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This activity is funded by an independent medical education grant from Sanofi. The activity is jointly provided by USF Health and touchIME.

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    Faculty & Disclosures
    Dr Vickie McDonald

    Guy’s & St Thomas’ NHS Foundation Trust, London, UK

    Dr Vickie McDonald is a consultant haematologist at Guy’s and St Thomas’ NHS Foundation Trust, London, UK. Dr McDonald’s main interests are disorders of coagulation, including immune thrombocytopenia (ITP). read more

    Dr McDonald is chief investigator of the UK Adult ITP Registry and principal investigator for several clinical trials for patients with ITP in the UK.

    Dr Vickie McDonald discloses: Advisory board or panel fees from Amgen, Novartis and Sobi. Grants/research support from Grifols (relationship terminated).
    Prof. Waleed Ghanima

    Østfold Hospital, Oslo, Norway

    Prof. Waleed Ghanima is the head of research and a consultant haematologist at Østfold Hospital, Oslo, Norway. He is also a professor in the Institute of Clinical Medicine at the University of Oslo. read more

    Prof. Ghanima gained his medical degree from the College of Medicine, University of Baghdad, Iraq. He joined Østfold Hospital in 1996, becoming a consultant haematologist in 2004, and he assumed his current position as head of research in 2014.

    Prof. Ghanima’s main research field is venous thrombosis and immune thrombocytopenia. He is a member of several professional societies and was President of the Norwegian Society of Haematology from 2013 to 2017. He is well published, with more than 185 articles in national and international peer-reviewed journals, including The New England Journal of Medicine, The Lancet, Blood, Thrombosis and Haemostasis, Haematologica, British Journal of Haematology and Thrombosis Research.

    Prof. Waleed Ghanima discloses: Advisory board or panel fees from Alpine, Amgen, Argenx, Cellphire, Grifols, HI-Bio, Hutchmed, Kedrion, Novartis, Pfizer, Principia Biopharma Inc, Sanofi, Sobi, Takeda and UCB. Grants/research support from Sanofi, Sobi and UCB. Speaker fees from Amgen, Bayer, Bristol Myers Squibb, Grifols, Novartis, Pfizer, Sanofi and Sobi.
    Prof. James B Bussel

    Weill Cornell Medicine, New York, NY, USA

    Prof. James Bussel serves as Emeritus Professor of Pediatrics, Medicine and Obstetrics and Gynecology at Weill Medical College of Cornell University, New York, NY, USA. read more

    Prof. Bussel is affiliated with the New York Presbyterian Hospital and founded and served for many years as the director of the Platelet Disorders Program. Prior to his current appointments, Prof. Bussel served as a haematologist at New York Presbyterian Hospital, Memorial Hospital for Cancer and Allied Diseases, and Lenox Hill Hospital.

    Prof. Bussel is board certified in paediatrics and paediatric haematology/oncology. He specializes in haematology, in particular immune thrombocytopenia (ITP). Throughout his distinguished career, Prof. Bussel has treated rare haematological conditions in both children and adults with unique and extensive expertise in ITP, other thrombocytopenias, including Evans syndrome, and foetal and neonatal alloimmune thrombocytopenia (FNAIT). Prof. Bussel was the first physician in the USA to use intravenous immunoglobulin as a treatment for ITP, which helped to pave the way for FDA approval in this indication and its application as the standard of care for FNAIT-affected pregnancies.

    After receiving his undergraduate degree from Yale University, Prof. Bussel earned his medical degree from Columbia College of Physicians and Surgeons. He completed an internship and residency in paediatrics at Cincinnati Children’s Hospital, followed by a fellowship in paediatric haematology/oncology at New York Hospital-Cornell University Medical Center and Memorial Sloan Kettering Cancer Center, where he became chief fellow. Though his training was in paediatrics, Prof. Bussel’s expertise in these rare conditions has resulted in him routinely treating both children and adults in his practice.

    Among his many achievements, Prof. Bussel has authored over 300 peer-reviewed research publications, over 40 book chapters and contributed to over 140 medical reviews, including authoring nine articles in The New England Journal of Medicine. He is a reviewer for medical journals, such as The New England Journal of Medicine, Blood, Pediatric Blood & Cancer and the British Journal of Haematology, for which he is an associate editor. Prof. Bussel has acted as the primary investigator and co-investigator for many research trials in ITP and has presented both nationally and internationally on topics related to his specialty. Prof. Bussel has received a number of named lectureships. He is the recipient of several prestigious awards including sharing the King Faisal Prize for Medicine in 2012 and receiving the Henry M. Stratton Medal for translational/clinical science from the American Society of Hematology in 2023.

    Prof. James B Bussel discloses: Advisory board or panel fees from Argenx, Alpine-Vertex, Janssen, Rallybio, Sobi and UCB.
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    touchONCOLOGY touchONCOLOGY
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    Poll

    Which of these potential approvals in ITP will have the most impact on your clinical practice?

    Submit your answer to see the results

    Sovleplenib
       
    Rilzabrutinib
       
    Mezagitamab
       
    Other
       

    Tutorial

    This icon indicates there is a poll question. Click it when you see it to interact with your peers.

    Poll

    Which of the following best describes the role of splenectomy in ITP in your practice?

    Submit your answer to see the results

    Does not have a role
       
    For patients who have received ≥3 prior treatments
       
    For patients who have received ≤2 prior treatments
       
    Other
       

    Tutorial

    This icon indicates there is a poll question. Click it when you see it to interact with your peers.

    Poll

    In your patients with heavy menstrual bleeding, what proportion require hospitalization?

    Submit your answer to see the results

    >75%
       
    50–75%
       
    25–50%
       
    <25%
       
     
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    Haematology, Rare Diseases CE/CME accredited

    touchCONGRESS
    Our faculty interpret key data from the congress, complimented by an expert panel discussing what has been presented. Close

    Insights from EHA and ISTH 2024: How can we optimize care for patients with chronic ITP?

    Faculty Podcast Featured
    Learning Objectives

    After watching this activity, participants should be better able to:

    • Recognize the impact of immune thrombocytopenia (ITP) on patients and their quality of life
    • Appraise the latest data for current chronic ITP treatments and how they may be applied to clinical practice to optimize patient outcomes
    • Evaluate the latest data for emerging chronic ITP therapies and their potential to impact patient outcomes
    Overview

    In this activity, an expert in ITP reviews key data on the impact of ITP on patients, as well as current and future treatments, presented at the European Hematology Association (EHA) and International Society on Thrombosis and Haemostasis (ISTH) 2024 congresses. Two additional leading experts discuss the potential implications of these data on clinical practice.

    This activity was filmed following the EHA 2024 Hybrid Congress (Madrid, Spain; 13–16 June) and ISTH 2024 (Bangkok, Thailand; 22–26 June 2024).

    This activity is jointly provided by USF Health and touchIME. read more

    Target Audience

    This activity has been designed to meet the educational needs of haematologists, haemato-oncologists, nurses and nurse practitioners involved in the management of patients with ITP.

    Disclosures

    USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

    Faculty

    Dr Vickie McDonald discloses: Advisory board or panel fees from Amgen, Novartis and Sobi. Grants/research support from Grifols (relationship terminated).

    Prof. Waleed Ghanima discloses: Advisory board or panel fees from Alpine, Amgen, Argenx, Cellphire, Grifols, HI-Bio, Hutchmed, Kedrion, Novartis, Pfizer, Principia Biopharma Inc, Sanofi, Sobi, Takeda and UCB. Grants/research support from Sanofi, Sobi and UCB. Speaker fees from Amgen, Bayer, Bristol Myers Squibb, Grifols, Novartis, Pfizer, Sanofi and Sobi.

    Prof. James B Bussel discloses: Advisory board or panel fees from Argenx, Alpine-Vertex, Janssen, Rallybio, Sobi and UCB.

    Content Reviewer

    Danielle Walker, DNP, APRN, AGNP-C has no financial interests/relationships or affiliations in relation to this activity.

    Touch Medical Contributors

    Katrina Lester and Hannah Fisher have no financial interests/relationships or affiliations in relation to this activity.

    Ian Seymour discloses: Independent contractor relationships with 90Ten Ltd., Axon Communications Ltd., Madano Healthcare, MadMicrobe Studios, Meditech Media and Open Health Group (relationships terminated).

    USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

    Requirements for Successful Completion

    In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

    If you have questions regarding credit please contact cpdsupport@usf.edu.

    Accreditations

    Physicians

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Advanced Practice Providers

    Physician Assistants may claim a maximum of 1.0 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

    The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

    Nurses

    USF Health is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

    A maximum of 1 contact hour may be earned by learners who successfully complete this continuing nursing education activity. USF Health, the accredited provider, acknowledges touchIME as the joint provider in the planning and execution of this CNE activity.

    This activity is awarded 1 ANCC pharmacotherapeutic contact hour.

    Date of original release: 5 September 2024. Date credits expire: 5 September 2025.

    If you have any questions regarding credit please contact cpdsupport@usf.edu.

    EBAC® Accreditation

    touchIME is an EBAC® accredited provider since 2023.

    This programme is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC®) for 1.0 hours of effective education time.

    The Accreditation Council for Continuing Medical Education (ACCME®), and the Royal College of Physicians and Surgeons of Canada hold an agreement on mutual recognition on substantive equivalency of accreditation systems with EBAC®.

    Through an agreement between the European Board for Accreditation of Continuing Education for Health Professionals and the American Medical Association (AMA), physicians may convert EBAC® CE credits to AMA PRA Category 1 CreditsTM. Information on the process to convert EBAC® credit to AMA credit can be found on the AMA website. Other healthcare professionals may obtain from the AMA a certificate of having participated in an activity eligible for conversion of credit to AMA PRA Category 1 CreditTM.

    Faculty Disclosure Statement / Conflict of Interest Policy

    In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event have been mitigated and declared to the audience prior to the CME activities

    Requirements for Successful Completion

    Certificates of Completion may be awarded upon successful completion of the post-test and evaluation form. If you have completed one hour or more of effective education through EBAC® accredited CE activities, please contact us at accreditation@touchime.org to receive your EBAC® CE credit certificate. EBAC® grants 1 CE credit for every hour of education completed.

    Time to Complete: 1 hour

    If you have any questions regarding the EBAC® credits, please contact accreditation@touchime.org

    This activity is CE/CME accredited

    To obtain the credit(s) from this activity, please complete this post-activity test.

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    Topics covered in this activity

    Haematology / Rare Diseases
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    This activity is funded by:

    An independent medical education grant from Sanofi.
    This activity is jointly provided by USF Health and touchIME.
    touchIME is an EBAC® accredited provider.

    USF Health

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    EBAC®

    touchIME is an EBAC® accredited provider since 2023.

    In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 5 September 2024. Date credits expire: 5 September 2025.

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    touchCONGRESS
    Insights from EHA and ISTH 2024: How can we optimize care for patients with chronic ITP?
    1.0 CE/CME credit
    Question 1/5
    Your female paediatric patient with ITP is attending a routine check-up with her parents. Her mother enquires about the potential future impact of ITP on her daughter as she transitions to adolescence. Based on recent findings from a retrospective chart review presented at ISTH 2024, what will you tell them?

    HMB, heavy menstrual bleeding; ISTH, International Society on Thrombosis and Haemostasis; ITP, immune thrombocytopenia; QoL, quality of life.

    Data from a retrospective chart review at a paediatric ITP centre in the USA presented at ISTH 2024 reported an incidence of HMB of 43.5% in female patients with ITP aged >10 years (n=85) and iron deficiency was reported in 78% of patients with ITP and HMB. The 37 patients with HMB required 42 visits to the hospital for the management of HMB. 

    Abbreviations

    ISTH, International Society on Thrombosis and Haemostasis; HMB, heavy menstrual bleeding; ITP, immune thrombocytopenia.

    Reference

    Doshi BS, et al. Presented at: ISTH 2024, Bangkok, Thailand. 22–26 June 2024. Poster PB0694.

    Question 2/5
    Based on data presented at EHA 2024, what proportion of patients with ITP experienced a sustained response for >4 years after TPO-RA discontinuation?

    EHA, European Hematology Association; ITP, immune thrombocytopenia; TPO-RA, thrombopoietin receptor agonist.

    Data presented at EHA 2024 from the French, prospective interventional STOPAGO study (NCT03119974) of adults with persistent or chronic primary ITP who discontinued TPO-RAs showed that 52.1% and 47.9% of patients experienced a sustained response off treatment for 1 year and >4 years, respectively. A sustained response off treatment was defined as a platelet count ≥30 x 109/L and no bleeding without ITP-specific medications.

    Abbreviations

    EHA, European Hematology Association; ITP, immune thrombocytopenia; TPO-RA, thrombopoietin receptor agonist.

    Reference

    Cottu A, et al. Presented at: EHA2024 Hybrid Congress, Madrid, Spain. 13–16 June 2024. Poster P1628.

    Question 3/5
    Your patient with chronic refractory ITP has previously received 3 lines of treatment and is now starting treatment with fostamatinib. Taking into consideration recent data presented at EHA 2024, and the latest understanding of the disease, what would you do next to best manage this patient?

    EHA, European Hematology Association; ITP, immune thrombocytopenia.

    A retrospective, multicentre, Italian observational study of heavily pre-treated patients with chronic ITP who received at least one dose of fostamatinib outside of clinical trials between 1 October 2021 and 1 April 2023 (N=91) was presented at EHA 2024. It reported hypertension as the second most common side effect (n=8), which led to fostamatinib discontinuation in one patient.1

    Patients receiving fostamatinib should have their blood pressure monitored every 2 weeks until stable, then monthly. Antihypertensive treatment should be used as necessary to ensure maintenance of blood pressure control.2,3

    Abbreviations

    EHA, European Hematology Association; ITP, immune thrombocytopenia.

    References

    1. Zaja F, et al. Presented at: EHA2024 Hybrid Congress, Madrid, Spain. 13–16 June 2024. Poster P2232.
    2. FDA. Fostamatinib PI. Available at: www.accessdata.fda.gov/drugsatfda_docs/label/2018/209299lbl.pdf (accessed 27 August 2024)
    3. EMA. Fostamatinib SmPC. Available at: www.medicines.org.uk/emc/product/11479/smpc/print (accessed 27 August 2024)
    Question 4/5
    When discussing data reported at EHA 2024 with colleagues, how would you describe the risk of GI toxicities associated with the SYK inhibitor sovleplenib?

    AE, adverse event; EHA, European Hematology Association; GI, gastrointestinal; SYK, spleen tyrosine kinase.

    ESLIM-01 is a randomized, double-blind, placebo-controlled, phase III trial (NCT05029635) to evaluate the efficacy and safety of the SYK inhibitor sovleplenib in patients with primary ITP in China. Data reported at EHA 2024 (data cut-off 14 July 2023) demonstrated a low rate of GI toxicities associated with sovleplenib (incidence of diarrhoea, vomiting and nausea all 1.6%).1 

    An open-label extension study (NCT02077192) investigating the efficacy and safety of the SYK inhibitor fostamatinib in patients with primary ITP reported diarrhoea as the most comment TEAE, occurring in 35% of patients; nausea occurred in 19% of patients.2 

    Abbreviations

    AE, adverse event; EHA, European Hematology Association; GI, gastrointestinal; ITP, immune thrombocytopenia; SYK, spleen tyrosine kinase; TEAE, treatment-emergent AE.

    References

    1. Yang R, et al. Presented at: EHA2024 Hybrid Congress, Madrid, Spain. 13–16 June 2024. Oral presentation S316.
    2. Bussel JB, et al. Am J Hematol. 2019;94:546–53.
    Question 5/5
    You are discussing potential enrolment in the LUNA3 clinical trial with your patient with chronic ITP who has previously received one line of therapy. They enquire about expected outcomes associated with rilzabrutinib. Based on interim data from the LUNA2 trial reported at ISTH 2024, what would you tell them?

    ISTH, International Society on Thrombosis and Haemostasis; ITP, immune thrombocytopenia; TPO-RA, thrombopoietin receptor agonist.

    Pooled analysis of parts A and B of the phase II LUNA2 trial (NCT03395210) investigating the efficacy and safety of the Bruton tyrosine kinase inhibitor rilzabrutinib in patients with relapsed/refractory ITP demonstrated higher clinical responses in patients with fewer prior and earlier lines of ITP treatment (86% vs 37% for second-line vs at least third-line; 71% vs 33% for <4 and ≥4 unique prior treatments; p≤0.05 for both).

    Abbreviation

    ITP, immune thrombocytopenia.

    Reference

    Kuter D, et al. Presented at: ISTH 2024, Bangkok, Thailand. 22–26 June 2024. Oral presentation OC 13.3.

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    This activity is funded by:

    An independent medical education grant from Sanofi.
    This activity is jointly provided by USF Health and touchIME.
    touchIME is an EBAC® accredited provider.

    USF Health

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    EBAC®

    touchIME is an EBAC® accredited provider since 2023.

    In compliance with EBAC® guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CME activities.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 5 September 2024. Date credits expire: 5 September 2025.

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