title: Improved Survival With Integration of Chinese Herbal Medicine Therapy in Patients With Acute Myeloid Leukemia: A Nationwide Population-Based Cohort Study.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: 1 Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Tom
authors.initials: T
authors.lastname: Fleischer
authors.affiliation: 1 Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan.|2 Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Tung-Ti
authors.initials: TT
authors.lastname: Chang
authors.affiliation: 3 Health Data Management Office, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Jen-Huai
authors.initials: JH
authors.lastname: Chiang
authors.affiliation: 1 Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan.|2 Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Mao-Feng
authors.initials: MF
authors.lastname: Sun
authors.affiliation: 1 Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan.|2 Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Hung-Rong
authors.initials: HR
authors.lastname: Yen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D027885:Astragalus propinquus; D015331:Cohort Studies; D000529:Complementary Therapies / Q000379:methods; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods; D008875:Middle Aged; D016016:Proportional Hazards Models; D027561:Salvia miltiorrhiza; D055815:Young Adult
chemical_list: D004365:Drugs, Chinese Herbal; C028972:dan-shen root extract; C027492:Huang Qi
keywords: Chinese medicine; NHIRD; Taiwan; acute myeloid leukemia; leukemia