Developing a Conditioning Regimen Calculator as Part of a Successful HCT Program

2. Developing a Conditioning Regimen Calculator as Part of a Successful HCT Program Roger Williams Medical Center a CharterCare Health Partner Presenter: Mark Curtis RPh Clinical Informatics Pharmacist

3. RPh Objectives : Discuss the current ASBMT Conditioning Regimen Recommendations Recognize the importance of chemo dosing on outcomes Demonstrate how a dosing calculator can support doctors, pharmacists and nursing in safe patient therapy Review the findings from a retrospective review of patients from 2010 through 2014.

4. Technician Objectives : Recognize the current ASBMT Conditioning Regimen Recommendations Recognize the importance of appropriate chemotherapy dosing Understand how accurate calculations are needed before the preparation of chemotherapy

5. Disclosures Presenter: Mark Curtis RPh Clinical Informatics Pharmacist Has no financial disclosures to report Roger Williams Medical Center a CharterCare Health Partner

12. VALIDATION: Doctors, Nurses, Pharmacists all helped test the calculator Regimen selection, patient metrics, and dose calculations were all tested for accuracy Over 80 different patient examples were used for testing Any discrepancy between the calculator and the manual calculation were reviewed and reconciled

13. RETROSPECTIVE REVIEW: 109 patients transplanted at RWMC between 2010 and 2014 Transplant types included Auto, Allo (MRD/MUD) and Cord Blood Reviewed dosing variances between the current ASBMT recommendations and the administered dose Two groups: those with out a variance and those who had a variance

14. RETROSPECTIVE REVIEW: Outcomes were reviewed: Days to Engraftment of ANC and Platelets Relapse rates Survivor rates It is very difficult to confirm cause and effect….

15. FINDINGS:

16. FINDINGS:

17. FINDINGS: Some regimen specific differences in time to engraftment between the two groups. Possible some differences in relapse and survivor rates Numbers are not enough in each group to be statistically significant

18. CONCLUSIONS: The calculator supports consistent and accurate regimen dosing that follows the latest ASBMT recommendations. There may be some Possible clinical benefit to strictly following the ASBMT recommendations

19. ACKNOWLEDGEMENTS Todd Roberts MD Medical Director of BMT RWMC Kimberly Loftus Transplant Coordinator RWMC Alejandro Carvajal, MD RWMC

20. Presentation Questions 1. Which of the following statements is not true about BMT Conditioning Regimens? A. Dose adjustments are always done using the same method, regardless of the drug being used. B. When Adjusted Ideal Body Weight is used it is the AIBW25. C. BMT conditioning regimen calculations can be complex. D. The intensity of therapy is important to patient outcomes 2. True or False: Using the calculator improves dosing accuracy and may improve outcomes.

21. Presentation Questions 1. Which of the following statements is not true about BMT Conditioning Regimens? A.Dose adjustments are always done using the same method, regardless of the drug being used. B. When Adjusted Ideal Body Weight is used it is the AIBW25. C. BMT conditioning regimen calculations can be complex. D. The intensity of therapy is important to patient outcomes 2. True or False: Using the calculator improves dosing accuracy and may improve outcomes.

22. QUESTIONS?