Following the death of 3 lymphoma patients at the Nantes University Hospital, Marisol Touraine requests the suspension of intensive chemotherapy before autografting.
Just a month ago at Nantes University Hospital, four adult patients with lymphoma, treated with intensive chemotherapy before autologous transplantation (BEAC protocol) presented serious complications. The suspicious deaths of three of them raised many questions. In an attempt to lift the veil on this new medical case, the public health department of the Paris prosecutor’s office has opened an investigation.
For his part, Marisol Touraine, Minister of Health, seized the General Inspectorate of Social Affairs (IGAS) on November 17. Recently, the first findings of IGAS concluded that to date, no incident has been reported by any other institution regarding the use of the BEAC protocol. The investigations are still ongoing and the judicial investigation is continuing. But new elements transmitted to the press once again sow doubt in this dossier.
Cardiac toxicity almost ruled out
In a press release published this Saturday, the Minister of Health informs that she asked the National Cancer Institute (INCa) and the National Agency for the Safety of Medicines and Health Products (ANSM) on November 29 to reassess the recommendations national authorities for the management of patients treated for lymphoma.
We then learn that‘Inca and the ANSM submitted yesterday, December 16, their recommendations to Marisol Touraine. In this report, the agencies recall “the absence of a highly predictive element of cardiac toxicity from cyclophosphamide, and the strictly unicentric and temporally grouped nature of these events which occurred at the Nantes University Hospital”.
The existence of other therapeutic alternatives
The agencies continue: “In the current state of the information available on the serious complications that have arisen at the Nantes University Hospital, due to the improvement in the supply situation of melphalan IV on the national territory, and the existence of other therapeutic alternatives, INCa and ANSM recommend, as a precaution, the temporary suspension of recourse to the BEAC protocol (1) ”.
So, failing to understand for the moment the reasons for the tragedy, Marisol Touraine decided to act. It validates these recommendations by asking the Directorate General of Health (DGS) to apply them. The Minister of Health specifies, however, that this request “does not concern the use, even at high doses, of one or more drugs making up the BEAC protocol, which remain essential in other treatment regimens”. The mystery and questions about the deaths of the three patients at the Nantes University Hospital therefore remain unresolved.
(1) The acronym corresponds to the combination of high doses of carmustine, etoposide, cytarabine and cyclophosphamide, used for conditioning prior to an autologous hematopoietic stem cell transplant.
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