Statement of Need

Malignancy is associated with an increased risk of venous and arterial thrombosis, and about 15% of cancer patients are affected by thromboembolic disease. Thrombotic complications of cancer adversely affect patients' quality of life and contribute to increased mortality. While malignancy itself induces a prothrombotic state, antitumor and supportive agents may also increase the risk of thrombosis. Intravenous immunoglobulin (IVIg) is commonly used to prevent or treat secondary immunodeficiencies associated with malignancies or treatment. Case studies have described thrombotic events, particularly stroke, occurring in cancer and noncancer patients treated with IVIg. It is critical that clinicians treating patients with cancer be able to identify the risk factors for thrombosis, including medications that could be associated with thrombotic risks, such as IVIg, and to recognize and treat thrombotic complications when they occur. Furthermore, clinicians need to be able to identify patients who require prophylactic therapy due to an increased risk of thrombosis, such as cancer patients undergoing surgery. The first part of this program will educate physicians about factors that increase the risk of thrombotic complications in patients with cancer and will discuss prophylactic and therapeutic management of thrombosis in malignancy. The second section will focus on the risk factors for arterial and venous thrombotic events in patients receiving IVIg.

Activity Purpose

The purpose of this CME/CE activity is to increase the awareness of hemato-oncologists on the risks and management of venous and arterial thromboembolism (TE) in their patients with leukemia/lymphoma.

Target Audience

This activity is targeted to clinicians with an interest in hematology and oncology.

Learning Objectives

Upon completion of this activity, participants should be able to:

 

• Discuss three aspects of the natural history of venous thromboembolism in malignancy
• Describe two mechanisms underlying thrombotic complications of malignancy
• Identify three factors that increase the risk of thrombotic complications in patients with cancer
• Describe two advantages of low-molecular-weight heparin (LMWH) vs unfractionated heparin (UFH) for prophylaxis or venous thrombotic embolism
• List three factors contributing to arterial thrombotic events in patients receiving intravenous immunoglobulin (IVIg)
• Identify four characteristics of IVIg products that may impact their safety profiles

Accreditation Statement

The Discovery Institute of Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement

The Discovery Institute of Medical Education designates this educational activity for a maximum of 1.0 category 1 credits toward the AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in this activity.

 

Nursing Accreditation

The University of North Texas Health Science Center Office of Professional and Continuing Education is an approved provider of continuing nursing education by the Texas Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. This activity meets Type I criteria for mandatory continuing education requirements toward relicensure as established by the Board of Nurse Examiners for the State of Texas. This activity is approved for 1.2 Contact Hours. To receive a certificate of successful completion, participants must complete the activity and submit the evaluation and credit request.

 

Funding Statement

This activity is funded through an educational grant from Talecris Biotherapeutics.

 

Chairperson

James B. Caress, MD
Associate Professor
Department of Neurology
Wake Forest University Medical Center
Winston-Salem, North Carolina

 

Faculty

Ann Wittkowsky, PharmD, CACP, FASHP, FCCP
Clinical Professor
Director
Department of Pharmacy Practice
Anticoagulation Services
University of Washington School of Pharmacy
Seattle, Washington

 

Faculty Disclosure Summary

The Discovery Institute of Medical Education requires that those involved in the content development and/or presentation of this CME activity disclose to the participant any significant financial interest or other relationship (1) with the manufacturers of any commercial products and/or providers of commercial services discussed in an educational presentation, and (2) with any commercial supporters of the activity.

This CME activity may include discussions regarding the use of medications which may be outside of the approved labeling for these products. Physicians should consult the current prescribing information for these products. The Discovery Institute of Medical Education requires the speaker to disclose that the product is not labeled for the use under discussion. Compliance is documentation that demonstrates the provider has a practice in place to make this requirement known to the faculty.

The following faculty have reported a financial interest or other relationship with the commercial supporter(s) of this activity or from a corporate organization whose product(s) may have relevance to the content of their presentations:

James Caress, MD

• Sources of Funding for Research: Talecris Biotherapeutics
  
• Consulting Agreements: None
  
• Speakers' Bureau/Honorarium Agreements: Talecris Biotherapeutics
  
• Financial Interests/Stock Ownership: None
  
• Discussion of Off-label, Investigational, or Experimental Drug Use: None

Ann Wittkowsky, PharmD, CACP, FASHP, FCCP

• Sources of Funding for Research: None
  
• Consulting Agreements: AstraZeneca Pharmaceuticals LP; Boehringer Ingelheim GmbH; GlaxoSmithKline; Novartis Pharmaceuticals Corp; sanofi-aventis Group; The Medicines Company
  
• Speakers' Bureau/Honorarium Agreements: None
  
• Financial Interests/Stock Ownership: None
  
• Discussion of Off-label, Investigational, or Experimental Drug Use: None