Cytarabine Crisis: Leukemia Drug Shortage Affecting Many Hospitals

Some hospitals report having enough of the drug; others say supplies are low.

ByABC News
April 14, 2011, 6:19 PM

April 14, 2011— -- ABC News heard from dozens of medical centers on reported shortages of the leukemia drug cytarabine. While some hospitals reported no shortages, others said supplies of the drug were running critically low -- and in some places, shortages have even affected patient care.

Below is a list of the hospitals that responded, as well as quotes from spokespeople for some of these institutions.

"We were on the verge of rescheduling all patients (adults and pediatric) but we found some... If the present reorder scheduled for this Friday does not come in, we have a two-week supply. Adults have now changed protocols (alternative therapies) -- there were no alternative therapy for pediatric patients, but since we needed less we've been able to keep up. Unfortunately, some pediatric patients are getting adult-size medications. We are really worried if we get a new patient with [leukemia], that will be very hard to keep up with."

"At one point last week we were completely out of enough cytarbine for any new patients. We had enough to finish the current patients we had in the hospital, but no new ones. We have gotten some small shipments since then."

"Absolutely. Major problem."

University Hospital said that there are currently four pediatric acute leukemia patients on this drug, but added that it would be difficult to accommodate any more patients on the amount they currently have.

"We have received three patient referrals from local physicians for the drug. We have enough left for four patients, or about one month."

"Tufts Medical Center does have a shortage of cytarabine. I have been told that we are working with only 40 grams in stock as of this moment and we needed 110 grams just today. There is no new stock in sight."

"We're projected to get some drug by the end of the week (hopefully), but we still don't know how much will arrive to the wholesaler and how much is set aside for us. As of today, we should have enough drug in our inventory to last through the week."

"Yes, we are acutely aware of the issues, have been 'affected' by the shortage and are managing the situation. Mayo has also contacted the FDA, along with other medical institutions, to express extreme concern about these and other shortages."

Dr. Joseph Flynn, clinical director of hematologic malignancies at OSUCCC-James said the shortage is an issue that has been ongoing for the past couple of months, and affects patients with not only AML, but also some lymphomas. Currently OSUCCC-James has about a six-week supply on hand, and the hospital's pharmacy manager is contacting supplies and other local hospitals trying to get more of the drug.

"[The] cytarabine shortage has critically affected our leukemia clinical trials being run by the CALGB at member institutions across the country. We have been actively trying to negotiate borrowing and sharing of cytarabine between institutions so that patients can stay on schedule with their protocol-directed treatments."

"We have struggled with the shortage for a number of months. We have modified our approach to accommodate the shortage. It has been very distressing for all involved. On the other hand we have been able to prioritize to make sure the stronger the indication the more likely the patient receives the cytarabine."

Hospitals Where a Cytarabine Shortage Has Not Yet Affected Patients

"We are experiencing a shortage of this drug. Cancer pharmacists and physicians worked out a plan to address this a few weeks ago. We are not out of this drug; [there have been] no treatment delays or missed treatments. We have been using the 'low dose' regimen as opposed to 'high dose' in order to save."

The City of Hope National Medical Center reports that they have taken patient referrals from outside institutions that did not have the drug. They have had three referrals in the past two weeks. They report that it will be increasingly difficult to meet the present dosage guidelines if the shortage persists.

"We do have a shortage of that drug here at East Carolina University."

"There is a shortage locally. Some of our local physicians are running out of the drug, and we have actually offered to treat a couple of people. We are relatively short of the drug as well but have been able to get what we need thus far."

"We currently have a limited supply of the drug, reserved for acute leukemia patients."

"Yes, we have experienced shortages of cytarabine."

Hospitals Not Yet Reporting a Cytarabine Shortage

"[We have had] one patient referral from a local practice for cytarabine."

Fred Hutchinson Cancer Center has not been experiencing a shortage, but the institution has received two patient referrals for cytarabine; one from Alaska and one from another center in Washington.

"We are managing our supply of the drug cytarabine -- and other critically necessary drugs -- with a very close collaboration between our pharmacy, physicians and medical teams. We have been aware of the limited availability of cytarabine for some time, so our team has worked proactively to plan, manage and prioritize the use of this treatment, as well as explore other possible treatment options for those patients."

Mark Weiss, director of hematological malignancies at the Kimmel Cancer Center: "We had a temporary shortage, but it now appears to be resolved... Thankfully, it did not impact patient care, but if it continued it would have had severe consequences."

"There was a recent shortage that we experienced a few months ago. This was part of a nationwide shortage of cytarabine and our first experienced shortage of the commonly used drug. Due to the shortage, some treatments needed to be postponed or the order of a patient's treatment cycle altered. But now there is an adequate supply."

"We have been able to maintain about a two-week buffer, but adequate new supplies have recently been made available."

"We have been able to secure adequate supply to meet our needs at St. Jude Children's Research Hospital and our affiliates for several weeks ahead. Our supply situation is stable at the present time. We have a plan in place in case we do not get adequate supplies of drug."

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