ASH Clinical News May 2016 | Page 28

Data Stream A Drop in the Bucket Not every drop of a person’s blood is the same, according to a study that looked at the variability between different drops of blood from a single finger-prick and blood obtained via phlebotomy. The findings suggest that up to nine drops of blood may be needed to get accurate results on point-ofcare tests. Researchers analyzed six to nine succ essive 20-mL drops of blood collected from one finger-prick in 11 blood donors. Compared with the fluctuation in blood parameters seen in venous blood analysis, the variation between the fingerprick blood drops was: The Designer Baby Boom? A new poll from STAT News and Harvard T.H. Chan School of Public Health found that Americans have mixed views on the ethical, social, and legal implications of new gene-editing technologies like CRISPR. “They’re not against scientists trying to improve genome-editing technologies,” Robert Blendon, ScD, professor of health policy and political analysis at Harvard T.H. Chan said, likely because an unexpected event, such as “the ability to eliminate a terrible disease could change people’s views in the years ahead.” In the poll of 1,000 people: 100 80 3.4 times higher for hemoglobin 60 40 20 5.7 times higher for white blood cell count 0 26% think altering DNA prenatally to reduce the risk of certain serious diseases should be legal 83% 59% 44% said that altering the genes of unborn babies to improve intelligence or physical characteristics should be illegal think federal health regulators should approve gene therapy favor funding studies of diseaserelated germline editing However, 69% said they had heard “little or nothing” about germline editing, so there is some headway to make before gene-editing hits the mainstream. 3 times higher for lymphocyte count Source: Harvard T.H. Chan School of Public Health, “The public and genetic editing, testing, and therapy,” January 2016. Size Matters 7.7 times higher for granulocyte count Super-sized single-dose vials are costing the U.S. health-care system $1.7 billion in wasted leftover drugs, according to an analysis of spending on 20 top-selling cancer drugs. Dosage of these infusional drugs is based on a patient’s weight or body size, and drugs must be either administered or discarded once open. “Because patients’ body sizes are unlikely to match the amount of drug included in the vial, there is nearly always some leftover drug – which still needs to be paid for,” the authors wrote. With rituximab, for example: 4 times higher for platelets • Recommended dose: 375 mg/m2 • Vial sizes available: 100 mg and 500 mg • Typical patient dose: 637.5 mg • Amount wasted: 62.5 mg “If you’re going to take a finger-prick stick to get your measures, you need to be aware that you’re sacrificing some accuracy,” the lead author said in a press release. This amounts to an estimated cost of leftover rituximab of $253.9 million. Source: Bond MM, Richards-Kortum RR. Drop-to-drop variation in the cellular components of fingerprick blood: implications for point-of-care diagnostic development. Am J Clin Pathol. 2016;144:885-94. Source: Bach PB, Conti RM, Muller RJ, et al. Overspending driven by oversized single dose vials of cancer drugs. BMJ. 2016 February 29. [Epub ahead of print] 26 ASH Clinical News May 2016