More About: Biology of Cachexia

Extract

This is in response to the correspondence in regard to hydrazine sulfate (1), which appeared in the April 15, 1998, issue of the Journal. In that letter, Dr. Wheeler stated that on the basis of “three randomized [National Cancer Institute- sponsored] trials” and a review of one—the CALGB (Cancer and Leukemia Group B)—of these trials by the U.S. General Accounting Office, hydrazine sulfate was found to be “no better” than a placebo.

In the CALGB trial (2), the authors essentially denied the use of tranquilizers, indicating that “virtually no patients received phenothiazine-type tranquilizers, with the exception of [short-term] prochlorperazine (Compazine)”; no mention was made of any use of the benzodiazepine tranquilizers. Yet, what Wheeler does not point out, the CALGB authors in their succeeding article published in the same journal (3) admit to the widespread use of phenothiazine tranquilizers, benzodiazepine tranquilizers, or both—in 94% of all 266 study patients. Of these patients, only 120 received these tranquilizers “less than 48 hours,” some receiving them on an “as needed” or “continual” basis (4).