Detection and Prevention of Drug-Induced Blood Dyscrasias

Abstract

THE RELUCTANCE of most physicians to report cases of suspected drug-induced blood dyscrasias is due to the difficulty in establishing a definite causal relationship between drug and disease; the evidence for this in most cases is inadequate. Unfortunately, this reluctance may lead to a delay in the recognition of toxic effects of new drugs. For example, cases of suspected chloramphenicol-induced aplastic anemia were observed sporadically soon after the drug was released in 1949, but so few case reports appeared that its potential toxicity was not apparent until 3 years later. By that time 12 individual groups had accumulated 37 cases of chloramphenicol-induced aplastic anemia, enough to warrant publication of a firm, but belated, warning. In order to prevent similar delays, the Council on Drugs of the American Medical Association established a Study Group on Blood Dyscrasias to act as a clearinghouse for all suspected cases caused by drugs and chemicals.