Adjunctive Herbal Medicine Use and Chemotherapy-Induced Thrombocytopenia in Acute Myeloid Leukemia: A Nested Case-Control Study.

Background: Systemic chemotherapy increases the risk of thrombocytopenia in patients with acute myeloid leukemia (AML), which may lead to risk of bleeding and treatment interruption. Accumulating evidence indicates that traditional Chinese medicinal herbs (TCMH) may accelerate symptom relief. We hypothesized that integrating TCMH alongside standard treatment may decrease the risk of chemotherapy-induced thrombocytopenia (CIT) in patients with AML. Aim: To compare the likelihood of CIT among patients with AML who received adjunctive TCMH plus standard treatment and those who received standard treatment alone. Methods: This nested case-control study analyzed individuals aged 20 and older who were newly diagnosed with AML, had no pre-existing CIT, and were identified from the Taiwan National Health Insurance Research Database between 2002 and 2010. Five controls were then randomly matched to each CIT case from the remaining eligible cohort. All participants were followed until December 31, 2013. Conditional logistic regression was used to assess the association between TCMH use and risk of developing CIT. Results: TCMH was prescribed in 5.5% of cases and 20.6% of controls. Combining TCMH treatment with standard therapy substantially reduced risk of CIT (OR= 0.21; 95% CI:0.11-0.39). The inverse association between adjunctive TCMH use and CIT was strongest among patients who received TCMH for more than 180 days. Age and gender did not influence the association between TCMH use and the risk of CIT. Conclusion: The current research emphasized the importance of framing a collaborative healthcare model for AML persons, especially involvement of TCMH, to effectively manage the poor complications that arise from cancer therapy.