M.D. Anderson’s leukemia depart- ment is the largest in the world and has a sufficient supply of the drug for now. Dr. Kantarjian says cytarabine, an inex- pensive generic drug, is in short supply only in the United States, not in other countries. In fact, he says he receives phone calls every day from oncologists all over the United States who ask about the cytarabine shortage. “As leukemia physicians, we have a moral obligation to continue to bring this issue to national attention until this problem is solved in the United States. I simply do not understand the deafening silence behind this major problem that may be killing U.S. citizens on a daily basis,” he says. Dr. Kantarjian says that in response to the cancer drug shortages, oncologists across the nation are concocting combi- nations of regimens for curative diseases like lymphoma and Hodgkin’s disease outside the clinical trial process. “We need an investigation as to why these drug shortages started happening recently, why the number of shortages is increasing, and why no one’s paying at- tention to this. I notice these shortages are only in generic drugs, not the expen- sive drugs under patent,” he said.
Centers for Disease Control and Preven- tion (CDC), and others in the public health community study virus samples and patterns collected worldwide to identify virus strains likely to cause the most illness during the upcoming influ- enza season. Based on that information and the recommendations of the FDA’s Vaccines and Related Biological Products Advisory Committee, the strains selected for the 2011–12 influenza season are:
• A/California/7/09 H1N1-like virus (pandemic H1N1 2009 influenza virus);
• A/Perth /16/2009 H3N2-like virus; and
• B/Brisbane/60/2008-like virus. On average, between 5 percent and
FDA approves 2011–12 flu season vaccines
The U.S. Food and Drug Administration (FDA) approved the 2011–12 influenza vaccine formulation for all six manufac- turers licensed to produce and distribute influenza vaccine for the United States. Vaccination remains the cornerstone
of preventing influenza, a contagious respiratory disease caused by influenza viruses. The vaccine formulation pro- tects against the three virus strains that surveillance indicates will be most com- mon during the upcoming season and includes the same virus strains used for the 2010–11 influenza season. Each year, experts from FDA, the World Health Organization, the U.S.
20 percent of the U.S. population devel- ops influenza each year, leading to more than 200,000 hospitalizations from re- lated complications, according to CDC. Influenza-related deaths vary yearly, ranging from 3,000 to 49,000. “Vaccines to prevent seasonal influ- enza have a long and successful track record of safety and effectiveness in the United States,” said Karen Midthun, MD, director of FDA’s Center for Biologics Evaluation and Research. “It is impor- tant to get vaccinated every year, even if the strains in the vaccine do not change, because the protection received the pre- vious year will diminish over time and may be too low to provide protection into the next year.”
In addition to the important role that health care professionals play in recom- mending influenza vaccination for their patients, influenza vaccination of health care personnel is also important to pro- tect themselves, their patients, their fam- ily, and the community from influenza. FDA urges health care organizations to encourage their members to follow CDC’s Advisory Committee on Immuni- zation Practices’ recommendations to be vaccinated.
The brand names and manufacturers
of the vaccines for the upcoming season are Afluria, CSL Limited; Fluarix, Glaxo- SmithKline Biologicals; FluLaval, ID Bio- medical Corporation; FluMist, MedIm- mune Vaccines Inc.; Fluvirin, Novartis
Vaccines and Diagnostics Limited; and Fluzone, Fluzone High-Dose and Flu- zone Intradermal, Sanofi Pasteur Inc. Fluzone Intradermal, approved May 9, 2011, will be available for those aged 18 through 64 years. This vaccine is delivered into the skin, rather than the muscle, using a very small needle. There is always a possibility of a less- than-optimal match between the virus strains predicted to circulate and the vi- rus strains that end up causing the most illness, according to FDA. However, even if the vaccine and the circulating strains aren’t an exact match, FDA says the vaccine may reduce the severity of the illness or may help prevent influenza- related complications. At press time, GlaxoSmithKline planned to supply 35 million to 37 mil- lion doses combined of FluLaval and Fluarix this flu season. Novartis planned to ship more than 30 million doses of Fluvirin influenza virus vaccine, and Sanofi Pasteur expected to deliver ap- proximately 70 million doses of seasonal influenza vaccine to the United States in the upcoming season.
Visit the CDC website,
www.cdc.gov/ flu, for updated information on flu vac- cine distribution and supply.
ACOG recommends mammograms start at 40
Due to the high incidence of breast can- cer in the United States and the potential to reduce deaths from it when caught early, The American College of Obstetri- cians and Gynecologists (The College) is- sued new breast cancer screening guide- lines that recommend mammography screening be offered annually to women beginning at age 40. Previous College guidelines recommended mammograms every one to two years starting at age 40 and annually beginning at age 50. According to Jennifer Griffin, MD, MPH, who coauthored The College guidelines, the change in mammogra-
October 2011 TEXAS MEDICINE 29
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68