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Kayo T, Suzuki M, Mitsuma T, Suzuki M, Ikeda S, Sukegawa M, Tsunoda S, Ohta M. Bleeding Risk of Acupuncture for Patients with Hematological Malignancies Accompanying Thrombocytopenia: A Retrospective Chart Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:77-84. [PMID: 37405736 DOI: 10.1089/jicm.2022.0710] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Introduction: In recent years, it has been reported that acupuncture is useful for alleviating the symptoms of patients with hematological malignancies, but the safety of acupuncture for such patients has not been established. This study evaluated the risk of bleeding from acupuncture in patients with hematological malignancies accompanying thrombocytopenia. Methods: The authors performed a retrospective investigation of the medical records of patients with hematological malignancies who received acupuncture during hospitalization at the hematology department of a single medical center in Japan. The bleeding risk at the acupuncture site was evaluated in the following four groups according to the platelet count measured on the day of acupuncture treatment: (1) <20 × 103/μL, (2) 20-49 × 103/μL, (3) 50-99 × 103/μL, and (4) 100 × 103/μL or more. Occurrence of grade 2 or higher bleeding according to the Common Terminology Criteria for Adverse Events, version 5.0, within 24 h from the acupuncture session or before the next session was defined as an event, and the risk of occurrence of bleeding was examined in each group. Results: Of 2423 acupuncture sessions conducted on 51 patients with hematological malignancies, 815 were included in the analysis. Ninety sessions were performed in the <20 × 103/μL platelet count group, 161 in the 20-49 × 103/μL group, 133 in the 50-99 × 103/μL group, and 431 in the 100 × 103/μL or more group. No bleeding event according to the authors' definition occurred in any of these groups. Conclusions: This study is the largest to date to assess the bleeding risk of acupuncture in patients with hematological malignancies accompanying thrombocytopenia. The authors considered that acupuncture could be safely performed without causing serious bleeding for patients with hematological malignancies accompanying thrombocytopenia.
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Affiliation(s)
- Takumi Kayo
- Department of Kampo Medical Research Institute and Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Masao Suzuki
- Department of Kampo Medical Research Institute and Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Tadamichi Mitsuma
- Department of Kampo Medical Research Institute and Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Manabu Suzuki
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Shohei Ikeda
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Masumi Sukegawa
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Saburo Tsunoda
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Masatsugu Ohta
- Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
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Del Giudice I, Cappelli LV, Delgado J, Niemann CU, Andersen MA, Rotbain EHC, Aarup K, Walewska R, Visentin A, Deodato M, Frustaci AM, Cavalloni C, Gentile M, Yassin MA, Lad D, Scarfò L, Flogegard M, Mattsson M, Raponi S, Ilari C, Starza ID, Orlandi EM, Tedeschi A, Trentin L, Semenzato G, Guarini A, Ghia P, Montserrat E, Foà R. Spontaneous regression in chronic lymphocytic leukaemia. Clinical features of 50 cases from the ERIC registry and review of the literature. Br J Haematol 2023; 201:353-356. [PMID: 36793194 DOI: 10.1111/bjh.18696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Luca Vincenzo Cappelli
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Julio Delgado
- Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Carsten Utoft Niemann
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Asger Andersen
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Emelie Hamotal Curovic Rotbain
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kathrine Aarup
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Renata Walewska
- Department of Haematology, University Hospitals Dorset, Bournemouth, UK
| | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Marina Deodato
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Anna Maria Frustaci
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Massimo Gentile
- Hematology Unit AO of Cosenza, Cosenza, Italy.,Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | | | - Deepesh Lad
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Lydia Scarfò
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Max Flogegard
- Hematology, Medicine Clinic, Falun Hospital, Falun, Sweden
| | - Mattias Mattsson
- Department of Hematology, Uppsala University Hospital, Uppsala, Sweden
| | - Sara Raponi
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Caterina Ilari
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Irene Della Starza
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | | | - Alessandra Tedeschi
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Gianpietro Semenzato
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Anna Guarini
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Paolo Ghia
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Emili Montserrat
- Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
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3
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Mahurin HM, Tarabadkar E, Hippe DS, Lachance K, Kim EJ, Loggers ET, Shinohara MM. Integrative medicine use in patients with cutaneous T-Cell lymphoma: A cross-sectional survey study. Complement Ther Med 2021; 61:102762. [PMID: 34302983 DOI: 10.1016/j.ctim.2021.102762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/01/2021] [Accepted: 07/16/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To characterize patterns of integrative medicine (IM) use and health-related quality of life (HRQoL) in patients with cutaneous T-cell lymphoma (CTCL). DESIGN Cross-sectional, online survey, created in conjunction with the Cutaneous Lymphoma Foundation (CLF). SETTING A link to the online survey was posted on the CLF Facebook page and emailed to the CLF listserv; 372 survey responses were received. MAIN OUTCOME MEASURES The study outcomes were IM use, cancer symptoms, and HRQoL measured via the Skindex-16 and Functional Assessment of Cancer Therapy-General (FACT-G). RESULTS A total of 292 patient responses (66 % female, median age 59y) were included in analysis. 87 % had mycosis fungoides and 12 % had Sézary syndrome. A majority (59 %) of patients reported using IM for their CTCL, with 48 % using IM to treat their disease and 47 % using IM to manage their symptoms. The most commonly used IM were vitamins/minerals (32 %), prayer/meditation (26 %), diet (24 %), and exercise/yoga (22 %). Higher itch scores were reported by patients using IM compared to non-users (31 (IQR 10-62) and 18 (IQR 3-46) respectively; p = 0.002). HRQoL was worse among patients who reported IM use; median Skindex-16 scores were 54 (IQR 28-72) among IM users compared to 33 (IQR 19-57) for non-IM users (p < 0.001). CONCLUSIONS IM use is common among patients with CTCL, particularly those with worse itching and worse HRQoL. IM interventions require further study given use by CTCL patients to treat disease and ameliorate symptoms.
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Affiliation(s)
- Heather M Mahurin
- University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA, 98195, United States.
| | - Erica Tarabadkar
- Department of Dermatology, Emory University, 1525 Clifton Rd, Atlanta, GA, 30322, United States
| | - Daniel S Hippe
- Department of Radiology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, United States
| | - Kristina Lachance
- Division of Dermatology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, United States
| | - Ellen J Kim
- Department of Dermatology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, United States
| | - Elizabeth T Loggers
- Division of Oncology, University of Washington, 825 Eastlake Ave E, Seattle, WA, 98109, United States; Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, United States
| | - Michi M Shinohara
- Division of Dermatology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, United States
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Keene MR, Heslop IM, Sabesan SS, Glass BD. Complementary and alternative medicine use in cancer: A systematic review. Complement Ther Clin Pract 2019; 35:33-47. [PMID: 31003679 DOI: 10.1016/j.ctcp.2019.01.004] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND PURPOSE Complementary and alternative medicine (CAM) use in cancer is increasing. The purpose of this study was to systematically review the literature to determine demographic profiles and prevalence and reasons for use in cancer patients. METHODS In this systematic review, the databases OVID, PubMed, and Scopus were searched for studies on CAM use in cancer between 2009 and June 2018. RESULTS The results showed that an average of 51% of cancer patients used CAM. Common independent demographic characteristics associated with CAM use were younger, female cancer patients, having higher education, earning a higher income and having previously used CAM. Frequent reasons for use, grouped into themes were shown to be to influence their cancer and general health and to treat complications of the cancer or therapy. CONCLUSION The review provides an insight and will serve to better inform health professionals on how this population is using CAM.
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Affiliation(s)
- Martin R Keene
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia.
| | - Ian M Heslop
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia
| | - Sabe S Sabesan
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia
| | - Beverley D Glass
- College of Medicine and Dentistry, James Cook University, Townsville, 4811, Australia
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5
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Bange E, Timlin C, Kabel C, Svoboda J, Roeker L, Mato AR. Evidence for and Against Green Tea and Turmeric in the Management of Chronic Lymphocytic Leukemia. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2018; 18:e421-e426. [PMID: 30007569 PMCID: PMC7397615 DOI: 10.1016/j.clml.2018.06.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 06/19/2018] [Indexed: 12/17/2022]
Abstract
Complementary and alternative medicine (CAM) is a diverse group of medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Chronic lymphocytic leukemia (CLL) is the most common leukemia diagnosed in the western hemisphere, and 16.5% to 66% of patients have reported using CAM. Most patients use spiritual/mind-body techniques and high doses of vitamins and herbs (most commonly polyphenols, including teas). We have reviewed the reported data on green tea and turmeric use in CLL patients.
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Affiliation(s)
- Erin Bange
- Center for CLL, Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Colleen Timlin
- Center for CLL, Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Charlene Kabel
- CLL Program, Leukemia Service, Section of Hematologic Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jakub Svoboda
- Center for CLL, Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Lindsey Roeker
- CLL Program, Leukemia Service, Section of Hematologic Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Anthony R Mato
- CLL Program, Leukemia Service, Section of Hematologic Oncology, Memorial Sloan Kettering Cancer Center, New York, NY.
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6
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Kim K, Kim SH, Ok ON, Kim IR, Lee S, Kim SH, Kim WS, Ryu MH, Lee MH. Use of complementary and alternative medicine by lymphoma survivors in South Korea. Eur J Oncol Nurs 2018; 33:91-96. [DOI: 10.1016/j.ejon.2018.01.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 01/16/2018] [Accepted: 01/30/2018] [Indexed: 11/12/2022]
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7
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Regulatory T Cells and Their Prognostic Relevance in Hematologic Malignancies. J Immunol Res 2017; 2017:1832968. [PMID: 29430466 PMCID: PMC5752970 DOI: 10.1155/2017/1832968] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/14/2017] [Indexed: 11/18/2022] Open
Abstract
Regulatory T cells (Tregs) have a fundamental function in monitoring the immune homeostasis in healthy individuals. In cancer and, in particular, in hematological malignancies, Tregs exert a major immunosuppressive activity, thus playing a critical role in tumor cell growth, proliferation, and survival. Here, we summarize published data on the prognostic significance of Tregs in hematological malignancies and show that they are highly conflicting. The heterogeneity of the experimental approaches that were used explains-at least in part-the discordant results reported by different groups that have investigated the role of Tregs in cancer. In fact, different tissues have been studied (i.e., peripheral blood, bone marrow, and lymph node), applying different methods (i.e., flow cytometry versus immunohistochemistry, whole blood versus isolated peripheral blood mononuclear cells versus depletion of CD25+ cells, various panels of monoclonal antibodies, techniques of fixation and permeabilization, and gating strategies). This is of relevance in order to stress the need to apply standardized approaches in the study of Tregs in hematological malignancies and in cancer in general.
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8
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Frenkel M, Sapire K. Complementary and Integrative Medicine in Hematologic Malignancies: Questions and Challenges. Curr Oncol Rep 2017; 19:79. [PMID: 29032389 DOI: 10.1007/s11912-017-0635-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Hematologic malignancies represent 9.7% of all cancers, making them the fourth most common type of cancer in the United States. The aggressive and complex treatments administered in hematologic malignancies result in a high burden of psychological needs. Complementary and integrative medicine (CIM) is becoming one of the options that patients use to address their distress during and after cancer treatments. It is not clear whether appropriate CIM can relieve distress in patients affected by these malignancies. This review covers the potential benefits of CIM as relates to nutrition, nutritional supplements, exercise, circadian rhythm, methods for reducing distress during bone marrow aspiration, massage therapy, and acupuncture, in treating patients with hematological malignancies. This review may provide a framework to enhance patient-doctor dialogue regarding CIM use in hematologic malignancies.
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Affiliation(s)
- Moshe Frenkel
- Department of Family Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX, USA. .,Integrative Medicine Program, Institute of Oncology, Meir Medical Center, Kfar Saba, Israel. .,, Hashoftim 1 B, 30900, Zichron Yaacov, Israel.
| | - Kenneth Sapire
- Department of Anesthesia and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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9
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Sharma V, Holmes JH, Sarkar IN. Identifying Complementary and Alternative Medicine Usage Information from Internet Resources. A Systematic Review. Methods Inf Med 2016; 55:322-32. [PMID: 27352304 PMCID: PMC4975632 DOI: 10.3414/me15-01-0154] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 04/25/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Identify and highlight research issues and methods used in studying Complementary and Alternative Medicine (CAM) information needs, access, and exchange over the Internet. METHODS A literature search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines from PubMed to identify articles that have studied Internet use in the CAM context. Additional searches were conducted at Nature.com and Google Scholar. RESULTS The Internet provides a major medium for attaining CAM information and can also serve as an avenue for conducting CAM related surveys. Based on the literature analyzed in this review, there seems to be significant interest in developing methodologies for identifying CAM treatments, including the analysis of search query data and social media platform discussions. Several studies have also underscored the challenges in developing approaches for identifying the reliability of CAM-related information on the Internet, which may not be supported with reliable sources. The overall findings of this review suggest that there are opportunities for developing approaches for making available accurate information and developing ways to restrict the spread and sale of potentially harmful CAM products and information. CONCLUSIONS Advances in Internet research are yet to be used in context of understanding CAM prevalence and perspectives. Such approaches may provide valuable insights into the current trends and needs in context of CAM use and spread.
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Affiliation(s)
| | | | - Indra N Sarkar
- Indra Neil Sarkar, Ph.D., MLIS, Center for Biomedical Informatics, Brown University, Box G-R, Providence, RI 02912, USA, E-mail:
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Mazzocut M, Truccolo I, Antonini M, Rinaldi F, Omero P, Ferrarin E, De Paoli P, Tasso C. Web Conversations About Complementary and Alternative Medicines and Cancer: Content and Sentiment Analysis. J Med Internet Res 2016; 18:e120. [PMID: 27311444 PMCID: PMC4929351 DOI: 10.2196/jmir.5521] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/22/2016] [Accepted: 04/10/2016] [Indexed: 02/01/2023] Open
Abstract
Background
The use of complementary and alternative medicine (CAM) among cancer patients is widespread and mostly self-administrated. Today, one of the most relevant topics is the nondisclosure of CAM use to doctors. This general lack of communication exposes patients to dangerous behaviors and to less reliable information channels, such as the Web. The Italian context scarcely differs from this trend. Today, we are able to mine and analyze systematically the unstructured information available in the Web, to get an insight of people’s opinions, beliefs, and rumors concerning health topics.
Objective
Our aim was to analyze Italian Web conversations about CAM, identifying the most relevant Web sources, therapies, and diseases and measure the related sentiment.
Methods
Data have been collected using the Web Intelligence tool ifMONITOR. The workflow consisted of 6 phases: (1) eligibility criteria definition for the ifMONITOR search profile; (2) creation of a CAM terminology database; (3) generic Web search and automatic filtering, the results have been manually revised to refine the search profile, and stored in the ifMONITOR database; (4) automatic classification using the CAM database terms; (5) selection of the final sample and manual sentiment analysis using a 1-5 score range; (6) manual indexing of the Web sources and CAM therapies type retrieved. Descriptive univariate statistics were computed for each item: absolute frequency, percentage, central tendency (mean sentiment score [MSS]), and variability (standard variation σ).
Results
Overall, 212 Web sources, 423 Web documents, and 868 opinions have been retrieved. The overall sentiment measured tends to a good score (3.6 of 5). Quite a high polarization in the opinions of the conversation partaking emerged from standard variation analysis (σ≥1). In total, 126 of 212 (59.4%) Web sources retrieved were nonhealth-related. Facebook (89; 21%) and Yahoo Answers (41; 9.7%) were the most relevant. In total, 94 CAM therapies have been retrieved. Most belong to the “biologically based therapies or nutrition” category: 339 of 868 opinions (39.1%), showing an MSS of 3.9 (σ=0.83). Within nutrition, “diets” collected 154 opinions (18.4%) with an MSS of 3.8 (σ=0.87); “food as CAM” overall collected 112 opinions (12.8%) with a MSS of 4 (σ=0.68). Excluding diets and food, the most discussed CAM therapy is the controversial Italian “Di Bella multitherapy” with 102 opinions (11.8%) with an MSS of 3.4 (σ=1.21). Breast cancer was the most mentioned disease: 81 opinions of 868.
Conclusions
Conversations about CAM and cancer are ubiquitous. There is a great concern about the biologically based therapies, perceived as harmless and useful, under-rating all risks related to dangerous interactions or malnutrition. Our results can be useful to doctors to be aware of the implications of these beliefs for the clinical practice. Web conversation exploitation could be a strategy to gain insights of people’s perspective for other controversial topics.
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Affiliation(s)
- Mauro Mazzocut
- CRO Aviano National Cancer Institute, Scientific and Patient Library, Aviano, Italy.
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11
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Fleischer T, Chang TT, Chiang JH, Hsieh CY, Sun MF, Yen HR. Integration of Chinese Herbal Medicine Therapy Improves Survival of Patients With Chronic Lymphocytic Leukemia: A Nationwide Population-Based Cohort Study. Medicine (Baltimore) 2016; 95:e3788. [PMID: 27227953 PMCID: PMC4902377 DOI: 10.1097/md.0000000000003788] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Utilization of Chinese Medicine (CM) is not uncommon in patients with chronic lymphocytic leukemia (CLL). However, the current knowledge of the usage and efficacy of CM among CLL patients is limited. The aim of this study was to determine the impact of integrative Chinese Herbal Medicine (CHM) on the disease course of CLL and ascertain the herbal products most commonly prescribed to patients with CLL.A Taiwanese nationwide population-based study involving the use of Western medicine and CM services provided by the National Health Insurance (NHI) was conducted.An NHI Research Database-based cohort study was performed; the timeframe of the study was January 2000 to December 2010. The end of the follow-up period was defined as December 31, 2011.A total of 808 patients were diagnosed with CLL in Taiwan within the defined study period. After randomly matching for age and sex and excluding patients younger than 18 years of age, data from 616 patients were analyzed.The 2 study groups both received standard of care treatment. In addition, 1 group also received CHM. Patients who were registered as receiving other forms of CM, such as acupuncture, were excluded.Hazard ratios of mortality were used to determine the influence of CHM and the therapeutic potential of herbal products.In total, 616 CLL patients were included in the analyses. We found that the HR associated with the adjunctive use of CHM was less than half when compared to the non-CHM group (0.43, 95% CI 0.33-0.55, P < 0.0001) and that treatment-naive patients who used CHM had the lowest HR. We also established that this association between reduction in HR and CHM was dose-dependent, and the longer CHM users received prescriptions, the lower the HR (P < 0.001).We supplied data from a relatively large population that spanned a significant amount of time. Our data suggests that the treatment of CLL with adjunctive CHM may have a substantial positive impact on mortality, especially for treatment-naive patients. Further research is needed to confirm whether there is a direct causal relationship between CHM and the outcomes displayed.
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Affiliation(s)
- Tom Fleischer
- From the Graduate Institute of Chinese Medicine (TF), College of Chinese Medicine, China Medical University; Department of Chinese Medicine (T-TC, M-FS, H-RY), China Medical University Hospital; School of Chinese Medicine (M-FS, H-RY); School of Post-baccalaureate Chinese Medicine (T-TC), China Medical University; Management Office for Health Data (J-HC), China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine (J-HC), College of Chinese Medicine, China Medical University; Division of Hematology and Oncology (C-YH), Department of Internal Medicine; Research Center for Traditional Chinese Medicine (H-RY), Department of Medical Research, China Medical University Hospital; Research Center for Chinese Medicine & Acupuncture (M-FS, H-RY), China Medical University, Taichung, Taiwan
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12
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Fleischer T, Chang T, Chiang J, Chang C, Hsieh C, Yen H. Adjunctive Chinese Herbal Medicine therapy improves survival of patients with chronic myeloid leukemia: a nationwide population-based cohort study. Cancer Med 2016; 5:640-8. [PMID: 26773538 PMCID: PMC4831282 DOI: 10.1002/cam4.627] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 11/27/2015] [Accepted: 12/01/2015] [Indexed: 12/27/2022] Open
Abstract
Despite good clinical results of current drugs, a good reason still exists to search for additional therapies for the management of Chronic Myeloid Leukemia (CML). Chinese Herbal Medicine (CHM) has thus far been overlooked by researchers and no data exists on the subject. We studied the impact of adjunctive CHM on the disease course of CML, using mortality as the major outcome measurement. We used the Taiwanese National Health Insurance Research Database to perform a nationwide population-based cohort study. Our study included CML patients diagnosed between 2000 and 2010. We matched groups according to age, sex, Charlson Comorbidity Index (CCI) score and use of imatinib, and compared the Hazard Ratios (HR) of CHM group and non-CHM users, as well as characterized trends of prescriptions used for treating CML. 1371 patients were diagnosed with CML in the years examined, of which 466 were included in to this study. We found that the HR of CHM group was significantly lower compared to non-CHM groups (0.32, 95% CI 0.22-0.48, P < 0.0001). We also established that this association between reduced HR was dose-dependent, and the longer CHM users received prescriptions, the lower the HR (P < 0.01). We also analyzed the most commonly used herbal products as well as the HR associated to their use, thus providing future research candidates. Our results supply a strong reason to assume that when administered by properly trained physicians, CHM may have a substantial positive impact on the management of CML.
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MESH Headings
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Databases, Factual
- Drugs, Chinese Herbal/therapeutic use
- Female
- Humans
- Kaplan-Meier Estimate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/epidemiology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Male
- Population Surveillance
- Proportional Hazards Models
- Taiwan/epidemiology
- Treatment Outcome
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Affiliation(s)
- Tom Fleischer
- Graduate Institute of Chinese MedicineCollege of Chinese MedicineChina Medical UniversityTaichungTaiwan
| | - Tung‐Ti Chang
- Department of Chinese MedicineChina Medical University HospitalTaichungTaiwan
- School of Chinese MedicineChina Medical UniversityTaichungTaiwan
- School of Post‐baccalaureate Chinese MedicineChina Medical UniversityTaichungTaiwan
| | - Jen‐Huai Chiang
- Management Office for Health DataChina Medical University HospitalTaichungTaiwan
- Graduate Institute of Integrated MedicineCollege of Chinese MedicineChina Medical UniversityTaichungTaiwan
- Research Center for Chinese Medicine and AcupunctureChina Medical UniversityTaichungTaiwan
| | - Ching‐Mao Chang
- Center for Traditional MedicineTaipei Veterans General HospitalTaipeiTaiwan
- Graduate Institute of Clinical MedicineGraduate Institute of Traditional Chinese MedicineCollege of MedicineChang Gung UniversityTaoyuanTaiwan
| | - Ching‐Yun Hsieh
- Division of Hematology and OncologyDepartment of Internal MedicineChina Medical University HospitalTaichungTaiwan
| | - Hung‐Rong Yen
- Department of Chinese MedicineChina Medical University HospitalTaichungTaiwan
- School of Chinese MedicineChina Medical UniversityTaichungTaiwan
- Research Center for Chinese Medicine and AcupunctureChina Medical UniversityTaichungTaiwan
- Research Center for Traditional Chinese MedicineDepartment of Medical ResearchChina Medical University HospitalTaichungTaiwan
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13
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Lad D, Malhotra P, Varma N, Sachdeva MS, Das A, Srinivasan R, Bal A, Khadwal A, Prakash G, Suri V, Kumari S, Jain S, Varma S. CLL: Common Leukemia; Uncommon Presentations. Indian J Hematol Blood Transfus 2014; 32:268-75. [PMID: 27429518 DOI: 10.1007/s12288-014-0488-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 12/03/2014] [Indexed: 12/25/2022] Open
Abstract
We report here a series of ten patients with uncommon presentations and associations of chronic lymphocytic leukemia (CLL) not reported hitherto or occasionally reported in literature. The first two cases describe unusual causes of abdominal distension in CLL and unusual sites infiltration by CLL. The next two cases illustrate occurrence of CLL in association with other hematological malignancies. Cases five and six describe unusual infections and their impact on CLL. Cases seven and eight depict associations of rare non-hematological autoimmune conditions with CLL. The last two cases describe transformation at unusual sites. This series of ten cases illustrates how a common leukemia like CLL can present in different forms and how despite so much progress in understanding of this leukemia so little is known of such presentations.
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Affiliation(s)
- Deepesh Lad
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Pankaj Malhotra
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Neelam Varma
- Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manupdesh Singh Sachdeva
- Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashim Das
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amanjit Bal
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Alka Khadwal
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Gaurav Prakash
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Vikas Suri
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Savita Kumari
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Sanjay Jain
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Subhash Varma
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
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14
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Rausch Osian S, Leal AD, Allmer C, Maurer MJ, Nowakowski G, Inwards DJ, Macon WR, Ehlers SL, Weiner GJ, Habermann TM, Cerhan JR, Thompson CA. Widespread use of complementary and alternative medicine among non-Hodgkin lymphoma survivors. Leuk Lymphoma 2014; 56:434-9. [PMID: 24745936 DOI: 10.3109/10428194.2014.916803] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
There are few studies examining complementary and alternative medicine (CAM) use and beliefs among non-Hodgkin lymphoma (NHL) survivors. Seven hundred and nineteen patients with NHL from the University of Iowa/Mayo Clinic Molecular Epidemiology Resource who completed the 3-year post-diagnosis questionnaire were included in this study. Altogether 636 (89%) reported ever using CAM, with 78% utilizing vitamins, 54% alternative therapies and 45% herbals. Female gender was associated with increased overall CAM use (p=0.0001) as well as use of vitamins (p=0.0001), herbals (p=0.006) and alternative therapy (p=0.0002) for cancer. Older age (>60) was associated with increased vitamin use (p=0.005) and decreased herbal use (p=0.008). Among users, 143 (20%) believed CAM assists healing, 123 (17%) believed CAM relieves symptoms, 122 (17%) believed CAM gives a feeling of control, 110 (15%) believed CAM assists other treatments, 108 (15%) believed CAM boosts immunity, 26 (4%) believed CAM cures cancer and 36 (5%) believed CAM prevents the spread of cancer.
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Affiliation(s)
- Sarah Rausch Osian
- Department of Emergency Medicine and the Center for Health Equity and Quality Research, University of Florida Jacksonville , Jacksonville, FL , USA
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15
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D'Arena G, Guariglia R, Pietrantuono G, Villani O, Martorelli MC, Mansueto G, Criscuolo C, Pierri T, Musto C, Musto P. More on spontaneous regression of chronic lymphocytic leukemia: two new cases and potential role of lamivudine in a further patient with advanced disease and hepatitis B virus infection. Leuk Lymphoma 2013; 55:1955-7. [PMID: 24152050 DOI: 10.3109/10428194.2013.858151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Giovanni D'Arena
- Unit of Hematology and Hemopoietic Stem Cell Transplantation, Centro di Riferimento Oncologico della Basilicata , Rionero in Vulture , Italy
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