title: Integration of Chinese Herbal Medicine Therapy Improves Survival of Patients With Chronic Lymphocytic Leukemia: A Nationwide Population-Based Cohort Study.
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.
authors.affiliation: 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.
authors.forename: Tom
authors.initials: T
authors.lastname: Fleischer
authors.forename: Tung-Ti
authors.initials: TT
authors.lastname: Chang
authors.forename: Jen-Huai
authors.initials: JH
authors.lastname: Chiang
authors.forename: Ching-Yun
authors.initials: CY
authors.lastname: Hsieh
authors.forename: Mao-Feng
authors.initials: MF
authors.lastname: Sun
authors.forename: Hung-Rong
authors.initials: HR
authors.lastname: Yen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015897:Comorbidity; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D004365:Drugs, Chinese Herbal