OVERVIEW
This free activity consists of a Lecture Presentation, a Learning Assessment, and an Evaluation form. The content of this virtual lecture is derived from a satellite symposium presented on April 23, 2009, in Philadelphia, Pennsylvania.

MEDIUM: Virtual Lecture
INTERNET RELEASE DATE: June 30, 2009
CE AVAILABLE UNTIL: June 30, 2010

Estimated time to complete this activity: 1.5 hours

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TARGET AUDIENCE
This activity has been designed to meet the educational needs of physicians, nurse practitioners, registered nurses and social workers involved in the care of patients with myelodysplasia and other hematopoietic neoplasms.

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ACTIVITY PURPOSE
This activity is intended to assist healthcare professionals in understanding how to recognize the early signs and symptoms associated with myelodysplasia and hematopoetic neoplasms.

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STATEMENT OF NEED
Myelodysplasia (myelodysplastic syndromes/MDS) are a group of diseases of the blood and marrow, with varying degrees of severity, treatment needs and life expectancy. The overall MDS incidence rate is estimated at close to four cases per 100,000 population, and an estimated 138,000 people were diagnosed with leukemia, lymphoma or myeloma in 2008.¹ MDS and other hematopoietic neoplasms may remain undiagnosed for some time—patients may be asymptomatic or present with nonspecific signs and symptoms that can be attributed to more common blood cytopenias.² MDS can progress such that the abnormal blast cells take over the marrow, and the disease “evolves” into acute myelogenous leukemia (AML). Symptoms of MDS and other hematopoietic neoplasms can include fatigue, shortness of breath, bone pain, increased susceptibility to infection and abnormal bleeding and bruising.

For patients who present with these symptoms, a high level of clinical suspicion is warranted. Diagnoses of MDS and other hematopoietic neoplasms are generally made by performing a physical examination and obtaining a thorough history along with the results of a complete blood count with differential, a peripheral blood smear and bone marrow tests. Early diagnosis and appropriate treatment are critical to delay disease progression and maintain quality of life.

¹The Leukemia & Lymphoma Society Facts 2008. National Cancer Institute: SEER Cancer Statistics Review 1975-2004; 2008.
²Larson RA. Myelodysplasia: when to treat and how. Best Pract Res Clin Haematol. 2006;19:293-300.

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EDUCATIONAL OBJECTIVES
After completing this activity, the participant should be better able to:

• Cite the distinct signs and symptoms associated with myelodysplasia and other hematopoietic neoplasms
• Describe methods of diagnosing myelodysplasia and other hematopoietic neoplasms
• Explain the importance of blood count abnormalities as they relate to the diagnosis of myelodysplasia and other hematopoietic neoplasms
• Review the pathophysiology of myelodysplasia and other hematopoietic neoplasms and how it impacts treatment

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METHOD OF PARTICIPATION
There are no fees for participating and receiving continuing education (CE) credit for this activity. During the period June 30, 2009, through June 30, 2010, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the post-test by recording the best answer to each question on the Learning Assessment pages; 4) complete the Evaluation form; and 5) mail, fax or electronically submit the Evaluation form to Postgraduate Institute for Medicine. (Registered nurses should submit to The Leukemia & Lymphoma Society.)

Participants must receive a score of at least 70% on the Learning Assessment and must complete and submit the Evaluation form to successfully complete this activity. Participants who successfully complete this activity will be issued a statement of credit via e-mail or US mail within 4 to 6 weeks.

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PHYSICIAN CONTINUING EDUCATION

ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Robert Michael Educational Institute LLC (RMEI). PIM is accredited by the ACCME to provide continuing medical education for physicians.

CREDIT DESIGNATION
Postgraduate Institute for Medicine designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

INTERNATIONAL PHYSICIANS
International physicians completing this activity will receive a certificate documenting participation in an activity designated for AMA PRA Category 1 Credits™. International physicians should contact their respective licensure and certification bodies for information on use/conversion of AMA PRA Category 1 Credit(s)™.

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NURSE PRACTITIONERS CONTINUING EDUCATION
Nurse practitioners should contact their respective licensure and certification bodies for information on use/conversion of AMA PRA Category 1 Credits™.

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NURSES AND SOCIAL WORKERS CONTINUING EDUCATION
Approval for nurses has been obtained by the National Office of The Leukemia & Lymphoma Society under provider number CEP 5832 to award 1.5 continuing education contact hours through the California Board of Registered Nursing.

The Leukemia & Lymphoma Society (LLS), provider number 1105, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org Approved Continuing Education Program (ACE). Approval Period: 12/2008–12/2011. LLS maintains responsibility for the program. Social workers should contact their regulatory board to determine course approval. Social workers will receive 1.5 CE clinical clock hours.

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FACULTY
Roger K. Strair, MD, PhD
Director, Hematologic Malignancies
Associate Director, Bone Marrow Transplantation
The Cancer Institute of New Jersey
Professor of Medicine
UMDNJ-Robert Wood Johnson Medical School
New Brunswick, New Jersey

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DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information and comparison with recommendations of other authorities.

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DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. PIM, RMEI and The Leukemia & Lymphoma Society do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM and RMEI. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

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DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:

• Dr. Roger K. Strair has no affiliations with commercial interests to disclose.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:

The Leukemia & Lymphoma Society

• Carson Jacobi, MPH, has no affiliations with commercial interests to disclose.

Robert Michael Educational Institute LLC

• Sherri Kramer, MD, has no affiliations with commercial interests to disclose.
• Laura Altobelli, MS, has no affiliations with commercial interests to disclose.

Postgraduate Institute for Medicine

• Linda Graham, RN, BSN, has no affiliations with commercial interests to disclose.
• Jan Hixon, RN, BSN, MA, has no affiliations with commercial interests to disclose.
• Trace Hutchison, PharmD, has no affiliations with commercial interests to disclose.
• Julia Kirkwood, RN, BSN, has no affiliations with commercial interests to disclose.
• Jan Schultz, RN, MSN, CCMEP, has no affiliations with commercial interests to disclose.

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FEE INFORMATION
There is no fee for this educational activity.

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QUESTIONS AND TECHNICAL ASSISTANCE
For questions regarding the content of this activity, contact the accredited provider for this CE activity: jjones@pimed.com. For technical assistance, contact jungsen@rmcom.net.

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SYSTEM REQUIREMENTS
Hardware/Software requirements include:
• Windows 95, 98se, ME, XP, NT 4.0, 2000   
  - Internet Explorer 4.0+
  - Netscape Navigator 6.2+
  - Mozilla Firefox 1.0+
• Macintosh 9.2, OS X 10.1+
  - Safari 1.1+
  - Netscape Navigator 6.2+
  - Internet Explorer 5.2+
  - Mozilla Firefox 1.0+
• Additional Requirements
  - Windows Media Player
  - Internal/external speakers
  - Broadband connection (DSL/cable) recommended

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