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CME: Advancing Treatment Strategies in Acute Lymphoblastic Leukemia (ALL) Drug Therapy

Activity Description / Statement of Need:

In this online CME self-learning program:


Acute Lymphoblastic Leukemia:


Acute lymphoblastic leukemia (ALL) is one of a group of malignancies caused by cytogenetic DNA mutations of developing hematopoietic stem cell precursors and mostly common to children with peak incidence at 2-5 years of age. Although approximately 80% of ALL cases present in children, they also occur in adults.  The symptoms of ALL are non-specific and similar to those of acute myelogenous leukemia (AML), which patients usually have 1-3 months of complaints.These symptoms include: fatigue, malaise, or palpitations associated with anemia; fever with or without infection due to leukopenia or leukocytosis; and petechiae, and bleeding or bruising of the oral mucosa, skin, or gastrointestinal tract due to thrombocytopenia.  Although the precise etiology of ALL remains unknown, some cases have been associated with: exposure to ionizing, toxic chemicals, herbicides; genetic conditions such as Down’s syndrome, Fanconi syndrome, neurofibromatosis; viruses like human T-lymphotropic viruses 1 and 2 and Epstein-Barr virus. 


Treatment goal in patients with ALL is to cure, with children commonly responding to treatment with better than adults. Children may have a remission rate of 99% with a cure rate of about 90%, whereas adults have remission rates of only 60-85% with only 30-40% reaching 5-year disease-free survival. Several biochemical pathways essential to the neoplastic process in ALL have been further elucidated, and additional treatments have been made available with potentially many more on the horizon. Helping the clinician discern the role of each of the first-line and more novel therapies based on the most up-to-date research merits continuing education programming in ALL.


Moreover, professional guidelines have been updated recently, and communicating related information to healthcare professionals in a timely manner is a demonstrated need.  The literature suggests that practicing healthcare professionals are oftentimes unable to keep up with the steady publishing of literature and evolution of clinical practice, and awareness of professional guidelines is no exception.  Recently published guidelines therefore also inherently suggest a gap in medical practice and justify the need for educational programming.




Faculty introduction, disclosures

Introduction content: cursory refresher and review

  • Epidemiology: statistics by severity
  • Causes and risk factors
  • Clinical features, presentation, and histopathology
  • Pathogenesis and the role of the immune system
  • Updates in biomarkers, staging, as applicable

Updates in treatment in patients with ALL

  • Clinical trials: what is new, and how should it impact practice?
  • Induction chemotherapy, consolidation therapy, and the ramifications of Philadelphia chromosome-positive vs. -negative status
  • Updates in the roles, relative to pharmacotherapy, of: best supportive care, transfusions, and radiotherapy
  • Pediatric updates
  • Emerging therapeutic options for ALL: what is on the horizon?
  • Clinical challenges
  • Patient case(s)

Summary, conclusions, and best practice recap

Target Audience:

Hematologist-oncologists, medical oncologists, oncology nurse practitioners, physician assistants who specialize in oncology, and any other healthcare professionals who otherwise come into regular clinical contact with and provide care for patients with ALL.

This program is supported by an educational grant from AMGEN

Release Date: September 10, 2016 -- Expiration Date: September 10, 2018

Faculty: Dan Douer, MD


Learning Objectives

By the end of the session the participant will be able to:

  • Summarize recent updates in what is known about ALL�s pathophysiology and diagnosis and how they relate to mechanisms of resistance to conventional therapy and targets for emerging therapy
  • Distinguish between the most appropriate treatment approaches to ALL and apply them to practice, taking into account the following: treatment modalities and the recent clinical trial evidence supporting them
  • Describe the risks and benefits of profile of treatments for ALL
  • Summarize the emerging therapies for ALL and anticipate their place in therapy
  • Select a treatment regimen for a patient who has been treated previously, taking relevant biomarkers and previous clinical response into account



Faculty Disclosure and Resolution of COI

 As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.


Faculty Disclosure: Dan Douer, MD, Clinical Professor of Medicine, Weill Cornel Medical College, discloses that he has received financial compensation from participation at advisory boards and/or research grants from Amgen and Baxalta.


Disclosures of Educational Planners: Charles Turck, PharmD is an officer and part owner of ScientiaCME, LLC.


Commercial Support Disclosure: This program is supported by an educational grant from AMGEN


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

Additional Courses That Are Related To This Activity

Advancing Treatment Strategies in Multiple Myeloma (MM) Drug Therapy

Acute Lymphoblastic Leukemia (ALL): Highlights from the 2016 American Society of Hematology (ASH 2016): Take-Aways, Emerging Practice Changes, and Barriers to their Implementation

Multiple Myeloma Pharmacotherapy: Therapeutic Updates, Best Practices, and Emerging Treatment Options

Acute Lymphoblastic Leukemia (ALL): Highlights from the 2016 American Society for Clinical Oncology: Take-Aways, Emerging Practice Changes, and Barriers to their Implementation