Doctors Do A Blood Transfusion For The Involvement Of Patients In Trials Of New Cancer Drugs

Doctors Do A Blood Transfusion For The Involvement Of Patients In Trials Of New Cancer Drugs.
Canadian researchers tell they've noticed a worrying trend: Cancer doctors ordering non-essential blood transfusions so that severely unfavourable patients can prepare for drug trials. In a letter published recently in the New England Journal of Medicine, the researchers publish on three cases during the terminal year in Toronto hospitals in which physicians ordered blood transfusions that could elect the patients appear healthier for the particular purpose of getting them into clinical trials for chemotherapy drugs premature ejaculation. The custom raises both medical and ethical concerns, the authors say.

And "On the doctor side, you want to do the best for your patients," said co-author Dr Jeannie Callum, conductor of transfusion medicine and tissue banks at Sunnybrook Health Sciences Centre in Toronto. "If these patients have no other options left side to them, you want to do the total you can to get them into a clinical trial. But the tenacious is put in a horrible position, which is, 'If you want in to the trial, you have to have the transfusion.' But the transfusion only carries risks to them".

A singularly acute complication of blood transfusions is transfusion-related perceptive lung injury, which occurs in about one in 5000 transfusions and usually requires the case to go on life support, said Callum. But into the bargain the potential for physical harm, enrolling very sick commoners in a clinical trial can also skew the study's results - making the sedate perform worse than it might in patients whose disease was not as far along.

The needless transfusions were discovered by the Toronto Transfusion Collaboration, a consortium of six see hospitals formed to carefully review all transfusions as a means of improving unyielding safety. At this point, it's unworkable to know how often transfusions are ordered just to get patients into clinical trials. When she contacted colleagues around the time to find out if the practice is widespread, all replied that they didn't go over the reasons for ordering blood transfusions and so would have no avenue of knowing.

Dr J Leonard Lichtenfeld, surrogate chief medical officer of the American Cancer Society, said he was not knowing of physicians manipulating eligibility for clinical trials through transfusions. However, the write raises a provocative issue that should be well-thought-out further.

And "This is something I have never heard of, never seen and I can't claim how common it is. I believe the authors have brought a very influential issue to the attention of the oncology community and our patients". If found to be commonplace, Lichtenfeld said the practising should stop. "Giving unrequired transfusions is not the way we should be increasing access to original cancer drugs".

Another layer to the issue that should be examined is how appropriate the "exclusion criteria" regarding participation in clinical trials are in the triumph place. The exclusion factors take into account a drug's toxicity and who is disposed to to be helped. "Exclusion criteria" are meant to screen patients by keeping people out who are too ill to metabolize a narcotic effectively, or too fragile to handle its side effects.

But drug companies want unambiguous results so there can be pressure to select healthier patients to make out the drug look better. If doctors are bypassing the denial criteria, it may be that they believe the criteria are unfairly leaving some very ill patients out of trials who could benefit jhaiya. "We have to make persuaded exclusions are not selecting for the best patients that will make the drug look its best".