Debbie Blamble, PharmD, BCOP

Questions about which vaccinations are safe to administer to patients with cancer — and the ideal time to administer them to patients on active cancer therapy — frequently arise in the clinic.


Since the introduction of tyrosine kinase inhibitors, chronic myeloid leukemia incidence has doubled.

The FDA recently revised the prescribing information of ofatumumab and rituximab, adding a boxed warning and recommendations to reduce the risk for hepatitis B virus reactivation.

Acute promyelocytic leukemia, a variant of acute myeloid leukemia, is characterized by unique molecular and clinical properties.

Acute promyelocytic leukemia, a variant of acute myeloid leukemia, is characterized by unique molecular and clinical properties.

Cancer and cancer therapies can increase a patient’s risk of developing venous thromboembolism.

A new formulation of vincristine, which received FDA approval in August, should be commercially available in the first quarter of 2013.

The Institute of Medicine recently published a new report on the dietary reference intakes for vitamin D, which were increased modestly. Many expected that the reference intake for vitamin D would increase substantially, given recent information suggesting that vitamin D deficiency may be implicated in several conditions, such as cancer, heart disease and diabetes. The following column discusses the role of vitamin D in cancer prevention and treatment after addressing how vitamin D deficiency is defined.

Aplastic anemia is a rare disease caused by a failure of the bone marrow stem cells. Pancytopenia, including anemia, is characteristic of the disorder. Patients are at risk of infection due to neutropenia and bleeding due to thrombocytopenia, as well as fatigue caused by anemia. Without treatment, more than 70% of those patients will die within the first year of diagnosis from complications of cytopenias.

High-dose methotrexate chemotherapy is used to treat a variety of malignancies, including lymphoid leukemias, lymphomas and sarcomas. Methotrexate inhibits dihydrofolate reductase, depleting cells of reduced folates necessary for purine biosynthesis. Achieving high serum levels of high-dose methotrexate takes advantage of several pharmacologic characteristics, including entering the cell by passive diffusion; achieving higher central nervous system concentrations; better competition with reduced folates for dihydrofolate reductase binding; and increased production of high-dose methotrexate polyglutamates, which are more slowly eliminated from the cell.