Overview

STATEMENT OF NEED

Tumor lysis syndrome is a rare, potentially life-threatening oncologic emergency typically associated with chemotherapy-induced tumor cell death in which potassium, phosphate, and nucleic acids are released into the bloodstream (Baudon et al, 2016). This release of intracellular materials results in severe metabolic abnormalities such as hyperuricemia and hyperphosphatemia, which may cause acute renal injury, and hypokalemia and hypocalcemia, which may cause seizures, neuromuscular symptoms, and cardiac arrhythmias (Howard et al, 2016; Baudon et al, 2016). The occurrence of TLS may prevent or delay the administration of potentially life-saving chemotherapy (Dinnel et al, 2015). Furthermore, the kidney damage, heart failure, fluid retention, and neuromuscular and gastrointestinal effects caused by TLS may lead to reductions in chemotherapy dosing and alter the selection of cytotoxic agents (McBride & Westervelt, 2012). The most effective management strategy is prevention; however, despite appropriate prophylactic measures, approximately 3% to 5% of high-risk patients receiving chemotherapy are affected (Baudon et al, 2016). The overall mortality rate of patients with TLS is 15% (Jones et al, 2015).

TARGET AUDIENCE

Hematologist/oncologists, physician assistants, nurse practitioners, pharmacists, oncology nurses, and other health care professionals involved in the treatment of patients with cancer.

LEARNING OBJECTIVES

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

• Assess the risk for TLS associated with emerging therapies for hematologic malignancies
• Develop evidence-based management plans to optimize prevention, recognition, and treatment of TLS in patients with hematologic malignancies
• Apply monitoring strategies to ensure adequate control of uric acid levels in patients diagnosed with TLS

Note: The learning objectives listed above apply to pharmacists, nurse practitioners, and registered nurses in addition to physicians.

FACULTY

Matthew S. Davids, MD, MMSc (Chairperson)
Director of Clinical Research
Dana-Farber Cancer Institute

Amy Goodrich, RN, BSN, MSN, CRNP-AC
Nurse Practitioner
Johns Hopkins Kimmel Cancer Center

 REGISTRATION

There is no fee to participate in or claim CME/NCPD/CPE credit for this activity.

Co-Provided by

Physicians

i3 Health is accredited by the American Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

i3 Health designates this activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physician Assistants

American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities approved for AMA PRA Category 1 Credit™ from organizations accredited by ACCME. Physician assistants may receive a maximum of 1.0 hour of Category 1 credit for completing this program.

Nurse Practitioners

The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Individuals are responsible for checking with the AANPCP for further guidelines.

Nursing Continuing Professional Development

i3 Health is accredited with distinction as a provider of nursing continuing professionnal development by the American Nurses Credentialing Center's Commission on Accreditation.

A maximum of 1.0 contact hour may be earned by learners who successfully complete this continuing nursing education activity. This activity has been approved for 0.9 contact hours of pharmacotherapy credit for Advanced Practice Registered Nurses.

Provider approved by the California Board of Registered Nursing, Provider Number 15824, for 1.0 contact hour.

Continuing Pharmacy Education

St. John Fisher University Wegmans School of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. UAN 0584-9999-21-017-H01-P is eligible for 1.0 ACPE CE hours.

ONCC RECERTIFICATION

The program content has been reviewed by the Oncology Nursing Certification Corporation (ONCC) and is acceptable for recertification points.

ONCC review is only for designating content to be used for recertification points and is not for CNE accreditation. CNE programs must be formally approved for contact hours by an acceptable accreditor/approver of nursing CE to be used for recertification by ONCC. If the CNE provider fails to obtain formal approval to award contact hours by an acceptable accrediting/approval body, no information related to ONCC recertification may be used in relation to the program.

OCN^®, CPHON^®, CBCN^®, AOCNP^®, AOCNS^®, and BMTCN^® renewal candidates may apply 1 ILNA point toward:

• Care Continuum
• Care of Pediatric Hematology and Oncology Patient
• Oncologic Emergencies
• Oncology Nursing Practice
• Preparative Regimens
• Symptom Management
• Treatment

Please note that some of the course content applies to multiple content areas. The numerical value above indicates the maximum amount of points that can be claimed in each domain. The total amount of ILNA points claimed may not exceed the total amount of CNE awarded from this course.

DISCLOSURE OF RELEVANT FINANCIAL INFORMATION WITH COMMERCIAL INTERESTS

i3 Health and St. John Fisher University Wegmans School of Pharmacy (WSOP) endorse the standards of the ACCME, ACPE, and ANCC that require everyone in a position to control the content of a CME/NCPD/CPE activity to disclose all financial relationships with commercial interests that are related to the content of the CME/NCPD/CPE activity. CME/NCPD/CPE activities must be balanced, independent of commercial bias, and promote improvements or quality in health care. All recommendations involving clinical medicine must be based on evidence accepted within the medical profession.

A conflict of interest is created when an individual has an opportunity to affect CME/NCPD/CPE content about products or services of a commercial interest with which he/she has a financial relationship, which therefore may bias their opinions and teaching. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, stocks, or other financial benefits.

i3 Health and St. John Fisher University Wegmans School of Pharmacy (WSOP) will identify, review, and mitigate all conflicts of interest that speakers, authors, or planners disclose prior to an educational activity being delivered to learners. Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation. i3 Health and St. John Fisher University Wegmans School of Pharmacy (WSOP) do not endorse any products or services.

Relevant financial relationships exist between the following individuals and commercial interests:

The i3 Health planners, reviewers, and managers have nothing to disclose.

St. John Fisher University Wegmans School of Pharmacy (WSOP) staff members have no relevant financial relationships to disclose.

Matthew S. Davids, MD, MMSc, discloses that he has served on an advisory board or panel for AbbVie, Adaptive Biotechnologies, Ascentage Pharma, AstraZeneca, BeiGene, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Pharmacyclics, Takeda, and TG Therapeutics and as a consultant for AbbVie, Adaptive Biotechnologies, AstraZeneca, BeiGene, Genentech, Janssen, Merck, Pharmacyclics, Research to Practice, TG Therapeutics, Verastem, and Zentalis. He has also received grant and research support from AbbVie, Ascentage Pharma, AstraZenenca, Genentech, MEI Pharma, Novartis, Pharmacyclics, Surface Oncology, TG Therapeutics, and Verastem.

Amy Goodrich, RN, BSN, MSN, CRNP-AC, discloses that she has served on an advisory board or panel for AbbVie, AstraZeneca, BeiGene, Celgene, Fresnius Kabi, Genentech, Pharmacyclics, Rigel, Sanofi, and Seagen.

i3 Health has mitigated all relevant financial relationships.

INSTRUCTIONS TO RECEIVE CREDIT

In order to receive credit for this activity, participants must:

1. Take the pretest
2. Read the manuscript
3. Pass the posttest with a score of ≥80%
4. Complete the activity evaluation
5. Download or print their Certificate of Credit

TECHNOLOGY REQUIREMENTS FOR VIRTUAL CME | NCPD | CPE ACTIVITIES

For virtual (asynchronous, archived live, home study; synchronous webinars) CME/NCPD/CE activities, include access to system requirements:

• The Internet browser(s) supported and minimum versions of each required by the learner to complete the online activity.
• The minimum memory, storage, processor, and internet speeds require by the learner to complete the online activity.

UNAPPROVED USE DISCLOSURE

i3 Health and St. John Fisher University Wegmans School of Pharmacy (WSOP) require CME/NCPD/CPE faculty (speakers) to disclose to attendees when products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not FDA approved), as well as any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty may discuss information about pharmaceutical agents that is outside of U.S. Food and Drug Administration approved labeling.

This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information.

DISCLAIMER

The information provided at this CME/NCPD/CPE activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a health care provider relative to diagnostic and treatment options of a specific patient’s medical condition.

COMMERCIAL SUPPORT

This activity is supported by independent educational grant from Sanofi Genzyme.

Aggregate participant data will be shared with commercial supporters of this activity.

CONTACT INFORMATION

Technical queries or questions regarding activity credit should be directed to i3 Health at This email address is being protected from spambots. You need JavaScript enabled to view it.

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