Current Issue

VOL 11 NO 4 • MAY/JUN 2020

This issue’s cover illustration depicts how damage to NTRK genes can lead to fusion proteins that cause unregulated cellular growth. Larotrectinib binds to a dimerized TRKC fusion protein and consequently stops the signaling cascades that would have followed. Artwork by Alexandra Webber Baker © 2020, DNA Illustrations, Inc., Asheville, North Carolina.


Advanced Practitioners and the COVID-19 Pandemic

Pamela Hallquist Viale, RN, MS, CNS, ANP

This is an incredibly strange time to be practicing in health care. Although predictions for a pandemic in the world have been talked and written about for decades, the COVID-19 pandemic has hit us with a vengeance, requiring health-care practitioners to step up and practice under a variety of di...

Research and Scholarship

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

In 2020, there will be an estimated 19,940 new cases of acute myeloid leukemia (AML) and 11,180 deaths in the United States (Siegel, Miller, & Jemal, 2020). The incidence of AML is increasing, in part due to the overall aging population; the median age at presentation is 68 years (American Ca...

Research and Scholarship

Perceptions of Health-Care Workers of the Cost and Safety of Oral Oncolytic Agents for Patients: A Survey

Madeline Tompkinson,(1) PharmD, Kelly Fine,(2) RPh, FAzPA, Dean Gruber,(3) RPh, Ivo Abraham,(4) PhD, RN, and Ali McBride,(5) PharmD, MS, BCPA, BCOP

Oral oncolytic agents are being approved by the US Food and Drug Administration (FDA) at a rapid pace. There are currently more than 800 new oncology therapies in the pipeline, 25% of which are oral agents (American Cancer Society [ACS], 2016). Oral oncolytic agents have several advantages over t...

Review Article

Risk Factors for Ifosfamide-Related Encephalopathy in Adult Cancer Patients: An Integrative Review

Amanda Lee Brink, DNP, APRN, FNP-BC, AOCNP®, Christi Bowe, MSN, APRN, ANP-C, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Ifosfamide is an antineoplastic medication that is used to treat a variety of malignancies but has the potential for inducing serious adverse effects. One such adverse effect is central nervous system toxicity, known as ifosfamide-related encephalopathy (IRE). Ifosfamide is most commonly administ...

Grand Rounds

Waldenström Macroglobulinemia: Clinical Presentation, Diagnosis, and Management

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

Case Study Mr. P was initially incidentally noted to have an elevated total protein in 2001 on an annual physical exam. As he was asymptomatic, workup was delayed until May 2002 when he had a bone marrow biopsy that showed approximately 20% involvement with lymphoplasmacytic lymphoma. His IgM lev...

Practice Matters

Mayo Clinic Hematology Fellowship for Advanced Practice Providers

Yi L. Hwa,(1) DNP, APRN, CNP, Jessica L. Shelly,(1) MSN, APRN, Darci L. Zblewski,(1) MSN, APRN, Megan T. Spychalla,(1) PA-C, Dawn M. Udenberg,(1) DNP, APRN, Kathryn R. Cieslak,(2) MS, Grzegorz S. Nowakowski,(1) MD, Martha Q. Lacy,(1) MD, and Ariela L. Marshall,(1,3) MD

The American population is growing, aging, and living longer. A shortage of hematologists/oncologists has been projected due to increased numbers of patients with new cancer diagnoses, those undergoing treatment, and long-term cancer survivors (American Society of Clinical Oncology, 2017; Yang et...

Practice Matters

Development of a Hematology-Oncology Advanced Practice Provider Fellowship Program

Jenna A. Kramer, ACNP-BC, and Camille Petraitis Valente, DNP, FNP-BC

Oncology care is a topic of great interest given its ever-growing complexity. In the United States, the population is living longer, cancer care is increasingly accessible, and there has been an overall expansion of oncologic services, creating a triad of demands for providers (American Society o...

Prescriber's Corner

Advancements in Therapy for Bladder Cancer: Enfortumab Vedotin

Kirollos S. Hanna, PharmD, BCPS, BCOP

Urothelial carcinoma (UC) is the sixth most common cancer in the United States and the second most common genitourinary cancer, with 81,400 new cases and 17,980 deaths estimated in 2020 (Siegel, Miller, & Jemal, 2020). Rates for new UC cases have been falling on average by 1.2% each year over...

Prescriber's Corner

Larotrectinib and Entrectinib: TRK Inhibitors for the Treatment of Pediatric and Adult Patients With NTRK Gene Fusion

Danielle B. Dunn, PharmD

Tropomyosin-related kinase (TRK) transmembrane proteins TRKA, TRKB, and TRKC are encoded by neurotrophic tyrosine receptor kinase (NTRK) genes NTRK1, NTRK2, and NTRK3, respectively (Amatu, Sartore-Bianchi, & Siena, 2016; Vaishnavi, Le, & Doebele, 2015). When the kinase domains are bound b...

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