Many hospitals that care for patients with acute leukemia do not have all-trans retinoic acid (ATRA) in stock, according to a study published in the November issue of the Journal of the National Comprehensive Cancer Network.
All-Trans Retinoic Acid for APL
Noting that ATRA is the backbone of management for patients with acute promyelocytic leukemia (APL), Marcus J. Geer, M.D., from the University of Michigan Medical School in Ann Arbor, and colleagues examined the clinical availability of ATRA and factors limiting access to ATRA. The United States was divided into six geographic regions. Twenty hospitals were randomly selected from states within each of these regions and were surveyed regarding treatment of patients with acute leukemia, availability of ATRA, and reasons for not stocking ATRA.
The researchers found that 31 percent of the hospitals had ATRA in stock. ATRA availability was not influenced by size of the hospital or by hospital status as academic versus nonacademic (53 versus 31 percent). Only 14 percent of the hospitals that referred patients with APL had ATRA readily available. Compared with referring centers, hospitals that treated patients with APL were more likely to have ATRA available (58 versus 14 percent).
“Our findings should spur an investigation into the impact of early access to ATRA on morbidity and mortality in APL,” the authors write. “Furthermore, a call from hematologists nationwide to their formulary committees is warranted to ensure that this lifesaving medication is available to patients in a timely manner.”
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