Between November 10 and 13, 3 lymphoma patients treated at the Nantes University Hospital died of a cardiac complication.
Four lymphoma patients treated by the Nantes University Hospital were victims of serious cardiac complications. Three of them died between November 10 and 13, the health ministry said in a press release released on Friday. These suspicious deaths in such a short period of time pushed Marisol Touraine to seize the General Inspectorate of Social Affairs (Igas).
Asked about France Info, Benoît Vallet, Director General of Health, acknowledged that this situation was “exceptional”, in particular because of the similar profiles of patients treated by chemotherapy with the same treatment protocol. At this stage, the exact causes are not known. The first conclusions of the investigation are expected within a week. Why actor decipher what happened.
What is lymphoma?
This cancer is the most common malignant tumor of the blood and lymphatic system. “It is the defense organs which are responsible for the defense of the organism which are affected, specifies to Why actor Pr Hervé Tilly, hematologist at the Henri Becquerel Cancer Center in Rouen (Normandy).
In 2012, more than 35,000 new cases of malignant hemopathies were identified in France, two thirds of which are lymphomas. It is the first cancer in adolescents and young adults. But behind this name hides nearly a hundred different diseases. These are divided into 2 large groups: Hodgkin lymphomas (10% of lymphomas) and non-Hodgkin lymphomas.
Treatment of patients at Nantes University Hospital
Due to the large number of different diseases, therapies adapt. However, chemotherapy is a classic treatment. In Nantes, the 4 patients were undergoing “an intensive chemotherapy course with autograft”, specified the Ministry of Health. “It is high-dose chemotherapy, which we know, in some cases, can overcome the resistance of cancer cells that have resisted other treatments. As a result, it is used in well-coded cases, ”explains the specialist.
When patients follow this treatment protocol, they are hospitalized for about a month. Chemotherapy lasts 5 days. This therapy has known serious side effects. Indeed, it lowers the level of white blood cells and platelets, so patients are more at risk of infection.
“So to overcome this drawback, we have been practicing autografting for years. This involves removing the cells from the patient a few days or weeks before chemotherapy and then reinjecting them after the treatment. This allows faster recovery of white blood cells and platelets, ”says Professor Tilly.
For this treatment, 4 molecules can be used, including cyclosphosphamide which the 4 patients received or melphalan.
Why did you use cyclosphosphamide
For Professor Tilly, this is not unusual. “This drug has been widely used by many centers and in many intensive chemotherapies for different cancers for over 20 years. This use is very classic, ”he assures us. The ministry has also confirmed that “this treatment is validated by the medical community”.
For about fifteen years, hematologists have had a new therapeutic option giving fewer side effects: melphalan. Doctors from Nantes University Hospital did not use it in the 4 patients because this drug is in supply tension. They therefore preferred to reserve the remaining batches of melphalan for patients suffering from myeloma, another cancer, for which there is no other alternative.
Herve Tilly, hematologist at the Henri Becquerel Cancer Center in Rouen: ” We have been managing stocks for several months as best we can … “
Here again, Professor Tilly affirms that his colleagues have acted like many cancer centers, and in particular his own. “We have had difficulty obtaining supplies for the past few months. These tensions come from the fact that melphalan can only be used in intensive chemotherapy and that it is only produced by one European laboratory, ”he describes. The France Lymphome Espoir association, and doctors including Professor Tilly, have also alerted the health authorities and the laboratory of this shortage and its consequences.
For now, nothing indicates that the therapeutic choice made by Nantes doctors explains these suspicious deaths. “It is a usual drug used in usual circumstances and in a service known for its reliability, so we really have to wait for the conclusions of the investigation”, concludes the specialist.
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