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Hematologic Cancers – An Introduction
October 27-28, 2015
Newark, NJ
www.healthtech.com/hematologic-cancers
_________________________________________________________________________________
Hematologic Cancers – An Introduction is a two-day, rapid and progressive face-to-face training
program. Led by specialist physicians delegates are provided with a comprehensive review of the
hematological system and provides an overview on the spectrum of hematologic cancers. This course
equips attendees with the knowledge to discuss Hematologic Cancers confidently and credibly.
Hematologic Cancers – An Introduction is a high calibre training program led by teams of specialist
physicians, it is ideal for the pharmaceutical, medical technology and biotechnology industries. Case
studies and open discussion form an integral part of the program.
This hematologic cancers learning program includes:
 Discussion on the pathophysiology of hematological malignancies such as leukemias,
lymphomas and myeloma
 Common treatments & management of these hematological malignancies such as high dose
chemotherapy and total body irradiation
 The challenges challenges these treatments present to patients
 Review of the issues and complications of bone marrow and stem cell transplant
Topics included in this hematological cancers training:
 The formation and maturation of blood cells
 Classification and epidemiology of hematological malignancies
 Presentations, diagnosis and staging
 Chemotherapy and irradiation
 Clinical trial issues
Faculty includes:
 Dennis Cooper, M.D., Professor of Medicine (Hematology), Yale School of Medicine
 Louis F. Diehl, M.D., Professor of Medicine, Hematological Malignancies, Duke University
School of Medicine, Duke University
 Carol Ann Huff, M.D., Associate Professor of Medicine and Oncology, Director, Myeloma
Program, Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center
 Mark Levis, M.D., Associate Professor of Oncology, Pharmacology, and Medicine at Sidney
Kimmel Comprehensive Cancer Center
 Douglas Smith, M.D., Associate Professor, Hematologic Malignancies, Sidney Kimmel
Comprehensive Cancer Center
Is this hematological cancers course for me?
This hematological cancers training is ideal for clinical research, medical information, regulatory
affairs, biometrics and strategic marketing personnel. Healthcare’s medical education training is
designed for both medical and non-medical staff within the pharmaceutical, medical device,
biotechnology and associated healthcare industries.
Venue/Administrative Details: Accommodation costs are not included in the course fee. However,
Healthcare has organized a special bed and breakfast rate at the venue for delegates who require
overnight accommodation – details of how to book will be provided with the joining instructions for the
course.
PROGRAM AGENDA
Tuesday, October 27 (8:45 am – 4:30 pm)
Registration – Tea/coffee available on arrival
Welcome/Opening remarks
Introduction / Overview
 Review – Hemopoiesis
- terminology and concepts
- control of hemopoiesis
 +ve and –ve regulators
 Classification and epidemiology of liquid tumors
- pre-leukemias
- chronic leukemias
 CLL
 CML
- acute leukemias
 AML
 ALL
- Myeloma
 Chemotherapy overview
- Flow cytometry
- immunohistochemistry
Discussion
Tea/coffee break
Tuesday, October 27 cont.
Stem Cell Transplantation
 Autologous / allogenic
- conditioning regimes
- indications
- complications (e.g. graft versus host disease)
Stem Cell Transplantation Discussion
LUNCH
CLL Case Studies and Discussion
Tea/coffee break
CML
 Clinical presentation
 Diagnosis and staging
 Treatment options
 Disease course and progression
CML Case Studies and Discussion
Close
Wednesday, October 28 (8:30 am – 3:45 pm)
Tea/coffee available on arrival
The Lymphomas
 Hodgkin’s disease /Non-Hodgkin’s lymphoma
- epidemiology / genetics
- clinical presentation
 Treatment and prognosis
The Lymphomas Case Studies and Discussion
Tea/coffee break
Acute Leukemias
 AML and ALL
 Clinical presentations
 Diagnosis
 Chromosomal abnormalities
 Treatment options
 Prognosis
Acute Leukemias Case Studies and Discussion
Lunch
Myelodysplasia and Myeloproliferation
 Clinical presentation
 Diagnosis and staging
 Treatment options
 Disease course and progression
Myelodysplasia and Myeloproliferation
Case Studies and Discussion
Tea/coffee break
Myeloma
 Clinical presentation
 Diagnosis and staging
 Treatment options
Myeloma Case Studies and Discussion
CLOSE
About the Instructors:
Dennis L. Cooper, M.D.
Professor of Medicine (Hematology)
Yale Cancer Center
Dennis Cooper, M.D., is a Professor of Internal Medicine (Hematology) at the Yale School of Medicine.
Following graduation from Rush Medical School, he completed his residency in Internal Medicine at
Yale-Newhaven Hospital followed by a chief residency at the University of Pittsburgh. He returned to
Yale for his fellowship training and then served as Fellowship Director and Clinical Director of the
Hematopoietic Stem Cell Transplant Service. His clinical interests are recurrent lymphoma, multiple
myeloma, and hematopoietic stem cell transplantation.
Louis F. Diehl, M.D.
Professor of Medicine, Hematological Malignancies
Duke University School of Medicine
Duke University
Dr. Diehl graduated from Georgetown University in 1970 with a BS in physics, where during research
projects applying physical measurement techniques to biological materials, he developed his first
interest in medicine. He graduated from Georgetown University Medical School, in 1975, and entered
active duty in the Army while completing an internal medicine residency (1978) at Walter Reed and
subsequent fellowship in Hematology-Oncology (1981). His initial research work centered on
Hodgkin’s lymphoma with subsequent work in the understanding of the treatment of non-Hodgkin’s
lymphoma. Throughout his career he has maintained a strong interest in the bias inherent in clinical
studies and how they can lead us to truth or folly. He has been a division director, program director
in both internal medicine and Hematology-Oncology, and a Chairman, Department of Medicine. After
leaving the Army in 1999, he went to Johns Hopkins where he worked in the division of Hematologic
Malignancies. He has been at Duke University Medical Center since 2004, directs the Oncology
Treatment Center and actively treats patients with Hematologic Malignancies.
Areas of Interest:
- Hodgkin lymphoma
- Non-Hodgkin lymphoma
- Chronic leukemias
- Acute leukemias
- Multiple myeloma
- Myelodysplasia
Research Interests:
- staging and treatment of Non-Hodgkin lymphoma
- long term care of patients with Hodgkin disease
- Bias in clinical trials
Associations:
- American Society of Hematology
- American Society of Clinical Oncology
- Cancer and Leukemia Group B
- American College Physicians
- Alpha Omega Alpha
Carol Ann Huff, M.D.
Associate Professor of Medicine and Oncology,
Director, Myeloma Program, Division of Hematologic Malignancies
Sidney Kimmel Comprehensive Cancer Center
Carol Ann Huff, MD, is an Assistant Professor of Oncology and Medicine at the Johns Hopkins
University School of Medicine in Baltimore, Maryland, where she is also the Director of the Myeloma
Program in the Division of Hematologic Malignancies.
Dr. Huff's research interest is in developing novel biologically-based therapies for myeloma including
attempts to target myeloma stem cells and immune-based approaches. Her efforts have focused on
improving response rates and overall survival for patients with multiple myeloma as well as reducing
the toxicity of bone marrow transplantation coupled with efforts to develop a targeted immune attack
post-transplantation.
Prior to receiving her medical degree from Baylor College of Medicine, Dr. Huff completed a Bachelor
of Science in Zoology at Duke University in Durham, NC. She completed her internship and residency
at the Johns Hopkins University School of Medicine before joining the Department of Medicine as an
Instructor where she was later promoted to Assistant Professor. Dr. Huff went on to complete a
clinical fellowship in Oncology before formally accepting a joint appointment in the Oncology
department.
Dr. Huff has authored many peer-reviewed articles, book chapters, and monographs in the field of
myeloma research and is a leading national speaker on this topic.
Mark Levis, M.D.
Associate Professor of Oncology, Pharmacology, and Medicine
Sidney Kimmel Comprehensive Cancer Center
Mark Levis, M.D., Ph.D., has been Member of the Hematology and Oncology Clinical Advisory Board of
Ambit Biosciences Corporation since February 28, 2008. Dr. Levis serves as Assistant Professor at
Johns Hopkins University in Baltimore. Mr. Levis laboratory research focuses on the development of
molecularly targeted therapies for leukemia. Currently, he is actively involved in the pre-clinical and
clinical development of small molecule inhibitors of the receptor tyrosine kinase, FLT3. He served as
Member of Scientific Advisory Board at Symphogen A/S.
Publications
Levis, M., Tse, K-F., Smith, B.D., Garrett, E., and Small, D. (2001). A FLT3 tyrosine kinase inhibitor is
cytotoxic to AML blasts harboring a FLT3/ITD mutation. Blood. 98:885.
Levis, M., Allebach, J., Tse, K-F., Sheng, R., Baldwin, B.R., Smith, B.D., Jones-Bolin, S., Ruggeri, B.,
Dionne, C., and Small, D. (2002). A FLT3-targeted tyrosine kinase inhibitor is cytotoxic to leukemia
cells in vitro and in vivo. Blood 99:3885.
Smith, B.D., Levis, M., Beran, M., Giles, F., Brown, P., Russell, L., Hellriegel, E., Murphy, K., Dauses,
T., Allebach, J., and Small, D. (2004) Single agent CEP-701, a novel FLT3 inhibitor, shows initial
response in patients with refractory acute myeloid leukemia. Blood. 103:3669
Levis, M. and Small, D. (2003). FLT3:ITDoes matter in leukemia. Leukemia. 17:1738.
Murphy, K.M., Levis, M., Hafez, M.J., Geiger, T., Cooper, L.C., Smith, B.D., Small, D., and Berg, K.D.
(2003). Detection of FLT3 internal tandem duplication and D835 mutations by a multiplex polymerase
chain reaction and capillary electrophoresis assay. J Mol Diagn. 5: 96-102.
Zheng, R., Levis, M, Piloto O, Brown P, Baldwin B., and Small, D. (2003) FLT3 ligand (FL) causes
autocrine signaling in AML cells. Blood. 103:267.
Levis, M., and Small, D. (2004). Small molecule FLT3 tyrosine kinase inhibitors. Current
Pharmaceutical Design. 10:1183.
B. Douglas Smith, M.D.
Associate Professor, Hematologic Malignancies
Sidney Kimmel Comprehensive Cancer Center
Dr. Smith graduated from Drexel University College of Medicine in 1991. Dr. Smith’s expertise
includes acute lymphoblastic leukemia, acute myeloid leukemia, blood transplant, bone marrow
transplant, chronic myeloid leukemia, drug development, hematologic malignancies, leukemia,
medical oncology, myelodysplasia, myelodysplastic syndrome, myeloproliferative disorders. His
research interests include acute and chronic leukemias; myeloid disorders and bone marrow
transplantation.
B. Douglas Smith, MD, received his medical degree from the Medical College of Pennsylvania in
Philadelphia, Pennsylvania, followed by internship, residency, and a Chief Residency in Internal
Medicine at the University of Rochester’s Strong Memorial Hospital. Dr. Smith went on to complete his
Oncology Fellowship at The Johns Hopkins University School of Medicine in Baltimore, Maryland. Dr.
Smith joined the faculty at Johns Hopkins upon completion of his training and is now an Associate
Professor of Oncology.
Dr. Smith’s research focuses on taking new and promising laboratory insights and developing them
into biology based treatment approaches for patients with myeloid malignancies. He has developed
close laboratory collaborations and has focused on the clinical development of three main areas:
cancer stem cell biology and differentiation-based treatment approaches, signal transduction and
targeted drug development, and immunotherapy using vaccine strategies.
Clinically, Dr. Smith’s interests center on treating patients with myeloid malignancies, including acute
and chronic myeloid leukemias, and myelodysplastic syndromes. He is recognized as a national leader
in these areas and serves on the NCCN Guideline Panel for both AML and CML. Dr. Smith also supports
the SKCCC at Johns Hopkins through his participation on the Johns Hopkins Institutional Review
Board.
Course Registration Form
Hematologic Cancers – An Introduction
October 27-28, 2015
Newark, NJ
Fill out and fax back to James Prudhomme at +1 781-972-5425
If you are paying by check or have any questions regarding payment, please call +1 781-972-5486.
To inquire about a group discount, call +1 781-972-5472 or email cunningham@healthtech.com.
Fee: VIP Discount Rate $4,037 USD (regular rate $4,750 USD)
YOUR DETAILS:
Title: (tick applicable) __ Dr. __ Mr. __ Mrs. __ Ms. __ Miss __ Other
_________________________________________________________________
First Name Last Name
_________________________________________________________________
Company Job Title
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Department Address
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City State Country
_________________________________________________________________
Telephone Fax Email
Charge my credit card
___ VISA ___MasterCard ___American Express
__Maestro* *Only debit cards issued by a UK bank can be
accepted.
________________________________________________
Name (as it appears on card)
________________________________________________
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_______________________________________________
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Security Number (from rear/front of card)
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Signature
Please note: No refund/credit of registration fee will be made for any cancellations received less than 20 working days prior to the date of the course.
Cancellations made more than 20 working days prior to course date will incur a $175 administration fee. Substitutions may be made at any time. If
Healthcare cancels or postpones this event, the registration fee will be refunded. Healthcare will not accept liability for any other costs. Please read our
Booking Conditions. This course is organized by Healthcare Education Services and is being co-marketed by Cambridge Healthtech Institute (CHI). By
registering through CHI, you save 15% off the registration rate charged by Healthcare Education Services.

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Hematologic Cancers Course - An Introduction

  • 1. Hematologic Cancers – An Introduction October 27-28, 2015 Newark, NJ www.healthtech.com/hematologic-cancers _________________________________________________________________________________ Hematologic Cancers – An Introduction is a two-day, rapid and progressive face-to-face training program. Led by specialist physicians delegates are provided with a comprehensive review of the hematological system and provides an overview on the spectrum of hematologic cancers. This course equips attendees with the knowledge to discuss Hematologic Cancers confidently and credibly. Hematologic Cancers – An Introduction is a high calibre training program led by teams of specialist physicians, it is ideal for the pharmaceutical, medical technology and biotechnology industries. Case studies and open discussion form an integral part of the program. This hematologic cancers learning program includes:  Discussion on the pathophysiology of hematological malignancies such as leukemias, lymphomas and myeloma  Common treatments & management of these hematological malignancies such as high dose chemotherapy and total body irradiation  The challenges challenges these treatments present to patients  Review of the issues and complications of bone marrow and stem cell transplant Topics included in this hematological cancers training:  The formation and maturation of blood cells  Classification and epidemiology of hematological malignancies  Presentations, diagnosis and staging  Chemotherapy and irradiation  Clinical trial issues Faculty includes:  Dennis Cooper, M.D., Professor of Medicine (Hematology), Yale School of Medicine  Louis F. Diehl, M.D., Professor of Medicine, Hematological Malignancies, Duke University School of Medicine, Duke University  Carol Ann Huff, M.D., Associate Professor of Medicine and Oncology, Director, Myeloma Program, Division of Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center  Mark Levis, M.D., Associate Professor of Oncology, Pharmacology, and Medicine at Sidney Kimmel Comprehensive Cancer Center  Douglas Smith, M.D., Associate Professor, Hematologic Malignancies, Sidney Kimmel Comprehensive Cancer Center Is this hematological cancers course for me? This hematological cancers training is ideal for clinical research, medical information, regulatory affairs, biometrics and strategic marketing personnel. Healthcare’s medical education training is designed for both medical and non-medical staff within the pharmaceutical, medical device, biotechnology and associated healthcare industries. Venue/Administrative Details: Accommodation costs are not included in the course fee. However, Healthcare has organized a special bed and breakfast rate at the venue for delegates who require overnight accommodation – details of how to book will be provided with the joining instructions for the course.
  • 2. PROGRAM AGENDA Tuesday, October 27 (8:45 am – 4:30 pm) Registration – Tea/coffee available on arrival Welcome/Opening remarks Introduction / Overview  Review – Hemopoiesis - terminology and concepts - control of hemopoiesis  +ve and –ve regulators  Classification and epidemiology of liquid tumors - pre-leukemias - chronic leukemias  CLL  CML - acute leukemias  AML  ALL - Myeloma  Chemotherapy overview - Flow cytometry - immunohistochemistry Discussion Tea/coffee break Tuesday, October 27 cont. Stem Cell Transplantation  Autologous / allogenic - conditioning regimes - indications - complications (e.g. graft versus host disease) Stem Cell Transplantation Discussion LUNCH CLL Case Studies and Discussion Tea/coffee break
  • 3. CML  Clinical presentation  Diagnosis and staging  Treatment options  Disease course and progression CML Case Studies and Discussion Close Wednesday, October 28 (8:30 am – 3:45 pm) Tea/coffee available on arrival The Lymphomas  Hodgkin’s disease /Non-Hodgkin’s lymphoma - epidemiology / genetics - clinical presentation  Treatment and prognosis The Lymphomas Case Studies and Discussion Tea/coffee break Acute Leukemias  AML and ALL  Clinical presentations  Diagnosis  Chromosomal abnormalities  Treatment options  Prognosis Acute Leukemias Case Studies and Discussion Lunch Myelodysplasia and Myeloproliferation  Clinical presentation  Diagnosis and staging  Treatment options  Disease course and progression Myelodysplasia and Myeloproliferation Case Studies and Discussion Tea/coffee break
  • 4. Myeloma  Clinical presentation  Diagnosis and staging  Treatment options Myeloma Case Studies and Discussion CLOSE About the Instructors: Dennis L. Cooper, M.D. Professor of Medicine (Hematology) Yale Cancer Center Dennis Cooper, M.D., is a Professor of Internal Medicine (Hematology) at the Yale School of Medicine. Following graduation from Rush Medical School, he completed his residency in Internal Medicine at Yale-Newhaven Hospital followed by a chief residency at the University of Pittsburgh. He returned to Yale for his fellowship training and then served as Fellowship Director and Clinical Director of the Hematopoietic Stem Cell Transplant Service. His clinical interests are recurrent lymphoma, multiple myeloma, and hematopoietic stem cell transplantation. Louis F. Diehl, M.D. Professor of Medicine, Hematological Malignancies Duke University School of Medicine Duke University Dr. Diehl graduated from Georgetown University in 1970 with a BS in physics, where during research projects applying physical measurement techniques to biological materials, he developed his first interest in medicine. He graduated from Georgetown University Medical School, in 1975, and entered active duty in the Army while completing an internal medicine residency (1978) at Walter Reed and subsequent fellowship in Hematology-Oncology (1981). His initial research work centered on Hodgkin’s lymphoma with subsequent work in the understanding of the treatment of non-Hodgkin’s lymphoma. Throughout his career he has maintained a strong interest in the bias inherent in clinical studies and how they can lead us to truth or folly. He has been a division director, program director in both internal medicine and Hematology-Oncology, and a Chairman, Department of Medicine. After leaving the Army in 1999, he went to Johns Hopkins where he worked in the division of Hematologic Malignancies. He has been at Duke University Medical Center since 2004, directs the Oncology Treatment Center and actively treats patients with Hematologic Malignancies. Areas of Interest: - Hodgkin lymphoma - Non-Hodgkin lymphoma - Chronic leukemias - Acute leukemias - Multiple myeloma - Myelodysplasia Research Interests: - staging and treatment of Non-Hodgkin lymphoma - long term care of patients with Hodgkin disease - Bias in clinical trials Associations: - American Society of Hematology
  • 5. - American Society of Clinical Oncology - Cancer and Leukemia Group B - American College Physicians - Alpha Omega Alpha Carol Ann Huff, M.D. Associate Professor of Medicine and Oncology, Director, Myeloma Program, Division of Hematologic Malignancies Sidney Kimmel Comprehensive Cancer Center Carol Ann Huff, MD, is an Assistant Professor of Oncology and Medicine at the Johns Hopkins University School of Medicine in Baltimore, Maryland, where she is also the Director of the Myeloma Program in the Division of Hematologic Malignancies. Dr. Huff's research interest is in developing novel biologically-based therapies for myeloma including attempts to target myeloma stem cells and immune-based approaches. Her efforts have focused on improving response rates and overall survival for patients with multiple myeloma as well as reducing the toxicity of bone marrow transplantation coupled with efforts to develop a targeted immune attack post-transplantation. Prior to receiving her medical degree from Baylor College of Medicine, Dr. Huff completed a Bachelor of Science in Zoology at Duke University in Durham, NC. She completed her internship and residency at the Johns Hopkins University School of Medicine before joining the Department of Medicine as an Instructor where she was later promoted to Assistant Professor. Dr. Huff went on to complete a clinical fellowship in Oncology before formally accepting a joint appointment in the Oncology department. Dr. Huff has authored many peer-reviewed articles, book chapters, and monographs in the field of myeloma research and is a leading national speaker on this topic. Mark Levis, M.D. Associate Professor of Oncology, Pharmacology, and Medicine Sidney Kimmel Comprehensive Cancer Center Mark Levis, M.D., Ph.D., has been Member of the Hematology and Oncology Clinical Advisory Board of Ambit Biosciences Corporation since February 28, 2008. Dr. Levis serves as Assistant Professor at Johns Hopkins University in Baltimore. Mr. Levis laboratory research focuses on the development of molecularly targeted therapies for leukemia. Currently, he is actively involved in the pre-clinical and clinical development of small molecule inhibitors of the receptor tyrosine kinase, FLT3. He served as Member of Scientific Advisory Board at Symphogen A/S. Publications Levis, M., Tse, K-F., Smith, B.D., Garrett, E., and Small, D. (2001). A FLT3 tyrosine kinase inhibitor is cytotoxic to AML blasts harboring a FLT3/ITD mutation. Blood. 98:885. Levis, M., Allebach, J., Tse, K-F., Sheng, R., Baldwin, B.R., Smith, B.D., Jones-Bolin, S., Ruggeri, B., Dionne, C., and Small, D. (2002). A FLT3-targeted tyrosine kinase inhibitor is cytotoxic to leukemia cells in vitro and in vivo. Blood 99:3885. Smith, B.D., Levis, M., Beran, M., Giles, F., Brown, P., Russell, L., Hellriegel, E., Murphy, K., Dauses, T., Allebach, J., and Small, D. (2004) Single agent CEP-701, a novel FLT3 inhibitor, shows initial response in patients with refractory acute myeloid leukemia. Blood. 103:3669 Levis, M. and Small, D. (2003). FLT3:ITDoes matter in leukemia. Leukemia. 17:1738. Murphy, K.M., Levis, M., Hafez, M.J., Geiger, T., Cooper, L.C., Smith, B.D., Small, D., and Berg, K.D. (2003). Detection of FLT3 internal tandem duplication and D835 mutations by a multiplex polymerase chain reaction and capillary electrophoresis assay. J Mol Diagn. 5: 96-102.
  • 6. Zheng, R., Levis, M, Piloto O, Brown P, Baldwin B., and Small, D. (2003) FLT3 ligand (FL) causes autocrine signaling in AML cells. Blood. 103:267. Levis, M., and Small, D. (2004). Small molecule FLT3 tyrosine kinase inhibitors. Current Pharmaceutical Design. 10:1183. B. Douglas Smith, M.D. Associate Professor, Hematologic Malignancies Sidney Kimmel Comprehensive Cancer Center Dr. Smith graduated from Drexel University College of Medicine in 1991. Dr. Smith’s expertise includes acute lymphoblastic leukemia, acute myeloid leukemia, blood transplant, bone marrow transplant, chronic myeloid leukemia, drug development, hematologic malignancies, leukemia, medical oncology, myelodysplasia, myelodysplastic syndrome, myeloproliferative disorders. His research interests include acute and chronic leukemias; myeloid disorders and bone marrow transplantation. B. Douglas Smith, MD, received his medical degree from the Medical College of Pennsylvania in Philadelphia, Pennsylvania, followed by internship, residency, and a Chief Residency in Internal Medicine at the University of Rochester’s Strong Memorial Hospital. Dr. Smith went on to complete his Oncology Fellowship at The Johns Hopkins University School of Medicine in Baltimore, Maryland. Dr. Smith joined the faculty at Johns Hopkins upon completion of his training and is now an Associate Professor of Oncology. Dr. Smith’s research focuses on taking new and promising laboratory insights and developing them into biology based treatment approaches for patients with myeloid malignancies. He has developed close laboratory collaborations and has focused on the clinical development of three main areas: cancer stem cell biology and differentiation-based treatment approaches, signal transduction and targeted drug development, and immunotherapy using vaccine strategies. Clinically, Dr. Smith’s interests center on treating patients with myeloid malignancies, including acute and chronic myeloid leukemias, and myelodysplastic syndromes. He is recognized as a national leader in these areas and serves on the NCCN Guideline Panel for both AML and CML. Dr. Smith also supports the SKCCC at Johns Hopkins through his participation on the Johns Hopkins Institutional Review Board.
  • 7. Course Registration Form Hematologic Cancers – An Introduction October 27-28, 2015 Newark, NJ Fill out and fax back to James Prudhomme at +1 781-972-5425 If you are paying by check or have any questions regarding payment, please call +1 781-972-5486. To inquire about a group discount, call +1 781-972-5472 or email cunningham@healthtech.com. Fee: VIP Discount Rate $4,037 USD (regular rate $4,750 USD) YOUR DETAILS: Title: (tick applicable) __ Dr. __ Mr. __ Mrs. __ Ms. __ Miss __ Other _________________________________________________________________ First Name Last Name _________________________________________________________________ Company Job Title _________________________________________________________________ Department Address _________________________________________________________________ City State Country _________________________________________________________________ Telephone Fax Email Charge my credit card ___ VISA ___MasterCard ___American Express __Maestro* *Only debit cards issued by a UK bank can be accepted. ________________________________________________ Name (as it appears on card) ________________________________________________ Account Number _______________________________________________ Start Date (mm/yy) End Date (mm/yy) _______________________________________________ Security Number (from rear/front of card) _______________________________________________ Signature Please note: No refund/credit of registration fee will be made for any cancellations received less than 20 working days prior to the date of the course. Cancellations made more than 20 working days prior to course date will incur a $175 administration fee. Substitutions may be made at any time. If Healthcare cancels or postpones this event, the registration fee will be refunded. Healthcare will not accept liability for any other costs. Please read our Booking Conditions. This course is organized by Healthcare Education Services and is being co-marketed by Cambridge Healthtech Institute (CHI). By registering through CHI, you save 15% off the registration rate charged by Healthcare Education Services.