Hematology CME

The Oncology for Practicing Physicians course is:
• Comprehensive, modularized, interactive, asynchronous and online, with the flexibility to select all or some modules
• Designed, developed, and authored by expert McGill clinicians under the direction of a McGill scientific committee
• Accredited for family physicians Mainpro-M 1 and specialists MOC Section 2 credits
• Based on comprehensive needs assessments
• Supportive of self-directed learning
• Accessible from a variety of electronic devices, including smartphones and tablets
• Providing access to oncology experts through the Ask the Expert feature

Target Audiences:
family physicians, specialists, trainees, medical students, nurses, and other healthcare professionals.

Over 125 text-only courses in a comprehensive variety of hematology and oncology areas. Some recent topics are:
• Comparative Effectiveness Research in Oncology
• Oncology Comparative Effectiveness Research: A Multi-Stakeholder Perspective on Principles for Conduct and Reporting
• Progress in the biological understanding and management of breast cancer associated CNS metastases
• Multicenter Italian Experience in Liver Transplantation for Hepatocellular Carcinoma in HIV Infected Patients
• Prospective Head and Neck Cancer Research: a Four-Decade Bibliometric Perspective
• Role of Postoperative Vitamin D and/or Calcium Routine Supplementation in Preventing Hypocalcemia After Thyroidectomy

Target Audiences: Hematologists, Oncologists

Activity Description / Statement of Need:

In this online, self-learning activity:

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin’s lymphoma (NHL), making up just under a third of NHL cases. In the United States, there are roughly 7 cases of DLBCL per 100,000 patients per year. The pathophysiology of DLBCL is complex and not fully understood; but is characterized by a widespread increase of very large, mature B-cells arising from various gene mutations. DLBCL is heterogenous group of tumors and includes many diverse subtypes based on location, presence of other cells within the tumor, and whether the patient has other related illnesses. Advanced age, immunodeficiency, and Epstein-Barr virus are associated risk factors for DLBCL. The disease is considered an AIDS-defining malignancy, marking the point at which an HIV infection is considered AIDS. Diagnosis of DLBCL is made by a tissue biopsy, and morphology and immunophenotyping play a crucial role in determining which subtype of DLBCL a patient has.

This learning activity has been designed to bring HCPs’ knowledge of present and emerging strategies for treatment and management of DLBCL up to date and to improve their competence and performance in treating it.

Target Audience:

Hematologists and oncologists; physician assistants, nurse practitioners,  pharmacists who practice in oncology, and any other HCPs with an interest in or who clinically encounter patients with DLBCL.

Activity Description / Statement of Need:

In this online, self-learning activity:

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, hematopoietic stem cell disorder characterized by complement-mediated destruction and loss of erythrocytes and the eponymous clinical manifestation of pink-red discoloration of the urine due to presence of hemoglobin. PNH is a rare disorder with a reported incidence of clinically significant disease of between 1 to 2 cases per million. However, it is possible that this range may be underestimated, as a subset of patients remain undiagnosed. PNH occurs worldwide with no known specific ethnic or geographic distribution patterns.

Approximately 40% of patients with PNH saw at least five or more specialists before receiving a diagnosis. PNH diagnosis is complicated by the rarity of the disorder and the nonspecific findings, meriting continuing healthcare educational programming.

Target Audience:

The following healthcare professionals: Hematologists; physician assistants, nurse practitioners, and pharmacists specializing in hematology and transplant medicine; and any other healthcare professionals with an interest in or who may clinically encounter patients with PNH.

There are many Oncology courses on this site offering between .75 – 1 CME credits.

Topics covered include:
Cancer Pain Management, Hodgkins Lymphoma, Cancer Immunotherapy, and many more.

Target Audience: Hematologists, Oncologists

Activity Description / Statement of Need:

In this online, self-learning activity:

Transthyretin amyloidosis (ATTR) is a progressive, multisystem, life-threatening disorder characterized by the extracellular deposition of misfolded, insoluble amyloid fibrils. The role of the TTR protein is to transport thyroxine and retinol-binding proteins, and it is vital for cognition, nerve regeneration, and axonal growth. TTR itself is innately amyloidogenic even without the presence of genetic mutations, which may account for wild-type ATTR (wtATTR), while a hereditary form of ATTR (hATTR) may be passed to offspring through autosomal dominant inheritance. Left untreated, the average life expectancy of ATTR is 3 to 15 years from symptom onset.

This accredited educational activity would identify the critical components of the management process and offer solutions to close gaps in diagnosis and care, with the ultimate goals being the improvement of ATTR management, treatment adherence when applicable, and health and cost outcomes. 

Target Audience:

The following HCPs: neurologists, cardiologists, and hematologists; physician assistants, nurse practitioners, and pharmacists in the aforementioned areas of specialty; and any other HCPs with an interest in or who may clinically encounter patients with ATTR.

Activity Description / Statement of Need:

In this online, self-learning activity:

Beta-thalassemia (BT) is a progressive, hereditary, microcytic, hypochromic form of anemia characterized by the reduced synthesis of hemoglobin subunit beta and the underproduction of hemoglobin A (HbA). Although there are limited data regarding the incidence of BT, historical estimates of BT have been placed at about 1 in 100,000 individuals. BT is most commonly found in patients with Mediterranean, the Middle Eastern, Central Asian, Indian, East Asian, and the North African heritage. BT is caused by a point mutation in the encoding gene for hemoglobin subunit beta (HBB) on chromosome 11, which either results in lower beta-globin production (termed beta-plus [B⁺] or prevent cells from producing any beta-globin at all (termed beta-zero [B⁰]). The clinical severity the disease depends on the extent of β and γ chain imbalance; more than 350 genetic alterations that can cause BT have been identified.

There is a demonstrated variation in treatment between providers who practice at a beta thalassemia center of excellence (CoE) and those who do not, and those practitioners at CoEs demonstrate greater familiarity with beta thalassemia and its therapies, including butyrates, gene therapy, and luspatercept. Additional areas of educational need include transitioning patients from pediatric care, management of complications, and clinical trial updates.

Target Audience:

The following healthcare professionals: hematologists; physician assistants, nurse practitioners, and pharmacists who practice in hematology; and any other healthcare professionals with an interest in or who may clinically encounter patients with BT.

Activity Description / Statement of Need:

In this online, self-learning activity:

Biosimilar drugs are products meant to be similar in quality, safety, and efficacy to an already licensed reference biotherapeutic product. Whereas generics are virtually identical replicas of conventional medications, biosimilars are not the same as the original product – a practically unavoidable outcome because of the considerably large molecular structure that biologics mimic. The literature suggests that learning activities focused on the evolving landscape of biosimilars, which are germane to the therapeutic area because of their potential role in cost containment. Both the FDA and medical literature independently affirm the need for clinician education on biosimilars, including: Comparative efficacy; adverse event rates and management (potential concerns have included immunogenicity); regulatory guidance on interchangeability and substitution – including prescribers retaining some degree of ability to intervene in a product’s substitution at the dispensing stage; and cost considerations.

Given the rapid expansion of these product types and the presence of gaps in the area of hematologic malignancies and oncologic and supportive care therapies, this activity has been designed to bring HCPs’ knowledge of biosimilar products in those areas up to date and to improve their competence and performance in employing them in practice.

Target Audience:

The following healthcare professionals: Hematologist-oncologists and medical oncologists; physician assistants, nurse practitioners, and pharmacists who practice in oncology; and any other healthcare professionals with an interest in or who clinically encounter patients with hematologic malignancy or oncologic disease states who may receive treatment with biosimilars.

Activity Description / Statement of Need:

In this online, self-learning activity:

Von Willebrand disease (vWD) is the most common congenital bleeding disorder worldwide. Affecting both male and female births in equal number, vWD is caused by a deficiency or defect in the von Willebrand factor (vWF) glycoprotein, which is responsible for mediating platelet and coagulation factor VIII function. vWD types 1 and 3 are caused by quantitative deficiencies in vWF. In contrast, type 2 vWD is caused by a qualitative defect in the production of vWF. Type 1 is the most common type of vWD, accounting for 60% to 70% of cases, followed by type 2, which is diagnosed in 25% to 30% of patients. Type 3 vWD, the rarest form, affects about 1 in 1,000,000 people. There is evidence that the use of factor VIII/vWF concentrates should be individualized, but no recent vWD guidelines address this issue. Although DDAVP is the treatment of choice for most type 1 vWD patients, data do not support the use of DDAVP for type 2B vWD owing in part to an increased risk for thrombocytopenia. Another practice gap is a lack of guidance around the appropriate ages at which patients with severe vWD are optimally initiated on vWF prophylaxis. Furthermore, although DDAVP is not contraindicated in pregnancy, 31% of physicians consider DDAVP a contraindication according to the results of one survey, illustrating a present area of controversy in practice.

Recent advances in replacement therapy with factor VIII/vWF concentrates have expanded treatment options. A few considerations may impact determination of best choice of agent, including hemostatic capacity and relative proportion of factor VIII. For these reasons and others, there has been a recent focus in individualizing replacement therapy in a manner that takes into account vWD type, thrombosis risk, and clinical indication and goals of therapy. Taking this information into account as well the fact that HCPs are oftentimes unable to keep up with the steady publishing of literature and evolution of clinical practice, continuing HCP education examining clinical decision-making and the appropriate selection of therapy is warranted.

Target Audience:

The following HCPs: hematologists and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in hematology; and any other healthcare professionals with an interest in or who clinically encounter patients with vWD.

Activity Description / Statement of Need:

In this online, self-learning activity:

Immune thrombocytopenia (ITP) is a phenomenon characterized by a peripheral platelet count of less than 100 x 109/L in the absence of any discernable cause, with an increased risk of bleeding. Also known as thrombocytopenic purpura, it occurs in around two to four cases per 100,000 adults, with incidence peaking bimodally: Once between 20-30 years with female predominance and also at 60 years with even distribution between the sexes.

The diagnosis of ITP is one of exclusion and includes platelet autoantibody testing. However, it is complicated and associated with documented gaps in care, with preventable delays in diagnosis and misdiagnosis not uncommon. One study found that one in seven patients diagnosed with ITP were misdiagnosed and reclassified as they received additional clinical evaluation. Another study found that over 22% of patients with ITP did not receive guideline-recommended peripheral blood film examination. These diagnostic challenges have real-world consequences on patient lives, creating anxiety in 73% of patients who experience a delayed diagnosis.

Treatment goals include prevention of severe bleeding episodes, maintaining platelet counts for symptomatic patients, minimizing treatment toxicity, and maximizing health-related quality of life. Conventional therapy includes corticosteroids, intravenous immunoglobulin (IVIg), and anti-D IVIg. However, treatment challenges remain, including variability in practice between providers and high rates of relapse between following standard first-line therapies together with considerable patient frustration. Moreover, some patient subpopulations are more challenging to treat and are less likely to achieve therapeutic success.

Target Audience:

HCPs specializing in: hematology; physician assistants, nurse practitioners, nurses, pharmacists; and any other healthcare professionals with an interest in or who clinically encounter patients with ITP.