Death Rate Higher in Minorities With Acute Leukemia

Death Rate Higher in Minorities With Acute Leukemia

A new study finds that blacks and Hispanics are less likely to develop acute leukemia than whites. But if they do become ill, they're much more likely to die.
"We don't know the reason for the disparity, but now that we know it exists we can investigate why it occurs," said study lead researcher Dr. Manali I. Patel, postdoctoral fellow in hematology/oncology at the Stanford Cancer Institute in Stanford, Calif., in a statement provided by the American Association for Cancer Research. "Like all disparities in cancer, there could be any combination of influences; however, we believe that socioeconomic factors and access to care may be playing an important role."
After studying medical records of nearly 41,000 patients with acute leukemia between 1998 and 2008, the researchers found that blacks had a 17% higher risk of dying of acute leukemia than whites, and Hispanics had a 12% higher risk.
Acute leukemia comes in two forms, acute lymphoblastic leukemia and acute myelogenous leukemia. One of them -- the former -- revealed a much higher difference in mortality. Blacks and Hispanics with acute lymphoblastic leukemia faced about a 45% and 46% higher risk, respectively, of dying than whites. For acute myelogenous leukemia, the added risk was 12% for blacks and 6% for Hispanics.
"These data tell us that the disparity in overall survival in acute leukemia is driven by higher death rates in [acute lymphoblastic leukemia]," Patel said.
Leukemia isn't the only cancer which minorities have a lower risk of getting but a higher risk of dying from, researchers said. "This paradox is seen in other solid tumors, such as breast cancer. It occurs less frequently in black women, but mortality rates, stage for stage, are higher," Patel said. "Now that we have taken the crucial first step to document this disparity in acute leukemia, we need to understand the factors behind it so we can address and correct it."
The study was scheduled to be released at the American Association for Cancer Research Conference on The Science of Cancer Health Disparities in Washington D.C.
Research presented at a medical meeting should be considered preliminary until published in a peer-reviewd journal.
-- Randy Dotinga

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Asthma Inhaler Primatene Mist Going Off the Market

Over-the-counter asthma inhalers containing chloroflouorocarbons (CFCs), which can damage the ozone layer, will not be made or sold after Dec. 31, the U.S. Food and Drug Administration announced Thursday.

The sole product affected is Primatene Mist, marketed by Armstrong Pharmaceutical Inc., because it is the only inhaler approved by the FDA to be sold without a prescription for the relief of occasional symptoms of mild asthma.
"With this phase-out, all of the other inhalers that could substitute for the CFC over-the-counter inhaler to relieve symptoms of mild asthma require a prescription," Dr. Andrea Leonard-Segal, director of the FDA's Division of Nonprescription Clinical Evaluation, said during a morning news conference.
Primatene Mist uses CFCs to propel epinephrine from the inhaler so it can be taken into the lungs.
"Consumers who use Primatene Mist need to take action now to see a health-care provider to get a prescription for a replacement product," Leonard-Segal said. "Primatene Mist may be even harder to find on store shelves even before Dec. 31, 2011."
People who have the product after Dec. 31 can continue to take it as long as it hasn't expired, Leonard-Segal said.
The product is being removed from the market to comply with the Montreal Protocol on Substances that Deplete the Ozone Layer. This international agreement, signed by the United States, calls for phasing out chemicals that deplete the ozone layer, including CFCs.
Many manufacturers have replaced CFCs with an environmentally friendly propellant called hydrofluoroalkane (HFA). However, there are no HFA versions of over-the-counter epinephrine inhalers currently available, the FDA said.
While the other types of medications delivered through HFA inhalers are effective, there are some significant differences between HFA and CFC inhalers that people need to be aware of, Leonard-Segal said.
They include:

• Priming. When you first use an HFA inhaler, or if you haven't used it in awhile, you need to "prime" the pump to ensure that you're getting the accurate dose of medication. Priming entails spraying a dose or doses into the air, and priming requirements are different for each inhaler. Ask your pharmacist or check the package insert for your inhaler's priming requirements.
• Inhaling. The spray from HFA inhalers doesn't come out as forcefully, and some people have reported feeling as if they're not getting enough medication. For more detailed instructions on the proper technique for using an inhaler, ask your doctor or pharmacist, or check the package insert, which also has instructions for using the inhaler.
• Cleaning. HFA inhalers need to be cleaned more often than CFC inhalers.

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