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. 2017 Jun;16(2):156-164.
doi: 10.1177/1534735416664171. Epub 2016 Aug 16.

Improved Survival With Integration of Chinese Herbal Medicine Therapy in Patients With Acute Myeloid Leukemia: A Nationwide Population-Based Cohort Study

Tom Fleischer  1 , Tung-Ti Chang  1   2 , Jen-Huai Chiang  3 , Mao-Feng Sun  1   2 , Hung-Rong Yen  1   2
Affiliations

Improved Survival With Integration of Chinese Herbal Medicine Therapy in Patients With Acute Myeloid Leukemia: A Nationwide Population-Based Cohort Study

Tom Fleischer et al. Integr Cancer Ther. 2017 Jun.

Abstract

Purpose: Acute myeloid leukemia (AML) is the most deadly subtype of leukemia, and many patients with this disease seek other complementary therapies, one of which is Chinese medicine. We set out to provide reliable data regarding the benefit of Chinese herbal medicine (CHM) for AML patients, using mortality as the main outcome measure. We also characterized the herbal prescriptions of patients.

Methods: Using the Taiwanese National Health Insurance Research Database, we performed a nationwide population-based cohort study among AML patients from 1997 to 2010. The Cox regression model was used to adjust for comorbidities and other variables, and the hazard ratios (HRs) of CHM users and non-CHM users were compared.

Results: After 1:1 matching, 498 patients were included into the study. The HR of the CHM group was 0.41 (95% CI = 0.26-0.65; P = .0001) compared with the non-CHM group. This decrease in HR was also shown to be dose dependent ( P < .001). The 3 single-herbs most commonly prescribed were Salvia miltiorrhiza (Dan Shen), Astragalus membranaceus (Huang Qi), and Spatholobus suberectus (Ji Xue Teng). The 3 mutli-herb products most commonly prescribed were Jia Wei Xiao Yao San, Gui Pi Tang, and Qi Ju Di Huang Wan.

Conclusion: Prospective controlled clinical data is still needed, however, this study provides real-world data regarding the benefit AML patients may have from CHM. This study suggests that all AML patients, regardless of age or other prognostic factors, may achieve longer survival times when receiving CHM in addition to standard therapy.

Keywords: Chinese medicine; NHIRD; Taiwan; acute myeloid leukemia; leukemia.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study population flowchart diagram. Of the total number of AML patients registered in the NHIRD (n = 5955), 4825 patients were diagnosed within the years 1997-2010. After the exclusion process, as well as matching 1:1 by age, sex, and index year, both groups contained 249 patients. Abbreviations: AML, acute myeloid leukemia; CHM, Chinese herbal medicine; NHIRD, National Health Insurance Research Database.
Figure 2.
Figure 2.
Kaplan-Meier curves of overall survival of patients according to length of consumption of Chinese herbal medicine (CHM): non-CHM user (included < 30 days), 30-89 days, 90-179 days, and >180 days (see Table 3). The curves have been adjusted according to the median lag time to treatment (213 days), as described in Table 3.
Figure 3.
Figure 3.
Kaplan-Meier curves of overall survival in patients with acute myeloid leukemia according to Chinese herbal medicine (CHM) use. The curves have been adjusted according to the median lag time to treatment (213 days), as described in Table 3.
Figure 4.
Figure 4.
Kaplan-Meier curves of overall survival in patients with acute myeloid leukemia according to Chinese herbal medicine (CHM) use, stratified by age group. The curves have been adjusted according to the median lag time to treatment (213 days), as described in Table 3.
See this image and copyright information in PMC

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