Hematologic Malignancies

Individualizing Care for Multiple Myeloma: Navigating Treatment Options and Addressing Patient Needs

Presented by Beth Finley-Oliver, MSN, ARNP, AGNP-BC, and Rachid Baz, MD

At JADPRO Live 2023 in Orlando, presenters discussed selecting treatment regimens for newly diagnosed and relapsed or refractory multiple myeloma. They also provided insights on comprehensive care centered around patient preferences, tre...

A Comprehensive Bone Marrow Aspirate and Biopsy Educational Program Utilizing Task Trainers

Jessica Casselberry, DNP, ANP-BC, AOCNP®, and Jennifer Fisher, DNP, WHNP

Background: Advanced practice providers (APPs) who care for patients with hematologic malignancies perform bone marrow aspiration and biopsies (BMBXs). Invasive bedside procedures are often taught through the observational training metho...

Role of Preemptive Cytomegalovirus Hyperimmunoglobulin in Cytomegalovirus Viremia Following Stem Cell Transplant: An Integrative Review

Jaci Whittaker, MSN, APRN, FNP-BC, Ashley Martinez, DNP, APRN, FNP-BC, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FANP, FAANP, FAAN

Introduction: Cytomegalovirus (CMV) is a major cause of morbidity and mortality in stem cell transplant (SCT) patients. Cytomegalovirus hyperimmunoglobulin (CMV-HIG) therapy has been described in the solid organ transplant setting. Howev...

Post-Transplant Cyclophosphamide for the Prevention of Graft-vs.-Host Disease in Allogeneic Hematopoietic Cell Transplantation: A Guide to Management for the Advanced Practitioner

Ekaterina Kachur, PharmD, BCOP, Jai N. Patel, PharmD, BCOP, CPP, Allison L. Morse, PharmD, BCOP, Donald C. Moore, PharmD, BCPS, BCOP, DPLA, FCCP, and Justin R. Arnall, PharmD, BCOP

Cyclophosphamide remains a critical component to haploidentical transplant conditioning regimens. Post-transplant cyclophosphamide (PTCy) emerged as an effective component of graft-vs.-host disease (GVHD) prophylaxis in the nonmyeloablat...

Patient-Reported Outcomes With Belantamab Mafodotin Treatment in Patients With Triple-Class Refractory Multiple Myeloma

Rakesh Popat,(1) BSc, MBBS, MRCP, FRCPath, PhD, Sagar Lonial,(2) MD, FACP, Peter M. Voorhees,(3) MD, Simona Degli Esposti,(4) MD, Boris Gorsh,(5a) PharmD, Ira Gupta,(5a) MD, Joanna Opalinska,(5) PhD, Sandhya Sapra,(5) PhD, Trisha Piontek,(5) BS, RN, Zangdong He,(5) PhD, David Kleinman,(6) MD, MBA, Debra Schaumberg,(7) SCD, OD, MPH, Antoine Regnault,(8) PhD, Juliette Meunier,(8) MSc, and Laurie Eliason,(5a) MPH

In the randomized phase II DREAMM-2 study, single-agent belantamab mafodotin demonstrated deep and durable responses and a manageable safety profile in triple-class refractory relapsed/refractory multiple myeloma (RRMM). We present patie...

Knowing Your Target: Altered Mental Status From an Unsuspected Source

Sarah Hemstetter, MSN, CRNP, AOCNP®

Daratumumab is a human monoclonal antibody targeting CD38 that is used in the treatment of multiple myeloma. In addition to being a target for cancer-related treatment, CD38 also plays a significant role in the immune response to infecti...

Anti-Spike Antibody Responses in Allogeneic Stem Cell Transplant Recipients to Two Doses of COVID-19 mRNA Vaccination: A Retrospective, Single-Center Analysis

Jaime L. Shahan, MPAS, PA-C, Robert H. Collins, MD, Prapti Patel, MD, Yazan F. Madanat, MD, and Madhuri Vusirikala, MD

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients were excluded from the initial SARS-CoV-2 mRNA vaccination efficacy trials. Suboptimal vaccine responses have been reported in immunocompromised cohorts such as pa...

Polycythemia Vera: Thinking Beyond the Hematocrit

Matthew Waggoner, MS, PA-C

Polycythemia vera is a Philadelphia chromosome–negative myeloproliferative neoplasm that results in increased myeloproliferation. It is a debilitating disease characterized by the overproduction of red blood cells, but it also can result...

Management of Ocular Toxicity in Patients Receiving Belantamab Mafodotin

Rebecca Lu, MSN, FNP-C, Ashley Morphey, RN, MSN, CCRP, Felicia Diaz, MSN, APRN, FNP-BC, AOCNP®, Jessica Chen, RN, MSN, OCN®, FNP-C, Azadeh Razmandi, OD, FAAO, and Tiffany Richards, PhD, ANP-BC, AOCNP®

While significant strides have been made in the treatment of multiple myeloma, treatment options remain limited and definite, and most patients ultimately succumb to their disease. The urgency for more treatment modalities remains, as pa...

Research Strategy for the Development of a Quality-of-Life Decision-Making Model for Older Patients With Acute Myeloid Leukemia

Sara M. Tinsley-Vance, PhD, APRN, AOCN®

Acute myeloid leukemia (AML) is a deadly cancer, especially for patients over 60 years of age who face the dilemma of choosing the best treatment during a time of crisis. Current research in the older AML population is focused on surviva...

Biomarker Pursuit: Keeping Current With Novel Biomarkers in Hematology/Oncology

Presented by Beth Faiman,(1) PhD, MSN, APRN-BC, AOCN®, BMTCN, FAAN, FAPO, Sandra E. Kurtin,(2) PhD, ANP-C, AOCN®, FAPO, and Rasheda Persinger,(3) MSN, AGNP-C, AOCNP®

In the popular biomarker-focused session at JADPRO Live 2022, presenters paired biomarkers with tumor types for which their expression is most commonly used to determine targeted therapy, identified key assays used to measure common biom...

Novel Treatments for Patients With Relapsed/Refractory Multiple Myeloma

Presented by Cesar Rodriguez, MD, and Donna Catamero, ANP-BC, OCN®, CCRC

Therapeutic options for patients with multiple myeloma have multiplied in the past decade. However, multiple myeloma remains an incurable disease, and relapsed/refractory myeloma is characterized by genetic and cytogenetic alterations th...

Physical Activity in Multiple Myeloma: A Review of the Current Literature

Michaela Hillengass,(1) RN, ACSM-CPT, Janine Joseph,(1) MS, MBA, Jane McCarthy, and Jens Hillengass,(1) MD, PhD

One of the major issues patients with multiple myeloma (MM) suffer from is bone instability and the resulting difficulties that come along with it, such as pain and immobility. Few studies have been performed in this patient group to inv...

Teclistamab-cqyv: The First Bispecific T-Cell Engager Antibody for the Treatment of Patients With Relapsed or Refractory Multiple Myeloma

Gwen Hua,(1) PharmD, BCOP, Ryan Scanlan,(2) PharmD Candidate, Rachael Straining,(1) PharmD, BCOP, and Daniel S. Carlson,(3) DO

Multiple myeloma (MM) remains an incurable malignancy originating from plasma cells. Despite significant advances in treatment, relapses remain inevitable, and novel therapies continue to be needed. Teclistamab-cqyv is a first-in-class, ...

Convergence of Hematology and Rheumatology: A Case Study

Mariangel Prieto, MSN, APRN, FNP-BC, AOCNP®

Advanced practitioners may frequently encounter patients who have a hematologic and rheumatologic diagnosis. These patients are usually managed by multiple specialists, including hematologists, rheumatologists, and dermatologists, given ...

The Role of the Research Advanced Practice Provider in CAR T-Cell Clinical Trials

Ly Dsouza, PA-C, MPAS

In recent years, chimeric antigen receptor (CAR) T-cell therapy has emerged as an effective and potentially paradigm-shifting therapy for patients with refractory lymphoma and myeloma. This novel therapy involves engineering T cells to r...

Role of Luspatercept in the Management of Lower-Risk Myelodysplastic Syndromes

Sara M. Tinsley-Vance,(1) PhD, APRN, AOCN®, Mark Davis,(2) MPAS, PA-C, and Olalekan Ajayi,(3) PharmD, MBA

Treatment options are limited for patients with anemia associated with lower-risk myelodysplastic syndromes (LR-MDS). The recent approval of luspatercept for the treatment of anemia associated with very low- to intermediate-risk MDS with...

Polatuzumab Vedotin for the Front-Line Treatment of Diffuse Large B-Cell Lymphoma: A New Standard of Care?

James A. Davis, PharmD, BCOP, Abigail Shockley, PharmD, Amanda Herbst, PA-C, and Lindsey Hendrickson, DNP, APRN, FNP-C

Diffuse large B-cell lymphoma (DLBCL) is the most common type of aggressive non-Hodgkin lymphoma in the US. For nearly 2 decades, standard front-line treatment has consisted of chemoimmunotherapy with rituximab, cyclophosphamide, doxorub...

What Is Happening to This Patient With a Rare Leukemia?

Amandine Ndje, MS, MBA, APRN, FNP-C, and Jacqueline B. Broadway-Duren, PhD, DNP, APRN, FNP-BC

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare cancer with primary sites in the skin and bone marrow and secondary sites in the lymph nodes, spleen, and central nervous system. First described in the 1990s, these cells ex...

Meta-Analysis of Same-Day Pegfilgrastim Administration Stratified by Myelotoxic Febrile Neutropenia Risk and Tumor Type

Neda Alrawashdh,(1,2) PhD, PharmD, Ali McBride,(3) PharmD, MS, BCPS, Mok Oh,(1) PhD, PharmD, Nimer Alkhatib,(1) PhD, PharmD, Christopher Lee,(4) PhD, RN, FAHA, FAAN, FHFSA, Jennifer Martin,(5) MA, Karen MacDonald,(6) PhD, RN, and Ivo Abraham,(1,3,6) PhD, RN

Background: Pegfilgrastim is recommended to be administered at least 24 hours following the completion of chemotherapy, yet some clinicians use a same-day administration protocol. In this meta-analysis, we compared the incidence of chemo...

Development of a Standardized Bone Marrow Procedure Training and Competency Toolkit for Advanced Practice Providers in a Large Community Oncology Practice

Katharine Lord,(1) PA-C, Sara Toth,(2) APRN, FNP-C, AOCNP®, AGN-BC, Jennifer Potter,(3) PA-C, Katherine Sellers,(4) PA-C, Monica White,(5) APRN, CNS-AH, ACNP-BC, AOCNP®, Anne Neugent,(4) APRN, FNP-C, and Tracy Martin,(4) APRN, ANP-C, AOCNP®, BMTCN, NursEd

Bone marrow procedures are a common diagnostic tool utilized in hematology/oncology and can be completed in the office by trained clinicians. Currently, there are limited guidelines for appropriate training and competency for bone marrow...

Hematologic Malignancies: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

P. Andrew Allred, MS, PA-C, Amy Pierre, MSN, ANP-BC, Meredith Beaton, MSN, RN, Pamela Lee, NP, MSN, and Amber Koehler, PA-C

P. Andrew Allred, MS, PA-C, of Banner MD Anderson Cancer Center, considers data on managing newly diagnosed MM and CAR T-cell therapy in MM. Amy Pierre, MSN, ANP-BC, of MSKCC and Flatiron Health, reviews findings on telemedicine inequiti...

Richter Transformation: Clinical Manifestations, Evaluation, and Management

Melanie Douglas, MS, PA-C

Richter transformation is a devastating and rare but not uncommon development of an aggressive B-cell lymphoma in patients with chronic lymphocytic leukemia or small lymphocytic lymphoma. Prognosis is dismal, with survival generally in t...

An Approach to Diagnosis of Richter Transformation in Chronic Lymphocytic Leukemia

Jackie Broadway-Duren, PhD, DNP, APRN, FNP-BC

Richter transformation (RT) is the development of high-grade lymphoma in patients with B-cell chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). CLL/SLL is a heterogenous disease with a highly variable clinical cour...

Practical Management of the Venetoclax-Treated Patient in Chronic Lymphocytic Leukemia and Acute Myeloid Leukemia

Matthew Waggoner,(1) MS, John Katsetos,(1) PA-C, Emilee Thomas,(1) MBA, MPH, PA-C, Ilene Galinsky,(2) BSN, MSN, ANP-C, and Heather Fox,(3) PA-C

Venetoclax is a potent oral, highly selective small-molecule inhibitor of the antiapoptotic B-cell lymphoma 2 protein approved for chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma in treatment-naive patients (in combinati...

Molecular Testing in Hematologic Malignancies

Laura J. Zitella, MS, RN, ACNP-BC, AOCN®

Molecular testing technologies have been increasingly integrated into clinical research and are essential tools in the care of patients with hematologic malignancies. During this session at JADPRO Live Virtual 2021, Laura J. Zitella, MS,...

Role of the Advanced Practitioner in the Management of Oral Chemotherapy for Adults With AML

Ashley Leak Bryant,(1) PhD, RN, OCN®, FAAN, and Kaitlyn Buhlinger,(2) PharmD, BCOP, CPP

Recent advances have resulted in an expansion of treatment options for AML, especially targeted therapies and low-intensity regimens. At JADPRO Live Virtual 2021, presenters reviewed novel and targeted oral chemotherapy for adults with A...

New Frontiers: The Role of CAR T-Cell Therapy in Multiple Myeloma

Alli McClanahan, APRN, and Megan Spychalla, PA-C

Multiple myeloma remains the second most common hematologic malignancy, and relapse rates are high, with refractory disease common with each relapse. Chimeric antigen receptor (CAR)–modified T cells are a promising new treatment, and at ...

Updates in the Diffuse Large B-Cell Lymphoma Treatment Landscape

Ashley Ames, FNP-BC, and Diane Lee, AGPCNP-BC

During JADPRO Live Virtual 2021, presenters discussed updates in the treatment of diffuse large B-cell lymphoma (DLBCL), including novel agents and chimeric antigen receptor (CAR) T-cell therapy, and how the treatment and management of p...

Cardiovascular Adverse Events and Mitigation Strategies for Chronic Myeloid Leukemia Patients Receiving Tyrosine Kinase Inhibitor Therapy

Lisa Nodzon, PhD, APRN, AOCNP®, Anecita Fadol, PhD, FNP-BC, FAANP, FAAN, and Sara Tinsley, PhD, APRN, AOCN®

Cardiovascular (CV) risk mitigation is an important consideration in the management of chronic myeloid leukemia (CML) patients. Although BCR-ABL1 inhibition by tyrosine kinase inhibitors (TKI) has led to a significant improvement in prog...

Lower Extremity Edema: More Than Just the Routine Workup

Alexis Brimm Akins, MSN, CRNP, FNP-C

Establishing a differential diagnosis for symptomatic oncology patients can be complex. The challenges for advanced practitioners in diagnosing acute symptoms in this patient population lie in the reality that symptoms exhibited can mimi...

Antibiotic Therapy and Gastrointestinal Graft-Versus-Host Disease in the Allogeneic Stem Cell Transplantation Population

Jessica Thomas, MSN, APRN, FNP-C, AOCNP®, Christi Bowe, MSN, APRN, ANP-C, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Purpose: Hematopoietic stem cell transplantation patients undergo rigorous courses of myeloablative chemotherapy that increase vulnerability for infections. Complications can arise in the form of graft-vs.-host disease (GvHD) manifesting...

Belantamab Mafodotin-blmf: A Novel Antibody-Drug Conjugate for Treatment of Patients With Relapsed/Refractory Multiple Myeloma

Emily Behren Ketchum, PharmD, Andrea Clarke, PharmD, BCOP, and Amber B. Clemmons, PharmD, BCOP

Multiple myeloma (MM) is a hematologic malignancy characterized by proliferation of plasma cells with or without production of monoclonal immunoglobulins. Management of patients with MM begins with induction therapy, typically a proteaso...

Mysterious Arm Swelling in a Patient With Non-Hodgkin Lymphoma Complicated by Superior Vena Cava Syndrome

Jessica S. Jang, RN, MSN, ACNP-BC, and Jeffrey S. Jang, BS

Hematologic malignancies often create difficult venous complications. Specifically, with lymphoma, the risk of venous thromboembolism (VTE) is high, often requiring highly specialized accuracy in balancing this coagulopathy. This case st...

Development and Implementation of an Advanced Practitioner–Led Survivorship Clinic for Patients Status Post Allogeneic Transplant

Linda K. Baer,(1) MSN, APRN, AOCNP®, Lauren Brister,(1) MSN, APRN, AOCNP®, and Susan R. Mazanec,(1,2) PhD, RN, AOCN®, FAAN

Background: Survivor recovery from hematopoietic cell transplantation (HCT) is long term, with significant physical and psychological morbidities that impact quality of life and reentry into personal and social lives. The optimal timing ...

Telehealth Interventions for Supportive Management and Early Recognition of Treatment-Related Symptoms in Patients With Hematologic Malignancies

Chasity Yajima, MSN, APRN, FNP-C, AOCNP®, Christi Bowe, DNP, APRN, ANP-C, NPD-BC, CPHQ, Diane Barber, PhD, APRN, ANP-BC, AOCNP®, FAANP, FAAN, and Joyce Dains, DrPH, JD, APRN, FNP-BC, FAANP, FAAN

Purpose: The purposes of this literature review were to (1) establish the utility of supportive telehealth interventions focusing on early identification of treatment-related symptoms in adult patients with hematologic malignancies, with...

Early Detection of Vulvovaginal Graft-Versus-Host Disease: An Integrative Review

Payton L. Ten Hagen, DNP, APRN, FNP-C, Christi Bowe, MSN, APRN, ANP-C, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Introduction: Vulvovaginal graft-vs.-host disease (VVGvHD) is a condition caused by a T-cell mounted immune response after allogeneic hematopoietic stem cell transplant (alloHSCT), which can lead to sclerotic changes of the external geni...

Short- and Long-Term Outcomes of Hematologic Malignancy Patients After Cardiopulmonary Resuscitation: Experience of a Large Oncology Center

Mary Lou Warren, DNP, APRN, CNS-CC, FCCM, Virginia V. Schneider, MPAS, PA-C, Yun Qing, MHS, PhD, Lei Feng, MS, Jeanne Y. Campbell, MPAS, PA-C, Jason W. Myers, ACNP-BC, Marian Von-Maszewski, MD, and Cristina Gutierrez, MD

Purpose: The objective of this study is to describe characteristics and short- and long-term outcomes of patients with hematologic malignancies who received cardiopulmonary resuscitation (CPR). Methods: A retrospective review was conduct...

Hematologic Malignancies: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Amber B. Koehler, PA-C, MS, P. Andrew Allred, MS, PA-C, and Donna Catamero, ANP-BC, OCN®, CCRC

With conference reporting provided by The ASCO Post, Amber B. Koehler, PA-C, MS, of Mayo Clinic, evaluates data on BTK inhibitors; fixed-duration, first-line treatment with ibrutinib plus venetoclax; and a novel oral BCL2 antagonist for ...

Management of Adverse Events Associated With Tyrosine Kinase Inhibitor Use in Adult Patients With Chronic Myeloid Leukemia in Chronic Phase: An Advanced Practice Perspective

Stephanie Bauer, RN, MSN, BC-FNP, Holly Comer, MSN, APRN, Brooke Ramsey, RN, MSN, ANP-BC, and Katy Thomas, RN, MSN, ANP-C

The tyrosine kinase inhibitors (TKIs) imatinib, dasatinib, nilotinib, bosutinib, and ponatinib have drastically improved the life expectancies of patients with chronic myeloid leukemia in chronic phase (CML-CP). While survival outcomes a...

A Review of the Bruton Tyrosine Kinase Inhibitors in B-Cell Malignancies

Donald C. Moore,(1) PharmD, BCPS, BCOP, DPLA, and Daniel Thompson,(2) PharmD

The B-cell receptor signaling pathway plays an integral role in the proliferation and survival of malignant B cells. Targeting the B-cell receptor pathway via the inhibition of Bruton tyrosine kinase (BTK) has evolved the treatment of a ...

Essential Thrombocythemia in a 15-Year-Old Female: Presentation, Workup, and Treatment Considerations in the Pediatric Population

Crystal Flagg, MPAS, PA-C, and Brad Pierce, MPAS, PA-C

Essential thrombocythemia (ET) is a diagnosis most often seen in adults but can also present in children in rare cases. This article reviews the presentation, diagnosis, and treatment of ET in a 15-year-old female followed by a review of...

Optimizing Treatment of Chronic Lymphocytic Leukemia

Presented by Sandra E. Kurtin, PhD, ANP-C, AOCN®

During JADPRO Live Virtual 2020, Sandra Kurtin, PhD, ANP-C, AOCN®, described personalization of the treatment of chronic lymphocytic leukemia (CLL) using molecular attributes of the disease, as well as patient characteristics. Dr. Kurtin...

Improving Outcomes in Hematopoietic Stem Cell Transplant: Recent Advances

Presented by Maritza Alencar, DNP, MBA, APRN-BC, BMTCN

During JADPRO Live Virtual 2020, Maritza Alencar, DNP, MBA, APRN-BC, BMTCN, described advances in the management and prevention of infectious disease complications and graft-vs.-host disease following transplant. Dr. Alencar also emphasi...

Diagnosis and Treatment of AL and ATTR Amyloidosis

Presented by Beth Faiman, PhD, RN, MSN, APRN-BC, AOCN®, FAAN, and Tiffany Richards, PhD, ANP-BC, AOCNP®

At JADPRO Live Virtual 2020, Beth Faiman, PhD, RN, MSN, APRN-BC, AOCN®, FAAN, and Tiffany Richards, PhD, ANP-BC, AOCNP®, differentiated between AL and ATTR amyloidosis, discussed key considerations in selecting therapy, and identified wa...

A Pharmacist-Led Oral Chemotherapy Program’s Impact on Chronic Myeloid Leukemia Patient Satisfaction, Adherence, and Outcomes

Taylor Dennison,(1,2) PharmD, Allison M. Deal,(3) MS, Matthew Foster,(1,3) MD, John Valgus,(1,2) PharmD, MHA, BCOP, and Benyam Muluneh,(2) PharmD, BCOP, CPP

Patients with chronic myeloid leukemia (CML) can be treated with oral tyrosine kinase inhibitors (TKIs). Pharmacist-led oral chemotherapy programs (POCPs) can improve TKI adherence rates, but evaluation of patient satisfaction with such ...

Development, Implementation, and Patient Perspectives of the Women’s Integrative Sexual Health Program: A Program Designed to Address the Sexual Side Effects of Cancer Treatment

Lori A. Seaborne, MPAS, PA-C, Megan Peterson, DNP, David M. Kushner, MD, Janelle Sobecki, MD, MA, and Joanne K. Rash, MPAS, PA-C

Background: Advanced practitioners (APs) are a growing demographic in survivorship care. One goal of survivorship care is to manage consequences of cancer treatments. Sexual dysfunction from prior therapies can impact quality of life. Ad...

Advanced Practice Perspectives on Preventing and Managing Tumor Lysis Syndrome and Neutropenia in Chronic Lymphocytic Leukemia

Amy Goodrich, RN, MSN, CRNP

Tumor lysis syndrome (TLS) and neutropenia are significant toxicities in the treatment of chronic lymphocytic leukemia (CLL). Both TLS and neutropenia can lead to potentially life-threatening complications for patients with chronic lymph...

Impact of Adherence to Ibrutinib on Clinical Outcomes in Real-World Patients With Chronic Lymphocytic Leukemia

Lauren M. Garner, PharmD, BCPPS, Theresa Kline, PharmD, BCPS, BCCP, Jordan Miller, PharmD, BCOP, CPP, Allison Deal, MS, Anqi Zhu, MS, PhD(c), Margaret R. Sketch, PharmD, MPH, Catherine C. Coombs, MD, and Benyam Muluneh, PharmD, BCOP, CPP

Background: Chronic lymphocytic leukemia (CLL) is a B-cell neoplasm with clonal expansion of small lymphocytes. Ibrutinib, an irreversible inhibitor of Bruton tyrosine kinase (BTK), is a first-line treatment option, and recent data sugge...

Acute Myeloid Leukemia: Advanced Practice Management From Presentation to Cure

Meredith Beaton, RN, MSN, AG-ACNP, Glen J. Peterson, RN, DNP, ACNP, and Kelly O’Brien, RN, MSN, ANP-C, ACNP-BC

Acute myeloid leukemia (AML) is the most common acute leukemia in adults, diagnosed in approximately 21,450 individuals annually in the US with nearly 11,000 deaths attributable to this disease (National Cancer Institute, 2020). Acute my...

Revisiting Infectious Complications Following Total Parenteral Nutrition Use During Hematopoietic Stem Cell Transplantation

Halina Rubin,(1) RPh, Jayesh Mehta,(1,2) MD, Jessica L. Fong,(1) PharmD, Deborah Greenberg,(1) PharmD, Solomiya Gruschak,(1,2) BS, and Steven Trifilio,(1,2) RPh

Background: Total parenteral nutrition (TPN) is frequently used to manage caloric needs during hematopoietic stem cell transplantation (HSCT). Previous studies in transplant patients who received TPN have reported widely discordant resul...

Hematologic Malignancies: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Amy Pierre,(1) MSN, ANP-BC, P. Andrew Allred,(2) MS, PA-C, and Allyson Price,(3) PA-C

Amy Pierre, MSN, ANP-BC, of Memorial Sloan Kettering Cancer Center, P. Andrew Allred, MS, PA-C, of Banner MD Anderson Cancer Center, and Allyson Price, PA-C, of MD Anderson Cancer Center, provide expert insights for advanced practitioner...

Patient-Reported Outcomes and Assessment of Quality of Life: A Focus on Multiple Myeloma

MaryAnn Fragola, ANP-C, DNP

Patients with multiple myeloma are living longer, yet the chronicity of newer treatment modalities has led to increased symptom burden and a notable effect on quality of life (QOL). The assessment of QOL and evaluation of patient-reporte...

Polatuzumab Vedotin for the Treatment of Relapsed/Refractory Diffuse Large B-Cell Lymphoma in Transplant-Ineligible Patients

Melanie Douglas, MS, PA-C

Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma. Although 5-year survival rates in the first-line setting can range from 60% to 70%, up to 50% of patients become refractory or relapse after treatment (Cru...

Waldenström Macroglobulinemia: Clinical Presentation, Diagnosis, and Management

Miriam Hobbs, DNP, APRN, CNP, Amie Fonder, PA-C, and Yi L. Hwa, DNP, APRN, CNP

Waldenström macroglobulinemia is a rare hematologic malignancy characterized by an IgM-associated lymphoplasmacytic lymphoma. Often, it is associated with an indolent disease course, and many patients are candidates for careful monitorin...

Understanding Barriers to Oral Therapy Adherence in Adults With Acute Myeloid Leukemia

Ashley Leak Bryant,(1) PhD, RN-BC, OCN®, Ya-Ning Chan,(1) MSN, RN, Jaime Richardson,(1) BSN, RN, OCN®, CCRP, Matthew Foster,(1) MD, Susie Owenby,(2) BSN, RN, and Debra Wujcik,(2) PhD, RN

Acute myeloid leukemia (AML) is a disease of older adults, with a median age at diagnosis of 68 years. The availability of oral anticancer medications has increased, although the standard treatment for AML remains in intravenous form. We...

Recent Advances in the Treatment Of Newly Diagnosed Multiple Myeloma

Presented by Edward Libby,(1) MD, and Josh Epworth,(2) ARNP

Edward Libby, MD, and Josh Epworth, ARNP, interpreted data on current and novel treatments, discussed how to select initial therapy based on patient risk and in alignment with guidelines and best practices, and evaluated the use of minim...

Integrating Best Practices to Improve Outcomes in Relapsed/Refractory Multiple Myeloma

Presented by Amy E. Pierre,(1) MSN, ANP-BC, and Joshua Richter,(2) MD

Amy E. Pierre, MSN, ANP-BC, and Joshua Richter, MD, break down the approved and emerging treatment options for relapsed/refractory multiple myeloma, including mechanisms of action, supporting clinical data, and associated adverse events,...

Improving Outcomes for Patients With Chronic Lymphocytic Leukemia

Presented by Mazyar Shadman,(1,2) MD, MPH, and Amy Goodrich,(3) CRNP

Mazyar Shadman, MD, MPH, and Amy Goodrich, CRNP, reviewed data regarding the mechanistic activity, efficacy, and safety of approved and emerging therapeutic options for chronic lymphocytic leukemia (CLL) and strategies for managing adver...

Addressing the Challenges of Aggressive Lymphomas

Presented by Katherine L. Byar, MSN, ANP-BC, BMTCN®, and Matthew Lunning, DO, FACP

Katherine L. Byar, MSN, ANP-BC, BMTCN®, and Matthew Lunning, DO, FACP, covered how to tackle challenges in the treatment of aggressive lymphomas by understanding how to apply emerging data, reviewing optimal therapies and treatment recom...

Glasdegib: A Novel Hedgehog Pathway Inhibitor for Acute Myeloid Leukemia

Daniel L. Thompson,(1) PharmD Candidate, and Donald C. Moore,(2) PharmD, BCPS, BCOP, DPLA

Acute myeloid leukemia (AML) is an aggressive myeloid disorder that is associated with a generally poor prognosis. Effective treatment options have been limited for older patients with AML who are not able to undergo intensive remission ...

Gilteritinib: A Novel FLT3 Inhibitor for Relapsed/Refractory Acute Myeloid Leukemia

Dennis Marjoncu,(1) PharmD, BCOP, and Benjamin Andrick,(2) PharmD, BCOP

Acute myeloid leukemia (AML) is the most common adult leukemia, with an overall poor prognosis. New agents targeting various receptors may improve treatment outcomes and overall survival. FMS-like tyrosine kinase 3 (FLT3) is a targetable...

Chronic Neutrophilic Leukemia: A Case Report of a Rare Myeloproliferative Neoplasm With a CSF3R Mutation

Lorinda A. Coombs, PhD, FNP-BC, AOCNP

Cases of chronic neutrophilic leukemia (CNL) are extremely rare and easily missed. The World Health Organization revised criteria in 2016 to include evaluation for CSF3R somatic mutations. In this article, we discuss an 84-year-old man w...

AL Amyloidosis: Unfolding a Complex Disease

Rebecca Lu, MS, FNP, and Tiffany A. Richards, PhD, ANP-BC

Light chain (AL) amyloidosis is a rare plasma cell dyscrasia. An estimated 12,000 people live with the disease in the United States. AL amyloidosis occurs from the misfolding of proteins that deposit in organs (heart, kidneys, digestive ...

The Role of Advanced Practitioners in Optimizing Clinical Management and Support of Patients With Cytokine Release Syndrome From CAR T-Cell Therapy

Sherry Adkins, MSN, ANP-C

CAR T-cell therapy is rapidly emerging as a promising treatment for many hematologic malignancies. However, CAR T cells can be associated with unique toxicities, including cytokine release syndrome (CRS), which can be severe or fatal if ...

Axicabtagene Ciloleucel: The First FDA-Approved CAR T-Cell Therapy for Relapsed/Refractory Large B-Cell Lymphoma

Amber C. King, PharmD, BCOP, and Jennifer S. Orozco, PharmD

Axicabtagene ciloleucel (axi-cel) is an anti-CD19 CAR T-cell therapy that has demonstrated efficacy in relapsed and refractory diffuse large B-cell lymphoma (DLBCL) patients who have had suboptimal responses to conventional therapies. Th...

Mogamulizumab-kpkc: A Novel Therapy for the Treatment of Cutaneous T-Cell Lymphoma

Sutton Watson,(1) PharmD, and Justin Bradley Marx,(2) PharmD, BCPS

Mogamulizumab-kpkc provides a novel mechanism of action for the treatment of mycosis fungoides and Sézary syndrome. The efficacy and safety of mogamulizumab-kpkc for the treatment of relapsed or refractory mycosis fungoides and Sézary sy...

Aztreonam and Vancomycin for Initial Treatment of Febrile Neutropenia in Penicillin-Allergic Patients During Hematopoietic Stem Cell Transplantation

Steven Trifilio, RPh, and Jayesh Mehta, MD

Most patients who undergo hematopoietic stem cell transplantation develop neutropenic fever and are at high risk for developing potentially life-threatening infections. β-lactam antibiotics remain the cornerstone for initial empiric trea...

A Review of PI3K Inhibitors in B-Cell Malignancies

Laura Cannon,(1) PharmD, MPH, Emmeline C. Academia,(2) PharmD, and Ashley E. Glode,(2) PharmD, BCOP

The phosphoinositide 3-kinase (PI3K) pathway plays a primary role in cellular proliferation and metabolism. Inhibition of the PI3K pathway is an emerging area of drug development and cancer research. Idelalisib, copanlisib, and duvelisib...

Letermovir for Cytomegalovirus Prevention in Patients Undergoing Hematopoietic Cell Transplantation

Kori Daniels, PharmD, and Amber Clemmons, PharmD, BCOP

Cytomegalovirus (CMV) is a double-stranded DNA virus that infects (seropositive on screening) more than half of adults by age 40. However, reactivation of detectable viral load (CMV reactivation) typically occurs only in immunocompromise...

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Hematologic Malignancies

Amy Pierre, MSN, ANP-BC, and Nancy M. Nix, PharmD, BCPS, BCOP

Amy Pierre, MSN, ANP-BC, of the Memorial Sloan Kettering Cancer Center, and Nancy M. Nix, PharmD, BCPS, BCOP of St. Joseph’s/Candler Health System offer an advanced practitioner perspective on trials assessing the efficacy and safety of ...

Ivosidenib: IDH1 Inhibitor for the Treatment of Acute Myeloid Leukemia

Shelby L. Merchant, PharmD, Kathryn Culos, PharmD, BCOP, and Houston Wyatt, PharmD, CSP

Abstract There is no standard therapy for refractory acute myeloid leukemia (AML), but several salvage therapies are available (National Comprehensive Cancer Network [NCCN], 2018). Recently, there have been major developments in the tre...

Immunoglobulin Light-Chain Amyloidosis: Clinical Presentations and Diagnostic Approach

Yi L. Hwa, DNP,(1) Teresa Fogaren, MSN, AGNP-C,(2) Allison Sams, AGPCNP-BC,(3) Douglas V. Faller, MD, PhD,(4) Dawn M. Stull, PharmD, BCOP,(5) Sara Thuenemann, RN, MSN, DHSc,(6) and Lisa Mendelson, MSN, AGPCNP-BC(7)

Abstract Systemic immunoglobulin light-chain (AL) amyloidosis is a rare disorder arising from a plasma cell clone that produces misfolded immunoglobulin light chains, which are deposited in various tissues and organs as amyloid fibrils....

Advances in the Management of Myeloma

Presented by Beth Faiman, PhD, MSN, APRN-BC, AOCN®, and Rachid Baz, MD

New agents for the treatment of myeloma have individual and class effects that advanced practitioners need to know about when helping to keep their patients on treatment regimens. At JADPRO Live, Beth Faiman, PhD, MSN, APRN-BC, AOCN®, an...

Sequencing Therapies in Indolent Lymphomas

Presented by Philip A. Thompson, MB, BS, and Lisa Nodzon, PhD, ARNP, AOCNP®

Several targeted agents have recently emerged for the treatment chronic lymphocytic leukemia and follicular lymphoma, which has made treatment selection more complex. Philip A. Thompson, MB, BS, and Lisa Nodzon, PhD, ARNP, AOCNP®, descri...

Modern Management of Classical Hodgkin Lymphoma

Presented by Amy Goodrich, CRNP, and Jose D. Sandoval-Sus, MD

Thanks to the introduction of checkpoint inhibitors, patients with classical Hodgkin lymphoma have a better chance at living longer with the disease. However, treatment-related side effects can impact quality of life in the short- and lo...

New Directions in Acute Myeloid Leukemia

Presented by Kelda Gardner, PA-C, MHS, and Melinda Tran, PharmD, BCOP

Acute myeloid leukemia (AML) is diagnosed in about 20,000 people a year and remains a very challenging malignancy to treat. Kelda Gardner, PA-C, MHS, and Melinda Tran, PharmD, BCOP, reviewed the basics of treating AML, including new asse...

Differential Diagnosis and Testing for Hematologic Malignancies

Presented by Sandra E. Kurtin, PhD, ANP-C, AOCN®, and Jennifer Knight, MD

Sandra E. Kurtin, PhD, ANP-C, AOCN®, and Jennifer Knight, MD, provided advice to the advanced practitioner audience on appropriately applying diagnostic tests in order to acquire actionable information about a patient’s disease.

Impact of a Replacement Algorithm for Vitamin D Deficiency in Adult Hematopoietic Stem Cell Transplant Patients

Sheila A. Kenny,(1) MSN, RN, ANP-BC, Karen Collum,(1) DNP, RN, OCN®, Catherine A. Featherstone,(1) MSN, RN, FNP-BC, Azeez Farooki,(1,2) MD, and Ann Jakubowski,(1,2) PhD, MD

Adults undergoing hematopoietic stem cell transplant (HSCT) are at risk for vitamin D deficiency. After HSCT, exposure to sunlight is restricted, and patients may experience poor nutrition and malabsorption from HSCT-related side effects...

Gemtuzumab Ozogamicin: Back Again

Chris Selby,(1) PharmD, BCOP, Lisa R. Yacko,(2) PharmD, BCPS, and Ashley E. Glode,(3) PharmD, BCOP

Abstract Despite the recent onslaught of approved medications in oncology, acute myeloid leukemia (AML) has been a disease state bereft of pharmaceutical development for decades. The long-standing first-line regimen, 7 + 3, was develope...

Breast Implant–Associated Anaplastic Large Cell Lymphoma: What We Know

Nadia E. K. DePaola, MS, PA-C, and Heather Coggins, MS, PA-C

Abstract Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) is a rare peripheral T-cell lymphoma, first reported in 1997. It is pathologically confirmed as a CD30-positive, anaplastic lymphoma kinase (ALK)–negative ALCL...

Diagnostic Snapshot: Painful Nodules and Recurrent Fever in a Patient With Acute Lymphoblastic Leukemia

Alexis C. Geppner, MLS(ASCP), PA-C

Interdisciplinary Educational Checklist for Allogeneic Stem Cell Transplant Patients

Jean A. Ridgeway, DNP, APN, NP-C, AOCN®

Abstract Allogeneic hematopoietic stem cell transplant (HSCT) has emerged as a unique treatment modality. Patients who receive an allogeneic HSCT report feeling inadequately equipped to manage their postdischarge plan of care. It is ess...

Inotuzumab Ozogamicin in Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia

Sherry Williams, PharmD, BCOP, and Miryoung Kim, PharmD, BCOP

Abstract Despite initial complete remission rates of up to 90%, long-term, disease-free survival remains poor in patients with newly diagnosed acute lymphoblastic leukemia (ALL). Response to salvage chemotherapy is suboptimal; therefore...

Diagnostic Snapshot: Acute Edema in the Oncology Patient

Alexandra Trudeau, BSN, BS, RN, CNOR, Danielle Bean, BSN, RN, Donna Fleming, MSN, RN, FNP-C, Glaiza Boado, BSN, RN, Natalia Samuels, MSN, RN, and Reshmi Kurup, BS, RN

Subcutaneous Rituximab in Follicular Lymphoma, Chronic Lymphocytic Leukemia, and Diffuse Large B-Cell Lymphoma

Bradley J. Yelvington, PharmD

Abstract Rituximab and hyaluronidase human is a new subcutaneous formulation of rituximab that was recently approved by the US Food and Drug Administration for the treatment of adults with follicular lymphoma, diffuse large B-cell lymph...

Tisagenlecleucel: The First CAR on the Highway to Remission for Acute Lymphoblastic Leukemia

Craig W. Freyer, PharmD, BCOP

Abstract Tisagenlecleucel is a first-in-class chimeric antigen receptor (CAR) T-cell therapy approved by the US Food and Drug Administration in 2017 for relapsed/refractory (RR) acute lymphoblastic leukemia (ALL) in patients up to 25 ye...

Feasibility of Outpatient High-Dose Methotrexate Infusions in Pediatric Patients With B-Lineage Acute Lymphoblastic Leukemia

Abstract High-dose methotrexate (MTX) given in four hospitalizations during interim maintenance for high-risk pediatric B-lineage acute lymphocytic leukemia significantly improves survival but increases resource utilization. Children re...

Enasidenib: An Oral IDH2 Inhibitor for the Treatment of Acute Myeloid Leukemia

Abstract Acute myeloid leukemia (AML) is a hematologic malignancy that affects predominantly older patients, with a median age of diagnosis around 67.  Overall prognosis is poor; however, novel targeted therapies that can potentially im...

A Deeper Dive Into Advanced and Future Directions in Treating Patients With Acute Myeloid Leukemia

Acute myeloid leukemia is a disease that affects predominantly older patients, with a median age at diagnosis of 68. Overall prognosis is poor, but novel therapies that have emerged in recent years offer hope that outcomes can improve. I...

Managing the Continuum of Myeloid Malignancies

Advanced practitioners can play an important role in assessing patients with myeloid malignancies for fitness and addressing vulnerabilities so that patients can benefit from allogeneic stem cell transplant, which remains the best option...

Contemporary Management of Hodgkin Lymphoma and Chronic Lymphocytic Leukemia

Identifying key molecular attributes can help in the risk-adapted treatment of Hodgkin lymphoma and chronic lymphocytic leukemia. At JADPRO Live, presenters reviewed best practices for managing patients with the rapidly expanding armamen...

Acute Promyelocytic Leukemia: A Summary

Abstract Acute promyelocytic leukemia is a distinct subtype of acute myeloid leukemia. The disease is characterized by a chromosomal abnormality involving translocation between chromosomes 15 and 17. Current therapy has advanced to incl...

Managing Tumor Lysis Syndrome in the Era of Novel Cancer Therapies

Abstract  Tumor lysis syndrome (TLS) is a potentially life-threatening emergency that can develop rapidly after the release of intracellular contents from lysed malignant cells. The advent of novel and targeted therapies that have impro...

Role of the Advanced Practice Provider in Clinical Trials: Contributions to the Management of Patients Receiving Inotuzumab Ozogamicin

Venetoclax: A Novel Treatment for Patients With del(17p) Chronic Lymphocytic Leukemia

Developing a Clinical Program Based on the Needs of Patients With Chronic Lymphocytic Leukemia: Preparing for Illness Episodes

Patients with chronic lymphocytic leukemia (CLL) are part of a new category of survivors emerging in the population of Americans who are living with cancer. These survivors who have received treatment are living with an incurable cancer ...

Treatment of a Locally Invasive Cutaneous Fusarium Species Infection With Voriconazole and Liposomal Amphotericin B in a Patient With Relapsed Acute Myeloid Leukemia

Case Study In February 2011, a 69-year-old, 1.91 m2 Caucasian male was diagnosed with acute myeloid leukemia (AML). Immediately prior to the diagnosis of AML, the patient was otherwise healthy until he developed multiple infections, inc...

New Treatment Paradigms Defined for Chronic Lymphocytic Leukemia

Within the past 3 years, the FDA has approved five new treatment options for patients with CLL. While these advances improve patient outcomes and the quality of care, there is a need for advanced practitioners to stay up to date and info...

Idelalisib: Practical Tools for Identifying and Managing Adverse Events in Clinical Practice

Abstract Idelalisib is a first-in-class oral selective inhibitor of phosphatidylinositol 3-kinase delta, which is selectively expressed in hematopoietic cells, where it is critical to B-cell receptor signaling and B-cell development and...

A Missed Opportunity: Understanding the Value of Documenting Occupational Exposure to Carcinogens in Adults With Acute Leukemia

Risk-Stratified Treatment in Chronic Lymphocytic Leukemia

Bosutinib Therapy in Patients With Chronic Myeloid Leukemia: Practical Considerations for Management of Side Effects

Abstract The past decade has witnessed great advances in the treatment of chronic myeloid leukemia (CML), brought about in large part by the development of BCR-ABL tyrosine kinase inhibitors (TKIs). Bosutinib joins the armamentarium of ...

Tyrosine Kinase Inhibitors for the Treatment of Chronic-Phase Chronic Myeloid Leukemia: Long-Term Patient Care and Management

Several tyrosine kinase inhibitors (TKIs) are now approved for the treatment of chronic myeloid leukemia in chronic phase. The efficacy of these drugs has been repeatedly demonstrated, as has their tolerability in most patients. However,...

Advancements in Therapy for Acute Lymphoblastic Leukemia: Blinatumomab

Multiple Myeloma: Risk Stratification and Toxicity Management

The treatment landscape for multiple myeloma is rapidly changing. At JADPRO Live 2017, presenters brought advanced practitioners up to date on the newest approaches to the management of this disease, as well as what to be aware of when t...

An Anecdotal Outpatient Approach to Caring for Patients With End-Stage Hematologic Malignancies

Abstract Historically, hospice has been a poor option for patients with end-stage hematologic malignancies, largely due to the need for regular transfusions to sustain life near the end, and to a lesser extent the treatment of curable e...

Integrating Emerging Data Into Clinical Practice: A Case-Based Approach for Multiple Myeloma

Selected Patient Cases From the APSHO Regional Lecture Series Introduction As the official publication of the Advanced Practitioner Society for Hematology and Oncology (APSHO), JADPRO is pleased to offer Part 2 of an accredited educa...

Ixazomib: An Oral Proteasome Inhibitor for the Treatment of Multiple Myeloma

The FDA approval of ixazomib for use in combination with lenalidomide and dexamethasone for patients with multiple myeloma who have received at least one prior therapy signalled the arrival of the first oral proteasome inhibitor, allowin...

New Treatment Strategies Making an Impact in Multiple Myeloma

Even though multiple myeloma remains incurable, mean overall survival has improved dramatically as newer game-changing therapies enter the scene. At the same time, treatment decisions and the management of toxicities related to newer dru...

Daratumumab: Dawn of a New Paradigm in Multiple Myeloma?

Elotuzumab: The First Monoclonal Antibody for the Treatment of Multiple Myeloma

Risk Stratification in Multiple Myeloma: Putting the Pieces Together

Iron Overload in Myelodysplastic Syndromes: Pathophysiology, Consequences, Diagnosis, and Treatment

Abstract Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic neoplasms varying in severity affecting one or more lines of hematopoiesis. Ineffective erythropoiesis results in dysregulation of iron metabolism. Most M...

Practical Strategies for Management of Lenalidomide-Associated Cytopenias in Myelodysplastic Syndromes With del(5q)

Case Study A male patient aged 67 years with a 2-year history of refractory anemia and myelodysplastic syndromes (MDS) with del(5q) started lenalidomide (Revlimid) treatment as a participant in the MDS-001 trial (List et al., 2005). At ...

Practical Guide to Bone Marrow Sampling for Suspected Myelodysplastic Syndromes

Myelodysplastic syndromes (MDS) comprise a group of diverse clonal hematopoietic stem cell malignancies that are characterized by ineffective hematopoiesis and progressive bone marrow failure. Clinical symptoms are generally nonspecific....

Optimizing Communication and Adherence to Iron Chelation Therapy From Diagnosis to Treatment in Patients With Myelodysplastic Syndromes

Abstract Myelodysplastic syndromes (MDS), a heterogeneous group of blood diseases, are usually diagnosed in older individuals, with a median age at diagnosis of more than 70 years. Anemia is a common symptom in patients with MDS and may...

Diagnostic Snapshot: "I Have a Bad Cold"

Brentuximab Vedotin Infusion Reaction Management: A Case Study

We report a case of a grade 3 (Common Terminology Criteria for Adverse Events [CTCAE]) infusion reaction to brentuximab vedotin (Adcetris), in a patient with refractory Hodgkin lymphoma, at a large National Cancer Institute–designated ca...

Nuances in the Management of Aggressive Lymphomas

Treatment for both Hodgkin and Non-Hodgkin lymphoma now includes chemotherapy, targeted therapy, and new immunotherapies. As research continues to shine the light on tumor genetics, clinical variability, and new treatment approaches, adv...

Belinostat for Relapsed or Refractory Peripheral T-Cell Lymphoma

The FDA approval of belinostat provides APs with an additional option for heavily pretreated patients with relapsed/refractory peripheral T-cell lymphoma who did not achieve a desirable response to traditional chemotherapy agents. Read a...

The Role of Advanced Practitioners in Optimizing Clinical Management and Support of Patients With Polycythemia Vera

Case StudyMr. M, a 65-year-old male, presented to his primary care physician with progressive fatigue, difficulty sleeping, and daily headaches for the past 3 weeks. His headaches were not associated with visual disturbances, cognitive d...

Ruxolitinib in Myelofibrosis and Polycythemia Vera