Challenging Cases in CML

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Release Date: November 12, 2015
Expiration Date: November 12, 2016

Expected time to complete this activity as designed: 60 minutes
There are no fees for participating in or receiving credit for this online activity.

Program Overview

Chronic myeloid leukemia (CML) is a small-population cancer; some 6,600 cases are anticipated to be diagnosed in the United States in 2015. The introduction of tyrosine kinase inhibitors (TKIs) in 1998 transformed the management of CML and has led to significantly reduced mortality and improved 5-year survival rates. Nevertheless, the CML health care community is faced with several clinical challenges that need to be addressed.

Target Audience

The target audience for this activity is nurse practitioners, nurses, and other health care professionals who provide care to patients with CML.

Learning Objectives

Upon completion of this educational activity, participants should be able to:

  • Recall the criteria for accelerated phase chronic myeloid leukemia (CML)
  • Identify treatment goals and strategies for accelerated phase CML patient management
  • Recognize clinical barriers for the management of accelerated phase CML
  • Outline potential treatments that may be used in patients experiencing treatment failure, focusing on the efficacy and safety of each agent
  • Implement therapeutic strategies for patients who are experiencing treatment failure, utilizing the most appropriate approach for the individual patient with CML


Diagnosis and Management of Accelerated Phase CML − Jonathan Webster, MD, and B. Douglas Smith, MD

Treatment Failure in First-line Therapy − Elias Jabbour, MD

Instructions for Participation and Credit

This activity is eligible for credit through November 12, 2016. After this date, this activity will expire and no further credit will be awarded.

  1. Read the target audience, learning objectives, and faculty disclosures.
  2. You may be asked to complete a short pre-test before accessing the educational content. This must be completed in order to move forward in the activity.
  3. Complete the educational content as designed.
  4. Complete the post-test. To receive a certificate, you must receive a passing score of 70%.
  5. Complete the activity evaluation survey to provide feedback and information useful for future programming.
  6. Certificates for CNE credit may be printed immediately after successfully completing the post-test and activity evaluation.

Faculty Biographies

Elias Jabbour, MD
Associate Professor
Department of Leukemia
Division of Cancer Medicine
The University of Texas MD Anderson Cancer Center
Houston, Texas

Dr. Elias Jabbour received his medical degree from Saint Joseph’s School of Medicine. He completed his residency at Hotel Dieu de France University Hospital, and his fellowship in hematology-oncology at the Gustave Roussy Institute. Dr. Jabbour joined The University of Texas MD Anderson Cancer Center as a fellow in the Department of Hematology/Leukemia and Stem Cell Transplantation and is currently associate professor in the Leukemia Department.

Dr. Jabbour has taken an active role in the medical community, participating in numerous scientific meetings. He has authored or co-authored numerous publications and abstracts, and serves as a reviewer for many scientific journals. He is actively involved in research in both acute and chronic forms of leukemia, as well as in clinical trials that led to the approval of several drugs in chronic myeloid leukemia (CML) and myelodysplastic syndromes. Dr. Jabbour’s research on resistance to imatinib and mutations of the protein kinase domain were presented in several international meetings and published in peer-reviewed journals. He is also developing tailored therapies to CML.

B. Douglas Smith, MD
Associate Professor of Oncology
Johns Hopkins University School of Medicine
Baltimore, Maryland

Dr. B. Douglas Smith received his medical degree from the Medical College of Pennsylvania in Philadelphia. He was a resident/chief resident in medicine at Strong Memorial Hospital in Rochester, New York, and an oncology fellow at the Kimmel Cancer Center at Johns Hopkins, Baltimore, Maryland. Dr. Smith is associate professor of oncology at Johns Hopkins University School of Medicine and on the active staff of Johns Hopkins Hospital.

A member of the American Society of Hematology, the American Society of Clinical Oncology, and the American Association for Cancer Research, Dr. Smith developed the first tumor banking protocol in hematologic malignancies and now serves as the co-director of the cancer center’s specimen accessioning core. He also serves as co-investigator for the oncology center’s UM1 (phase I) grant. He is a recognized national leader in new therapeutics for AML and CML and currently serves on the NCCN guideline panels for both of these diseases. Dr. Smith also supports the SKCCC and Department of Oncology by serving as the co-chair of institutional review board-2.

Dr. Smith’s research focuses on taking new and promising laboratory insights and developing them into biology-based treatment approaches for patients with AML, CML, and MDS. His work has evolved from collaborations with many laboratory-based physician-scientists and he has translated numerous novel therapies into the clinic, including differentiation-based strategies, small molecule inhibitors of signal transduction pathways, agents that alter cell cycle kinetics and DNA-damage repair, and immunomodulatory approaches. Many of these trials share the common theme of studying the impact of the treatment on the cancer stem cells in hopes of limiting their role in treatment failure. Dr. Smith’s work integrates correlative studies to assess biologic activity of the experimental therapies.

Jonathan A. Webster, MD
Oncology Fellow
The Sidney Kimmel Comprehensive Cancer Center
Johns Hopkins Hospital
Baltimore, Maryland

Dr. Jonathan Webster received his medical degree from Stanford University School of Medicine, Stanford, California. He completed his internship and residency in internal medicine at The Johns Hopkins Hospital, Baltimore, Maryland where he is currently an oncology fellow. Dr. Webster has been published in several peer-reviewed publications including The Journal of Biological Chemistry, Journal of Clinical Oncology, The Journal of Pathology, Breast Cancer Research and Treatment, and Nature Chemical Biology.


Accreditation Statement: MediCom Worldwide, Inc., 101 Washington Street, Morrisville, PA 19067 is approved by the California Board of Registered Nursing, Provider Number CEP11380. MediCom designates this CNE activity for 1.0 contact hour. Program Number 15-059-024


As an organization accredited by the Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Pharmacy Education (ACPE) and California State Board of Registered Nursing, MediCom Worldwide, Inc. requires everyone who is a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest. Accordingly, the following disclosures were made.

Faculty Disclosures

Dr. Elias Jabbour has received grant support related to research activities and consultant fees from ARIAD Pharmaceuticals, Inc., Pfizer Inc., and Teva Pharmaceutical Industries Ltd., in addition to consultant fees from Bristol-Myers Squibb Company.

Dr. B. Douglas Smith and Dr. Jonathan Webster have disclosed no relevant financial relationships.

Planning Committee Disclosures

The individuals listed below from MediCom Worldwide, Inc. reported the following for this activity: Joan Meyer, RN, MHA, executive director, has no relevant financial relationships.

Peer Reviewer Disclosure

In accordance with MediCom Worldwide, Inc. policy, all content is independently peer reviewed for balance, objectivity and commercial bias. The peer reviewers have no relevant financial relationships to disclose.

Off-Label Disclosures/Investigational Disclosures

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

Dr. Jabbour has indicated that he does intend to discuss off-label uses of drugs, mechanical devices, biologics or diagnostics approved by the US Food and Drug Administration (FDA) for use in the US.

Dr. Smith and Dr. Webster have indicated that they do not intend to discuss off-label uses of drugs, mechanical devices, biologics or diagnostics approved by the US Food and Drug Administration (FDA) for use in the US.

Dr. Jabbour has indicated that he does intend to discuss investigational drugs, mechanical devices, biologics or diagnostics not approved by the FDA for use in the US.

Dr. Smith and Dr. Webster have indicated that they do not intend to discuss investigational drugs, mechanical devices, biologics or diagnostics not approved by the FDA for use in the US.

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If you have any questions or concerns regarding this activity, please contact MediCom Worldwide, Inc. at 1-800-408-4242 or email us at

Provided by MediCom Worldwide, Inc.
This activity is supported by educational grants from ARIAD Pharmaceuticals, Inc., Novartis, and Teva Pharmaceuticals.

©2015 MediCom Worldwide, Inc., 101 Washington St., Morrisville, PA 19067, 800-408-4242.
No portion of this material may be copied or duplicated without the expressed permission of MediCom Worldwide, Inc.

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