The FDA has approved asparaginase Erwinia chrysanthemi (Erwinaze – EUSA), an asparagine-specific enzyme derived from the gram-negative bacillus Erwinia chrysanthemi, for use in combination with other chemotherapeutic agents for treatment of acute lymphoblastic leukemia (ALL) in patients who have had allergic reactions to Escherichia coli-derived asparaginase (Elspar or pegaspargase [Oncaspar]).ALL is the most common malignancy of childhood. Multidrug chemotherapy can cure about 80% of children with ALL.1 Initial treatment ("induction") usually includes vincristine, a glucocorticoid, and an...

News about recent price increases for EpiPen and EpiPen Jr (Mylan) may have patients asking about other options for emergency treatment of anaphylaxis. Adrenaclick and its generic equivalent (epinephrine injection auto-injector) are the only other epinephrine auto-injectors currently available in the US. According to Impax (the manufacturer of both the brand and generic products), Adrenaclick is no longer being manufactured; the generic product will continue to be marketed after supplies of Adrenaclick are depleted. Auvi-Q (Sanofi), an epinephrine auto-injector that was approved by the FDA in...

Many patients ask their physicians whether they should take vitamins. Since the last Medical Letter article on this subject, more data have become available on the benefits and risks of taking vitamin supplements.

The enzyme alpha-galactosidase (Beano - AkPharma), derived from a mold and classified as a food, is sold without presecription in pharmacies and food stores. The manufacturer recommends taking the anzyme to decrease intestinal gas producted by eating the high-fiber diets now widely recommended in the USA.

Indium 111 In-satumomab pendetide (CYT-103, OncoScint CR/OV Kit - Cytogen), a new intravenous imaging agent, has been approved by the US Food and Drug Administration for detection of extrahepatic spread of colorectal and ovarian tumors.

Strontium-89 chloride was recently approved for marketing by the US Food and Drug Administration. It is offered for relief of pain caused by metastatic bone lesions

Dexrazoxane (Zinecard - Pharmacia) was recently approved by the US Food and Drug Administration (FDA) for protection against cardiac toxicity from (Adriamycin, and others) in women with metastatic breast cancer.

Use of alendronate (Fosamax), estrogen and other drugs for prevention and treatment of osteoporosis (Medical Letter, 38:1, 1996) has been accompanied by widespread availability of bone density screening tests, not only in doctors offices and hospitals, but even in retail stores. Bone densitometry provides a quantitative measurement of bone mineralization that can be used to predict the risk of osteoporotic fractures.

Dolasetron (Anzemet - Hoechst Marion Roussel), a selective serotonin (5-HT3) receptor antagonist similar to ondansetron (Zofran) and granisetron (Kytril - Medical Letter, 36:61, 1994) is now available for both oral and intravenous use in prevention of nausea and vomiting due to cancer chemotherapy. A 5-HT3 antagonist plus dexamethasone (Decadron, and others) is the most effective regimen for prevention of acute vomiting caused by cancer chemotherapy. Dolasetron has also been approved by the FDA for prevention and treatment of postoperative nausea and...

Extracts made from leaves of the ginkgo tree (Ginkgo biloba) are available in the uSA as deitary supplements, in France and Germany as licensed drugs and worldwide as herbal remedies for treatment of dementia and many other indications.