Beyond fludarabine: pentostatin plus cyclophosphamide are a well-tolerated alternative in reduced intensity conditioning

Dimitrova, Dimana; Kanakry, Jennifer A.

doi:10.1038/s41409-022-01819-y

Bone Marrow Transplant

2022

DOI: 10.1038/s41409-022-01819-y

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Beyond fludarabine: pentostatin plus cyclophosphamide are a well-tolerated alternative in reduced intensity conditioning

Dimana Dimitrova

Jennifer A. Kanakry

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2024

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Clinical review of substitutions or alternatives for critical chemotherapy drug shortages in hematologic malignancies

Tinajero,

Markary,

Chen

et al. 2024

American Journal of Health-System Pharmacy

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Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Over the past decade, drug shortages have become increasingly more problematic for clinicians, with over 300 drug shortages reported in the first quarter of 2023. Shortages of chemotherapy drugs can have a negative impact on patient care, as omission or delay of treatment can lead to worse outcomes. Although many articles have been published on this topic, currently no review articles discuss strategies for using alternative regimens or substitutions in the event of severe chemotherapy drug shortages. Summary In this article, we review the literature on antineoplastic agents used to treat hematologic malignancies that experienced a drug shortage from 2010 through 2023, providing recommendations for substitutions and alternative regimens in the event of a critical shortage. In particular, we discuss how shortages of fludarabine, cytarabine, daunorubicin, methotrexate, and platinum agents may be addressed, including supporting clinical evidence. Conclusion Further publications assessing possible alternatives and substitutions for chemotherapy agents and examining the efficacy of previous strategies are needed to mitigate potentially devastating interruptions to care for patients with cancer during severe drug shortages.

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Clinical review of substitutions or alternatives for critical chemotherapy drug shortages in hematologic malignancies

Tinajero,

Markary,

Chen

et al. 2024

American Journal of Health-System Pharmacy

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Beyond fludarabine: pentostatin plus cyclophosphamide are a well-tolerated alternative in reduced intensity conditioning

Cited by 1 publication

References 11 publications

Clinical review of substitutions or alternatives for critical chemotherapy drug shortages in hematologic malignancies

Clinical review of substitutions or alternatives for critical chemotherapy drug shortages in hematologic malignancies

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