pm – 4:45 pm Thursday, September 15

Targeting Patient and Family Education for ALK/MEK Inhibitor Therapy: What We Learned from the COG Nursing Evidenced Based Project (C204)

coglogoChildren with cancer have historically received multiple modalities of therapy to treat their disease processes including surgery, chemotherapy, radiation and stem cell transplant. These modalities incur the potential for significant acute toxicity and late effects from therapy. In the last decade, the addition of a new modality known as biotherapy has become an integral player in the treatment of pediatric cancers. Biotherapy includes targeted therapies used to attack and destroy cancer cells while minimizing effects on healthy cells and tissue. Read more...
8:30 am – 9:30 am Friday, September 16

General Session: State of Nursing: Pediatric Hematopoietic Stem Cell Transplantation: A Glimpse of the Past, Current State, a Glance of the Future (102)

Over the last 60 years, significant advances in in hematopoietic stem cell transplantation (HSCT) has provided improvements in effective treatment or cure and overall survival for many patients. There has been considerable HSCT progress and success in a variety of pediatric malignant and non-malignant diseases. This state of the science presentation will be providing the evolution and current and future highlights of Pediatric HSCT as it relates to disease conditions, stem cell sources, conditioning regimens, cellular immunotherapy, toxicity related treatments and supportive care. Read more...
3:00 pm – 4:00 pm Friday, September 16

General Session: Sickle Cell Disease: Pathophysiology, Pain, and Prevention of Problems (103)

Sickle Cell Disease (SCD) is the most common inherited hemoglobinopathy in the United States; the etiology is a DNA mutation that results in the different amino acids at position 6 of the beta-globin chain, where valine is produced instead of glutamine. The sickling of the red blood cell sets off a cascade of pathology. Vaso occlusion causing ischemia to almost every body system accounts for the majority of morbidity and is the etiology of acute pain episodes. Acute pain episodes account for the majority of health care utilization by this population.

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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...
2:15 pm – 3:15 pm Saturday, September 17

Strategies in Survivorship Care: Addressing Current Long-term Follow-up Surveillance Gaps Through Individualized Survivorship Care Plans And Specialty Survivorship Clinics (234) 

With current 10-year survival rates greater than 80% for pediatric, adolescent, and young adult (AYA) cancer patients there exists and ever-increasing population of pediatric and AYA cancer survivors. Pediatric and AYA survivors who finish cancer-directed treatment are often burdened with significant risks for long-term complications. This includes risks of secondary cancers and accelerated development of usual age-related comorbid conditions such as heart failure, kidney disease and osteopenia. Given these risks, cancer survivors require specialized health care monitoring and surveillance. The Childhood Cancer Survivor Study has identified significant, suboptimal adherence to COG screening guidelines for secondary malignancies (breast, colorectal, and skin) and cardiac disease amongst this high-risk population. Many survivors and their caregivers also report that they feel uninformed yet worried about potential late effects. This current gap emphasizes the importance of individualized survivorship care post cancer treatment, both short and long term.

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Speaker:
Stephanie Neerings MSN APRN FNP-BC
CNE Hours
1
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