title: Adjunctive Chinese Herbal Medicine therapy improves survival of patients with chronic myeloid leukemia: a nationwide population-based cohort study.
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.
authors.affiliation: Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Tom
authors.initials: T
authors.lastname: Fleischer
authors.affiliation: Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.|School of Chinese Medicine, China Medical University, Taichung, Taiwan.|School of Post-baccalaureate Chinese Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Tung-Ti
authors.initials: TT
authors.lastname: Chang
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.|Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung, Taiwan.
authors.forename: Jen-Huai
authors.initials: JH
authors.lastname: Chiang
authors.affiliation: Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Graduate Institute of Clinical Medicine, Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ching-Mao
authors.initials: CM
authors.lastname: Chang
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ching-Yun
authors.initials: CY
authors.lastname: Hsieh
authors.affiliation: Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.|School of Chinese Medicine, China Medical University, Taichung, Taiwan.|Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung, Taiwan.|Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hung-Rong
authors.identifier: http://orcid.org/0000-0002-0131-1658
authors.initials: HR
authors.lastname: Yen
mesh_terms: D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D016208:Databases, Factual; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D011159:Population Surveillance; D016016:Proportional Hazards Models; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D004365:Drugs, Chinese Herbal
keywords: CML; Chinese herbal medicine; NHIRD; Taiwan; leukemia