All in for ALL Mitigating VOD Risk in Patients Being Treated for R/R ALL

Beaumont Health Historically, the prognosis of relapsed/refractory (R/R) acute lymphoblastic leukemia (ALL) has been poor with median overall survival (OS) of only 6 months and cure rates of less than 10%, even with intensive salvage chemotherapy and hematopoietic stem cell transplant (HSCT). (Samra, 2020) However, with the advent of new and revolutionary therapies, including a CD22-directed antibody drug conjugate inotuzumab ozogamicin (InO), outcomes for patients have improved exponentially. (Samra, 2020) Yet while InO is highly active, it has a unique hepatotoxicity profile, including a higher risk of veno-occlusive disease (VOD) in recipients of HSCT. (Kebriaei, 2018) For this reason, effective patient management must include evaluation and management of the important AEs associated with this therapy, with a focus on diagnosis, prevention, monitoring, and management of VOD. (Kebriaei, 2018) To effectively translate expert guidance to practice and build clinician confidence in optimizing therapeutic benefit through management of AEs, clinicians benefit from peer-to-peer exchanges to model best practices and discuss practical strategies to achieve goals. Fortunately, with education clinicians’ attitudes, knowledge, competence and behavior can change. To enable clinicians to deliver a personalized approach to care University of Chicago and ACHL are proposing to create an opportunity for small group learning among community oncologist via live visiting professorship programs (VPPs). The VPP is education delivered via small group live settings (faculty will be virtual) in hospitals and community cancer centers throughout the country. The small group setting of the VPP affords clinicians a forum to interact with their colleagues, share real world experiences, have collaborative discussion, and address key challenges with the current environment, while fostering a safe environment for social exchange. The goal of this education is to build clinical confidence in the multidisciplinary treatment teams by supporting peer-to-peer learning. These small group meetings foster direct interaction between hematologists in a supportive, non-threatening atmosphere thereby encouraging discussion of and reflection on, clinical concerns, barriers and opportunities for improved practice, consultations, and more. For clinicians who may reside in non-urban settings, it provides a great opportunity for networking and outreach to colleagues outside of their network.