A study finds that a shortage of a drug called mechlorethamine resulted in cancer relapses in children, teens, and young adults who had Hodgkin’s Lymphoma. The study was done before the shortage of the drug was known. It is an example of the tragic consequences that can result from drug shortages.
A study was done that showed the first evidence of the impact of drug shortages. The researchers focused on a drug called mechlorethamine. It is one of the drugs that is in short supply.
One thing that happens when there is a shortage is that doctors end up substituting other, comparable, drugs for the one that they cannot get at the moment. In this case, doctors replaced mechlorethamine with cyclophosphamide.
Both drugs are used to treat patients who have middle risk or high risk Hodgkin’s Lymphoma. According to the Mayo Clinic, Hodgkin’s Lymphoma is one of two common types of cancers of the lymphatic system.
Symptoms include swelling of lymph nodes in the neck, armpits or groin, and persistent fatigue. It can also include fever and chills, night sweats, unexplained weight loss, itching, coughing, trouble breathing, or chest pain. Hodgkin’s lymphoma is most often diagnosed between the age of 15 and 35.
Researchers used hospital records to discover the effects of the switch from mechlorethamine to cyclophosphamide. The researchers compared cancer relapse rates between the 181 patients who were treated with mechlorethamine to the 40 patients who were treated with cyclophosphamide after the shortage occurred.
They found that 25% of the patients on the new regimen, the cyclophosphamide, suffered cancer relapses. However, only 12% of the patients who were using the original drug, mechlorethamine, had their cancer relapse.
None of the patients died as a result of switching drugs. However, the percentages are considered to be a statistically significant difference. Those who had a relapse needed more treatment which exposed them to more toxic doses of cancer drugs and bone marrow transplants. The researchers note that exposure is tied to heart disease and more cancer later in life.
It is worth noting that mechlorethamine is the generic version of a drug called mustargen. It has been said that generic drugs do not make the manufacturers of the drug as much money as they can get from the “brand name” version of it. It has been suggested that this could, possibly, be a factor in some drug shortages. The study is the first to show that harm can come when patients are switched from one drug to another due to a shortage.
Image by Adrian Clark on Flickr