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Relapse of Hodgkin lymphoma in children, young people traced to drug shortage

By Catholic Online (NEWS CONSORTIUM)
December 28th, 2012
Catholic Online (www.catholic.org)

A relapse of Hodgkin lymphoma among children, teenagers and young people has now been traced to a drug shortage. It's the first reported example of the tragic consequences of the shortage. They say the issue highlights the need that lifesaving treatment must be the top priority in any health care system.

LOS ANGELES, CA (Catholic Online) - Researchers from St. Jude Children's Research Hospital report that children, adolescents and young adults with Hodgkin lymphoma in a national clinical trial showed an estimated two-year cancer-free survival rate that dropped from 88 to 75 percent.

It must be stressed that the study began before any reported drug shortages. The downward curve began in 2009 after a shortage of mechlorethamine became evident. At that time, the drug mechlorethamine was replaced by cyclophosphamide for treatment of patients with middle or high-risk Hodgkin lymphoma.

While none of the study patients died as a result, those who relapsed had more rigorous therapy that was linked with higher risks of infertility and other health issues later.

The outcomes demonstrated the first available evidence of a drug shortage that resulted in disadvantages in specific patients.

Many caregivers and patients have recently had their medical treatments compromised by drug shortages, like mechlorethamine and other injectable drugs. Mechlorethamine, available since the 1960's for cancer treatment has only recently become obtainable again.

Cyclophosphamide is a safe and effective substitute for mechlorethamine and has bee used for many years for treatment of both children and adults with Hodgkin lymphoma.

"This is a devastating example of how drug shortages affect patients and why these shortages must be prevented. Our results demonstrate that, for many chemotherapy drugs, there are no adequate substitute drugs available," Monika Metzger, M.D., an associate member of the St. Jude Department of Oncology and the study's principal investigator, said.

Previous shortages had previously been solved using substitutions. This study has given a real face to the drug shortage problem, showing that it is real. There are actual therapies that are unable to be given because drugs are just not available.

"Despite heroic efforts by the drug shortage office of the Food and Drug Administration to solve the shortages of a number of medically necessary drugs, it is clear that patients are still suffering from the unavailability of life-saving drugs. A more systematic solution to the problem is needed," Michael Link, M.D., a member of the pediatric hematology-oncology service at Packard Children's Hospital said

Hodgkin lymphoma is cancer that attacks the lymph system and makes up approximately six percent of childhood cancers. The good news is that around 90 percent of patients in the United States with this cancer will become long-term survivors.

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