NCCN Guidelines® Insights - Acute Lymphoblastic Leukemia, Version 1.2019
Survival outcomes for older adults with acute lymphoblastic leukemia (ALL) are poor and optimal management is challenging due to higher-risk leukemia genetics, comorbidities, and lower tolerance to intensive therapy. A critical understanding of these factors guides the selection of frontline therapies and subsequent treatment strategies. In addition, there have been recent developments in minimal/measurable residual disease (MRD) testing and blinatumomab use in the context of MRD-positive disease after therapy. These NCCN Guidelines Insights discuss recent updates to the NCCN Guidelines for ALL regarding upfront therapy in older adults and MRD monitoring/testing in response to ALL treatment.
This activity is designed to meet the educational needs of physicians, nurses, pharmacists, and other healthcare professionals who manage patients with cancer.
Upon completion of this activity, participants will be able to:
- Integrate updates to the NCCN Guidelines for Acute Lymphoblastic Leukemia into the management of older adult patients with acute lymphoblastic leukemia
- Describe the rationale behind the decision-making process for developing the NCCN Guidelines for Acute Lymphoblastic Leukemia, with a focus on upfront therapy in older adults and MRD monitoring/testing in response to treatment for acute lymphoblastic leukemia
NCCN Medical Education Disclosure Policy
It is the policy of NCCN that every 12 months, all faculty, moderators, activity planners and all internal planning staff participating in NCCN continuing education activities are expected to disclose any financial relationships with a commercial interest as defined by the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support. In addition, all faculty presentations have been reviewed for adherence to the ACCME’s Standards for Commercial Support (the provider develops activities/educational interventions independent of commercial interests [SCS 1, 2 and 6] by experts on the topics).
Per the ACCME Standards for Commercial Support, individuals who do not disclose relevant financial relationships will be disqualified from involvement in the CE activity as a content developer, planner, or presenter. A complete list of individuals’ relationships with external entities is available upon request.
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 NCCN staff listed below discloses no relevant financial relationships:
Kerrin M. Rosenthal, MA; Kimberly Callan, MS; Genevieve Emberger Hartzman, MA; Erin Hesler; Kristina M. Gregory, RN, MSN, OCN; Rashmi Kumar, PhD; Karen Kanefield; and Kathy Smith.
Individuals Who Provided Content Development and/or Authorship Assistance:
Patrick A. Brown, MD, Chair, has disclosed that he receives consulting fees/honoraria from Amgen Inc., Novartis Pharmaceuticals Corporation, and Shire; and that he receives consulting fees from Jazz Pharmaceuticals Inc.
Bijal Shah, MD, Vice Chair, has disclosed that he receives grant/research support from Jazz Pharmaceuticals Inc. and Incyte Corporation; serves as a scientific advisor for Celgene Corporation and Novartis Pharmaceuticals Corporation; serves on the product/speakers bureau for Amgen Inc.; and receives consulting fees/honoraria from Pharmacyclics, Inc.
Matthew Wieduwilt, MD, PhD, Panel Member, has disclosed that he receives grant/research support from Amgen Inc., Merck & Co., Inc., Leadiant Biosciences, Inc., and Servier; and he has equity interest/stock options in Reata Pharmaceuticals, Inc.
Aaron Logan, MD, PhD, Panel Member, has disclosed that he receives grant/research support from Kite Pharma, Inc., Pharmacyclics, Inc., and Astellas Pharma US, Inc.; and receives consulting fees/honoraria from Amgen Inc., Agios Pharmaceuticals, and Incyte Corporation.
Daniel J. DeAngelo, MD, PhD, Panel Member, has disclosed that he receives consulting fees/honoraria from Amgen Inc., Blueprint Medicines, Celgene Corporation, Incyte Corporation, Jazz Pharmaceuticals Inc., Novartis Pharmaceuticals Corporation, Pfizer Inc., Shire, and Takeda Pharmaceutical Company Ltd.; and receives grant/research support from AbbVie Inc., GlycoMimetics, Inc., Novartis Pharmaceuticals Corporation, and Blueprint Medicines.
Eunice S. Wang, MD, Panel Member, has disclosed that she is a scientific advisor for AbbVie Inc., and Otsuka Pharmaceutical Co., Ltd; receives consulting fees/ honoraria from Amgen Inc.; receives grant/research support from ImmunoGen, Inc.; and is on the product/speakers bureau of Incyte Corporation and Novartis Pharmaceuticals Corporation.
Amir Fathi, MD, Panel Member, has disclosed that he is a consultant for Celgene Corporation, Novartis Pharmaceuticals Corporation, Takeda Pharmaceutical Company Ltd., Daiichi Sankyo, Inc., and Astellas Pharma US, Inc.; and is a scientific advisor for Agios Pharmaceuticals, Jazz Pharmaceuticals Inc., and Astellas Pharma US, Inc.
Ryan D. Cassaday, MD, Panel Member, has disclosed that he receives grant/research support from Amgen Inc., Kite Pharma, Inc., and Merck & Co., Inc., and receives honoraria from Pfizer Inc.
Mark Litzow, MD, Panel Member, has disclosed that he receives grant/research support from Astellas Pharma US, Inc.; Actinium Pharmaceuticals, Inc.; Novartis Pharmaceuticals Corporation; AbbVie Inc.; Pluristem Therapeutics Inc.; and Tolero Pharmaceuticals, Inc. He receives consulting fees from sanofi-aventis U.S. LLC.
Ndiya Ogba, PhD, Oncology Scientist/Medical Writer, NCCN, has disclosed that she has no relevant financial relationships.
To view all of the conﬂicts of interest for the panel, go to NCCN.org/disclosures/guidelinepanellisting.aspx.
In support of improving patient care, National Comprehensive Cancer Network (NCCN) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
NCCN designates this journal-based CME 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.
NCCN designates this educational activity for a maximum of 1.0 contact hour.
NCCN designates this knowledge-based continuing education activity for 1.0 contact hour (0.1 CEUs) of continuing education credit. UAN: JA4008196-0000-19-007-H01-P
NCCN has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credit. Approval is valid until May 10, 2020. PAs should only claim credit commensurate with the extent of their participation.
- 1.00 AAPA Category 1 CME credit
- 1.00 ACPE contact hours
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC contact hours
- 1.00 Participation
To access this activity, users will need:
- A device with an Internet connection
- Adobe Reader or other PDF reader software for article and certificate viewing/printing