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* 1. Which of the following treatment strategies is most consistent with contemporary guideline-based care for adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL)?

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* 2. A 30-year-old woman with Philadelphia chromosome–negative B-cell ALL is receiving pegaspargase as part of her treatment regimen. She develops nausea, hypotension, and diffuse skin erythema and pruritus within minutes of starting her second pegaspargase infusion. The symptoms resolve after the infusion is stopped, and she is treated with intravenous fluids, diphenhydramine, and dexamethasone. Which of the following is the most appropriate next step in the management of her asparaginase therapy?

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* 3. In AYAs with ALL treated with pediatric-inspired asparaginase-based protocols, early discontinuation of asparaginase has been associated with which of the following outcomes?

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* 4. A 26-year-old man with Philadelphia chromosome–negative B-cell ALL on a pediatric-inspired regimen that includes E coli–derived asparaginase is found to have a trough serum asparaginase activity (SAA) level of 0.05 IU/mL on day 7 after dosing, without any clinical symptoms. Repeat testing confirms an SAA level of 0.05 IU/mL. Which of the following best describes this situation and its recommended management?

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* 5. A 35-year-old man with obesity and ALL receiving pegaspargase develops grade 3 hyperbilirubinemia and grade 3 elevation in AST and ALT liver enzymes. He is otherwise clinically stable. Which of the following reflects the recommended approach to his asparaginase therapy?

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* 6. What is your highest attained credential?

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* 7. What is your specialty?

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* 8. Which of the following describes your primary practice setting?

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* 9. How many years have you been in practice? (Please use numbers only)

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* 10. How many patients with acute lymphoblastic leukemia (ALL) or acute lymphoblastic lymphoma (LBL) do you see per MONTH? (Please use numbers only)

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* 11. Please let us know how this activity will help you with patient care.

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* 12. Please rate how well the activity met the identified objective:

  Strongly Agree Agree Neutral Disagree Strongly Disagree
Evaluate the latest evidence on the efficacy and safety profiles of pediatric-inspired asparaginase-based ALL treatment protocols for the young adult population
Employ appropriate monitoring of asparaginase-based protocols in ALL in young adults, including therapeutic drug levels, pharmacokinetics, and clinical values
Recognize, differentiate, and appropriately manage safety and toxicity issues that can occur during treatment of ALL with asparaginase, such as hypersensitivity reactions, infusion reactions, and other commonly encountered adverse effects

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* 13. Please rate the effectiveness of the presenting faculty:

  Strongly Agree Agree Neutral Disagree Strongly Disagree
The faculty was effective in presenting the material
The faculty was knowledgeable about the subject matter

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* 14. Please rate the effectiveness of the CME/CE content:

  Strongly Agree Agree Neutral Disagree Strongly Disagree
The content addressed the learning objectives (purpose)
The activity enhanced my current knowledge base
The information was relevant to my practice and my educational needs
The information will help me improve patient care
The activity provided new ideas or information I expect to use
The activity provided appropriate learning assessment activities
The activity addressed the ABMS/ACGME core competencies of patient care, professionalism, and medical knowledge

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* 15. Based upon your participation in this activity, do you intend to change your practice behavior? Choose only one of the following options:

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* 16. If you plan to change your practice behavior, what types of changes do you plan to implement? Check all that apply:

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* 17. How confident are you that you will be able to make your intended changes?

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* 18. In what time frame do you anticipate making these intended changes?

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* 19. Which of the following parameters do you anticipate will be the primary barrier to implementing these changes? Please choose only one of the following options and provide any additional details in the box below:

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* 20. Was the content of this activity fair, balanced, objective, and free of bias?

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* 21. How confident were/are you in using pediatric-inspired, asparaginase-based regimens to treat young adult patients with ALL?

  Very Confident Confident Somewhat Confident Unsure Not Very Confident
Before this activity?
After this activity

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* 22. How confident were/are you in identifying a hypersensitivity reaction (clinical or silent) to asparaginase therapy?

  Very Confident Confident Somewhat Confident Unsure Not Very Confident
Before this activity?
After this activity

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* 23. How likely were/are you to maintain planned asparaginase exposure in young adults with ALL by using guideline-concordant strategies to manage hypersensitivity or silent inactivation, rather than discontinuing asparaginase therapy?

  Very Confident Confident Somewhat Confident Unsure Not Very Confident
Before this activity?
After this activity

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* 24. What did you think of the format of this activity and why? Please be as specific as possible.

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* 25. Complete to receive your credit

Thank you for participating! Please click "Done" to submit your answers. You will receive your certificate via email within 3 weeks.

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