Management of Bone Health in Patients with Hematologic Malignancies
Many patients with hematologic malignancies are at risk for treatment-induced bone loss which in turn can result in pathologic fractures, hypercalcemia, bone pain, and decline in motility and performance status. Cancer-treatment induced bone loss is a treatable long-term complication in patients with hematologic malignancies. Much of the morbidity and mortality associated with bone loss can be prevented with effective screening, lifestyle changes, and appropriate supportive care interventions. Early diagnosis and treatment is essential to prevent bone fragility and decrease the risk of fractures. With the availability of more effective treatment options resulting in significantly improved long-term survival, the management of bone health and maintenance of bone integrity has become an important component of comprehensive cancer care and should be an integral part in the treatment of patients with hematological malignancies requiring a broad knowledge base. A multidisciplinary health care team is needed for the optimal assessment and treatment of bone-related complications. Hematologists and oncologists require ongoing education to provide the expert guidance necessary for the optimal management of bone health and treatment-related bone complications without compromising the curative potential of anticancer therapy. It is critical that health care providers are up-to-date with the most current evidence-based recommendations to be able to make best practice decisions. Educating clinicians on the importance of long-term bone health will help them integrate appropriate screening measures and use approved bone-modifying agents into the management plan of patients who are at risk or experiencing cancer treatment-related bone loss.
This information was originally presented at the NCCN 13th Annual Congress: Hematologic Malignancies™ held in New York, New York, from September 21-22, 2018.
This educational program is designed to meet the educational needs of oncologists, hematologists, nurses, pharmacists, and other health care professionals who manage patients with hematologic malignancies.
Following this activity, participants should be able to:
- Identify the risk factors for bone loss and/or fragility fractures in patients with hematologic malignancies.
- Describe the problem of steroid induced bone fragility.
- Review bone densitometry (DXA scan) and FRAX as screening tools.
- List non-drug and drug therapy options that will prevent bone loss and lower the risk of fragility fractures.
Azeez Farooki, MD
Memorial Sloan Kettering Cancer Center
Disclosure of Relevant Financial Relationships
All faculty and activity planners participating in NCCN continuing education (CE) activities are expected to disclose any relevant financial relationships with a commercial interest as defined by ACCME’s, ACPE’s, and ANCC’s Standards for Commercial Support. All faculty presentations have been reviewed for adherence to ACCME’s Criterion 7: The provider develops activities/educational interventions independent of commercial interests (SCS 1, 2, and 6) by experts on the topics. Full disclosure of faculty relationships will be made prior to the activity.
NCCN continuing education considers financial relationships to create a “conflict of interest” when an individual has both a financial relationship with a commercial interest and the opportunity to affect CE content about the products or services of a commercial interest with which he/she and/or a spouse or partner has a financial relationship.
NCCN continuing education considers “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. NCCN does not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship.
All faculty for this continuing education activity are competent in the subject matter and qualified by experience, training, and/or preparation for the tasks and methods of delivery.
Faculty presentations may include discussion of off-label use. Faculty will disclose that the use in question is not currently approved by the FDA per the product labeling.
The faculty listed below discloses the following relevant financial relationships:
Azeez Farooki, MD
Alexion Pharmaceuticals, Inc.: Other financial benefit
Amgen Inc.: Scientific Advisor
Genentech, Inc.: Consulting Fee
NCCN Staff Disclosures
The NCCN Activity Planning staff listed below discloses no relevant financial relationships:
Robert W. Carlson, MD; Melissa Esplen; Mark A. Geisler; Kristina M. Gregory, RN, MSN, OCN; Kristin Kline Hasson; Rose Joyce; Karen Kanefield; Lisa G. Kimbro, MBA, CPA (employed by NCCN until 8/10/2018); Joan S. McClure, MS (employed by NCCN until 8/1/2018); Lisa Perfidio, MS; Shannon Ryan; Kathy Ann Smith, CMP, CHCP; Gary J. Weyhmuller, MBA, SPHR
The NCCN Activity Planning staff listed below discloses the following relevant financial relationships:
Donald Harting, ELS, CHCP
Laboratory Corporation of America (LabCorp): Equity interest/Stock Options
Pfizer Inc.: Equity Interest/Stock Options
Boston Scientific Corporation: Equity Interest/Stock Options
The NCCN Clinical staff listed below discloses no relevant financial relationships:
Rashmi Kumar, PhD
National Comprehensive Cancer Network is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
NCCN designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. PAs may receive a maximum of 0.50 hour of Category 1 credit for completing this activity.
National Comprehensive Cancer Network (NCCN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
NCCN designates this educational activity for a maximum of 0.45 contact hour.
|National Comprehensive Cancer Network is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.|
NCCN designates this knowledge-based continuing education activity for 0.50 contact hour (0.05 CEUs) of continuing education credit. UAN: 0836-0000-18-117-H01-P
- 0.50 ACPE contact hours
- 0.50 AMA PRA Category 1 Credit™
- 0.45 ANCC contact hours
- 0.50 Participation
To complete this activity, users will need:
- A device with an Internet connection
- One of the two latest versions of Google Chrome, Mozilla Firefox, or Safari (Internet Explorer is no longer supported)
- Adobe Flash Player and/or an HTML5 capable browser for video or audio playback
- Adobe Reader or other PDF reader software for certificate viewing/printing