About the JMML CME Activity

It is very uncommon that any one physician will encounter many cases of juvenile myelomonocytic leukemia (JMML) throughout his or her career due to the rarity of the disease. Also, as noted during the JMML Foundation’s 2005, 2007, and 2008 Symposia and Working Group Meetings, it appears that the greatest current opportunity for raising the survival rate for JMML is not through use of a particular drug, but rather through the standardization of disease management of children with JMML before, during, and after transplant.

For these reasons, The JMML Foundation’s Continuing Medical Education (CME) Activity was established to facilitate the process of curing JMML by instructing physicians, including primary care providers, transplanters, and current and future researchers, on the most current scientific research about, and international expert treatment guidance for, JMML.

This JMML CME Activity is designed to comply with the health information standards set forth by the Health on the Net Foundation (HONcode principles) and the National Institutes of Health (NIH) Medline Plus. All CME materials are made available through the JMML Foundation website in order to keep costs low and to maximize the timely availability of the materials to physicians worldwide. Additionally, all materials are made available to the general public in order to allow families and friends of children with JMML to have as many tools as possible to best perform their own roles in curing JMML.

There is no fee for participation in this JMML CME Activity.

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Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through a joint sponsorship between CME Outfitters, LLC, and The JMML Foundation. CME Outfitters, LLC is accredited by the ACCME to provide continuing medical education for physicians.

CME Outfitters designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.  Participants must complete all segments to request credit.

Access the CME Outfitters, LLC Privacy and Confidentiality Policy at http://www.cmeoutfitters.com/privacy.asp. Contact the accredited provider at: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

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Statement of Need

Juvenile Myelomonocytic Leukemia (JMML) is a rare form of childhood leukemia that affects approximately 1 per million children, meaning that very few hematologist/oncologists have ever treated a patient with JMML.  The current survival rate for kids with JMML is <15% without treatment, ~55% with a bone marrow transplant, and up to an additional third of relapsed patients with a second bone marrow transplant. These rates are far below the survival rate for children with ALL.  Chemotherapy has so far proven ineffective at inducing a lasting remission for patients.

Currently, few standardized treatment protocols targeted to JMML exist. One is administered by the European Working Group on the Myelodysplastic Syndromes (EWOG-MDS), and one by the Japanese Pediatric Leukemia/Lymphoma Study Group (JPLSG).  These protocols overlap in research objectives but are not similar enough for sample populations to be combined. Only the Japanese protocol is currently part of a funded study; the other is a voluntary regimen until funding is available for a full trial to commence.

Though research is published and shared worldwide regarding JMML by various individuals, the potential for international cooperation for research and treatment is not maximized or centrally coordinated.

Based on this information, The JMML Foundation, whose mission is “to cure JMML and to improve the quality of life of JMML patients and families through research, education, advocacy, and charity,” has determined the need for web-based CME-certified training on JMML and a recurring International JMML Symposium.  The goal of the symposium will be “to establish an international scientific forum, driven simply by a focus on the JMML disease and not by country or institutional goals, that combines clinical, basic, and translational research in order to improve survivability among JMML patients.”  The goals of this web-based CME-certified training program, consisting of material presented at the December 2009 JMML Foundation International Symposium (slide presentations, transcripts, and audio and video of all presentations) are to encourage more physicians and researchers to collaborate in the search for a cure for Juvenile Myelomonocytic Leukemia (JMML) by presenting an overview of current international research, and to provide up-to-date training on JMML diagnosis and clinical options to physicians worldwide who are treating a child with JMML.

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JMML CME Activity Learning Objectives

The goals of this web-based CME-certified training program, consisting of material presented at the December 2009 JMML Foundation International Symposium (slide presentations, transcripts, and audio and video of all presentations) are to encourage more physicians and researchers to collaborate in the search for a cure for Juvenile Myelomonocytic Leukemia (JMML) by presenting an overview of current international research, and to provide up-to-date training on JMML diagnosis and clinical options to physicians worldwide who are treating a child with JMML.

The specific learning objectives of this CME Activity are as follow:

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Instructions for requesting your CME certificate:

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Hardware and Software Requirements

Watching video presentations in this CME requires access to the following system requirements:

Transcripts and Slides in PDF format may be opened and viewed using Adobe Acrobat Reader.  If you do not already have Adobe Acrobat Reader installed on your computer, you can downloaded and install it for free at http://get.adobe.com/reader/.

Audio files in MP3 format may be opened and listened to using media players such as Windows Media Player, Apple Quicktime, or RealPlayer SP.  Quicktime may be downloaded and installed for free at http://www.apple.com/quicktime/download/. RealPlayer SP may be downloaded and installed for free at http://www.real.com/realplayer.

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View CME Presentations

1. "Basic Science of Juvenile Myelomonocytic Leukemia (JMML): An Introduction"

• Contents:  An overview of the history of JMML basic science research, as well as current genetic information known about JMML.
• Learning objective:  At the conclusion of this activity you will be able to explain the current state of basic science known with regard to JMML
• Faculty name and affiliation:  Benjamin S. Braun, MD, PhD, University of California, San Francisco
• Faculty disclosure:  Dr. Braun has no disclosures to report.

2. "Juvenile Myelomonocytic Leukemia (JMML): Optimizing Translational Studies in Order to Achieve a Cure”

Contents:  A discussion of the basic characteristics of the JMML disease, current translational studies in the U.S., and proposed topics for further consideration and collaboration in future research and clinical studies.

Learning objective:  At the conclusion of this activity you will be able to  discuss current translational studies and questions that must be answered to advance translational research for aimed at curing JMML

Faculty name and affiliation:  Mignon Loh, MD, University of California, San Francisco

Faculty disclosure:  Dr. Loh has no disclosures to report.

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3. "Juvenile Myelomonocytic Leukemia (JMML) Preclinical Models (Overview)"

Contents:  An overview of the murine models that have been developed to shed light on the genetics of JMML and facilitate the process of testing new agents for JMML.

Learning objective:  At the conclusion of this activity you will be able to discuss pre-clinical models that have been used or will be used to facilitate understanding of JMML

Faculty name and affiliation:  Rebecca Chan, MD, PhD, Indiana University School of Medicine

Faculty disclosure:  Dr. Chan has no disclosures to report.

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4. "A Clinical Perspective on Juvenile Myelomonocytic Leukemia (JMML)"

Contents: A discussion of the previous WHO-accepted diagnostic criteria and the revised diagnostic criteria agreed-upon by international experts in JMML research and clinical treatment in December 2008, as well as a brief overview of the results of historical clinical studies for JMML.

Learning objectives:  At the conclusion of this activity you will be able to...

a. Describe the most current JMML diagnostic criteria proposed at the 2008 JMML International Working Group meeting.

b. Explain the effectiveness of various clinical options for treating children with JMML.

Faculty disclosure: Dr. Flotho has no disclosures to report.