January 24 Jan 24
2020
8:00 AM - 9:00 AM
Friday Fri

Pediatric Grand Rounds (CME): Rebranding Langerhans Cell Histiocytosis

Carl Allen MD, PhD - Texas Children's Cancer Center

The Stanford Department of Pediatrics Presents The Anne T. Bass Lecture Series in Hematology, Oncology and Stem Cell Transplantation

Children with Langerhnans cell histiocytosis (LCH) develop granulomatous lesions with characteristic clonal CD207+ dendritic cells that can arise as single lesions or life-threatening disseminated disease.  Despite the wide range of clinical presentations, LCH lesions are histologically indistinguishable based on severity of disease, and uncertain classification as an immune versus neoplastic disorder has historically challenged development of optimal clinical strategies for patients with LCH.  Recently, activating somatic mutations in MAPK pathway genes, most notably BRAFV600E, have been discovered in almost all cases of LCH.  

Speakers

Carl Allen, MD, PhD

Associate Professor,
Texas Children's Cancer Center


Session Description

Children with Langerhnans cell histiocytosis (LCH) develop granulomatous lesions with characteristic clonal CD207+ dendritic cells that can arise as single lesions or life-threatening disseminated disease.  Despite the wide range of clinical presentations, LCH lesions are histologically indistinguishable based on severity of disease, and uncertain classification as an immune versus neoplastic disorder has historically challenged development of optimal clinical strategies for patients with LCH.  Recently, activating somatic mutations in MAPK pathway genes, most notably BRAFV600E, have been discovered in almost all cases of LCH.  Further, the stage of myeloid differentiation in which the mutation arises defines the extent of disease and risk of developing LCH-associated neurodegeneration.  MAPK activation in LCH precursor cells drives myeloid differentiation, inhibits migration, and inhibits apoptosis, resulting in accumulation of resilient pathologic DCs that recruit and activate T cells.  New insights into pathogenesis support reclassification of LCH as a myeloid neoplastic disorder.  While we now understand the broad outlines of mechanisms of LCH, continued research will uncover opportunities to identify novel targets and inform personalized therapeutic strategies based on cell of origin, somatic mutation, inherited risk factors and residual disease.

Education Goals

  • Review clinical presentations of LCH
  • Review current diagnostic and clinical approaches to LCH
  • Discuss implication of recent discoveries on models of LCH pathogenesis
  • Discuss therapeutic opportunities to improve outcomes for children with LCH

Location

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Lucile Packard Children's Hospital, West Building Auditorium

725 Welch Road
Stanford CA, 94304
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CME Credit

Accreditation

The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation

The Stanford University School of Medicine designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Cultural and Linguistic Competency

California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency.  The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area. The Stanford University School of Medicine Multicultural Health Portal also contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws. You are encouraged to visit the portal: http://lane.stanford.edu/portals/cultural.html

Contact Stanford Center for Continuing Medical Education for CME credit transcript. Email Magna Patel, RSS Manager at magna@stanford.edu or stanfordcme@stanford.edu.

Planner and Faculty Disclosure to Learners

In accordance with the standards of the Accreditation Council for Continuing Medical Education (ACCME), all speakers, planners and/or persons who can influence the CME content must disclose to learners any relationships with commercial interests providing products or services that are relevant to the content of the presentation. The following individual(s) HAVE indicated the following relationships:

Planner

Bertil Glader, MD
Contracted Research: Agios

The following speakers, planning committee members and/or persons who can influence CME content have indicated they have NO relationships with commercial industry to disclose relevant to the content of this CME activity:

Course Director

Alan Schroeder, MD, Associate Chief for Research, Division of Pediatric Hospital Medicine

Planners

Mary Leonard, MD, MSCE, Chair Department of Pediatrics
Matthew Porteus, MD, PhD, Associate Professor, Division of Stem Cell Transplantation and Regenerative Medicine
Neville H. Golden, MD, Chief, Division of Adolescent Medicine
Lisa Chamberlain, MD, MPH, Associate Professor, General Pediatrics
Minnie Dasgupta, MD, Chief Resident, Pediatric Residency Program

Speaker

Carl E. Allen, MD, PhD