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Journal of Traditional Chinese Medicine >

2025 , Vol. 45 >Issue 1: 152 - 159

DOI: https://doi.org/10.19852/j.cnki.jtcm.2025.01.014

Effect of add-on therapy with Traditional Chinese Medicine on the survival of patients with anemic lower-risk myelodysplastic syndromes in the real-world setting: a retrospective study

  • Weiying QU ,
  • Xyucheng TAN ,
  • Yihan ZHAO ,
  • Yanan YU ,
  • Lin ZHAO
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  • 1 Department of Hematology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200120, China
    2 Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
    3 Department of Hematology and CHEN Jianjie National Famous Old Chinese Medicine Expert Inheritance Studio, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200120, China

Received date: 2023-06-16

  Accepted date: 2023-12-23

  Online published: 2025-01-10

Supported by

China Academy of Chinese Medical Sciences Innovation Fund: Precise Positioning Decision-making Platform for Clinical Trials of Traditional Chinese Medicine Based on Predicition Model(CI2021A04707);The Fundamental Research Funds for the Central Public Welfare Research Institutes: Research on Traditional Chinese Medicine Syndrome Differentiation-based a Bayesian Decision Model of Basket Trial(ZZ13-YQ-076);The Fifth Batch of National TCM Clinical Outstanding Talent Training Program. The Fund of National Natural Science Foundation of China (Youth Science Foundation Project): Effect of Compound Shenlu Granule on Apoptosis of CD34+ Cells in Lower-risk Myelodysplastic Syndromes Bone Marrow based on p38 Mitogen-activated Protein Kinase Pathway(81403233)

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Abstract

OBJECTIVE: To illustrate the effect of add-on therapy of Traditional Chinese Medicine (TCM) on the long-term survival of anemic lower-risk myelodysplastic syndromes (LR-MDS) patients.

METHODS: In this study, we conducted a retrospective analysis of the data of patients with LR-MDS who were identified from Shuguang Hospital between January 2006 and June 2020. The Kaplan-Meier method was used to calculate overall survival (OS), while the Cox model was employed to analyze prognostic factors of long-term survival. A total of 162 patients who met the inclusion criteria were divided into two groups: the TCM group (n = 78) or the non-TCM group (n = 84).

RESULTS: There were no significant differences in baseline characteristics. The cumulative survival rate of the TCM group was significantly higher than that of the non-TCM group [log-rank P = 0.029, hazard ratio (HR) = 0.484, 95% confidence interval (CI) (0.249, 0.942), P < 0.05]. Patients with longer TCM treatment appeared to have better OS (≥ 12 months vs < 12 months); [HR, 0.166 95% CI (0.055, 0.508), P < 0.001)]. According to the Cox model analysis, the combination of TCM and conventional Western Medicine may be a protective factor affecting the long-term survival of LR-MDS patients [HR = 0.509, 95% CI, (0.261, 0.993), P = 0.048]. The hematologic improvement erythroid response (HI-E) rate of the TCM group was significantly higher than that of the non-TCM group (69.23% vs 52.38%; P = 0.028). However, the duration of HI-E and cases of disease progression after HI-E did not significantly differ from the non-TCM group (P > 0.05).

CONCLUSIONS: The integration of TCM and Western Medicine has the potential to extend the OS of LR-MDS patients when compared to the use of Western Medicine alone.

Key words： lower-risk myelodysplastic syndromes; medicine, Chinese traditional; overall survival; retrospective studies

Cite this article

Weiying QU , Xyucheng TAN , Yihan ZHAO , Yanan YU , Lin ZHAO . Effect of add-on therapy with Traditional Chinese Medicine on the survival of patients with anemic lower-risk myelodysplastic syndromes in the real-world setting: a retrospective study[J]. Journal of Traditional Chinese Medicine, 2025 , 45(1) : 152 -159 . DOI: 10.19852/j.cnki.jtcm.2025.01.014

References

1. Zeidan AM, Linhares Y, Gore SD. Current therapy of myelodysplastic syndromes. Blood Rev 2013; 27: 243-59.
2. Bejar R, Steensma DP. Recent developments in myelodysplastic syndromes. Blood 2014; 124: 2793-803.
3. Fenaux P, Adès L. How we treat lower-risk myelodysplastic syndromes. Blood 2013; 121: 4280-286.
4. Hiwase DK, Kutyna MM, Chhetri R. Transfusion dependency is associated with inferior survival even in very low and low risk IPSS-R patients. Blood 2013; 122: 1518.
5. Merz A, Germing U, Kobbe G, et al. EASIX for prediction of survival in lower-risk myelodysplastic syndromes. Blood Cancer 2019; 9: 85.
6. Carraway HE, Saygin C. Therapy for lower-risk MDS. Hematology Am Soc Hematol Educ Program 2020; 2020: 426-33.
7. Santini V, Almeida A, Giagounidis A, et al. A randomized phase Ⅲ study of lenalidomide versus placebo in RBC transfusion-dependent patients with lower-risk non-del(5q) myelodysplastic syndromes and ineligible for or refractory to erythropoiesis-stimulating agents. J Clin Oncol 2016; 34: 2988-96.
8. Toma A, Kosmider O, Chevret S, et al. Lenalidomide with or without erythropoietin in transfusion-dependent erythropoiesis-stimulating agent-refractory lower-risk MDS without 5q deletion. Leukemia 2016; 30: 897-905.
9. Shenoy N, Vallumsetla N, Rachmilewitz E, Verma A, Ginzburg Y. Impact of iron overload and potential benefit from iron chelation in low-risk myelodysplastic syndrome. Blood 2014; 124: 873-81.
10. Zhao MM, Zhang Y, Li LS, Zi KY, Bo L. Efficacy and safety of Danggui Buxue Decoction in combination with western medicine treatment of anemia for renal anemia: a systematic review and Meta-analysis. Ann Transl Med 2017; 5: 136-44.
11. Yang M, Chan GC, Deng R, et al. An herbal decoction of Radix Astragali and Radix Angelicae sinensis promotes hematopoiesis and thrombopoiesis. J Ethnopharmacol 2009; 124: 87-97.
12. Linn YC, Lu J, Lim LC, Sun H, Sun J, Zhou YM. Traditional Chinese herbal medicine in the supportive management of patients with chronic cytopaenic marrow diseases e A phase Ⅰ/Ⅱ clinical study. Complement Ther Clin Pract 2011; 17: 152-6.
13. Sun SZ, Ma R, Hu XM, et al. Karyotype and DNA-methylation responses in myelodysplastic syndromes following treatment with traditional Chinese formula containing arsenic. Evid Based Complement Alternat Med 2012: 2012: 969476.
14. Vardiman J. The classification of MDS: from FAB to WHO and beyond. Leuk Res 2012; 36: 1453-8.
15. Cheson BD, Greenberg PL, Bennett JM, et al. Clinical application and proposal for modification of the International Working Group (IWG) response criteria in myelodysplasia. Blood 2006; 108: 419-25.
16. Volpe VO, Komrokji RS. Treatment options for lower-risk myelodysplastic syndromes. Where are we now? Ther Adv Hematol 2021: 12: 2040620720986641.
17. Expert Committee on Myelodysplastic Syndromes of Hematology Committee of China Association of Integrative Medicine. Expert consensus on the diagnosis and treatment of Myelodysplastic Syndrome with Integrated Traditional Chinese and Western Medicine. Chin J Integrated Tradit Chin West Med 2018; 038: 914-20.
18. Liu X, Wang P, Xia YY, et al. Observation on the efficacy of low-risk myelodysplastic syndrome in the adjuvant treatment of kidney and spleen. Xian Dai Zhong Xi Yi Jie He Za Zhi 2015; 33: 3680-2.
19. Shen XH, Sun WL, Bao JZ, et al. Clinical observation on the treatment of myelodysplastic syndrome in the detoxification of spleen and kidney tonifying. Shanghai Zhong Yi Yao Za Zhi 2012; 26: 34-7.
20. Fenaux P, Ades L. How we treat lower-risk myelodysplastic syndromes. Blood 2013; 121: 4280-6.
21. Steensma DP. Graphical representation of clinical outcomes for patients with myelodysplastic syndromes. Leuk Lymphoma 2016; 57: 17-20.
22. Anna WG, Krzysztof M, Rafa? M, et al. Red blood cell transfusion dependency and hyperferritinemia are associated with impaired survival in patients diagnosed with myelodysplastic syndromes: results from the first polish MDS-PALG registry. Adv Clin Exp Med 2016; 25: 633-41.
23. Mayra BL, Sarah RR, Thomas S, Kulasekararaj AG, Matos JE, Tang D. Association between red blood cell transfusion dependence and burden in patients with myelodysplastic syndromes: a systematic literature review and Meta-analysis. Eur J Haematol 2021; 107: 3-23.
24. Harnan S, Ren S, Gomersall T, et al. Association between transfusion status and overall aurvival in patients with myelodysplastic ayndromes: a systematic literature review and Meta-analysis. Acta Haematol 2016; 136: 23-42.
25. Platzbecker U, Symeonidis A, Oliva EN, et al. A phase 3 randomized placebo-controlled trial of darbepoetin alfa in patients with anemia and lower-risk myelodysplastic syndromes. Leukemia 2017; 31: 1944-50.
26. Fenaux P, Santini V, Spiriti MAA, et al. A phase 3 randomized, placebo-controlled study assessing the efficacy and safety of epoetin-alpha in anemic patients with low-risk MDS. Leukemia 2018; 32: 2648-58.
27. Wang DX, Xu YG, Du Y, et al. Arsenic concentration in peripheral blood is correlated with efficacy of a Traditional Chinese Medicine regimen containing realgar for the treatment of myelodysplastic syndrome. J Tradit Chin Med 2021; 41: 630-5.
28. Chen WD, Huang HS, Su YC, et al. The characteristics and prescription patterns of Chinese herbal medicine in clinical practice for the treatment of anemia. Taiwan J Obstet Gynecol 2018; 57: 570-7.
29. Dang ZB, Liu XL, Wang XH, et al. Comparative effectiveness and safety of Traditional Chinese Medicine supporting Qi and enriching blood for cancer related anemia in patients not receiving chemoradiotherapy: a Meta-analysis and systematic review. Drug Des Devel Ther 2019; 13: 221-30.
30. Yang FX, Wang Y, Xia PF, et al. Review of chemical constituents,pharmacological effects and clinical applications of Danggui Buxue decoction and prediction and analysis of its Q-markers. Zhong Guo Zhong Yao Za Zhi 2021; 46: 2677-85.
31. Hu X, Lu H, Deng YL, Wan Q, Yie SM. Effect of rat medicated serum containing Zuo Gui Wan and/or You Gui Wan on the differentiation of stem cells derived from human first trimester umbilical cord into oocyte-like cells in vitro. Evid Based Complement Alternat Med 2015; Article ID 825805.
32. Huang JJ, Dai D, Shen XH. Study on the mechanism of Astragalus dangshen in the treatment of myelodysplastic syndrome based on network pharmacology. Zhong Yi Lin Chuang Yan Jiu 2021; 13: 6.
33. Zheng KY, Choi RC, Xie HQ, et al. The expression of erythropoietin triggered by Danggui Buxue Tang, a Chinese herbal decoction prepared from Radix Astragali and Radix Angelicae Sinensis, is mediated by the hypoxia-inducible factor in cultured HEK293T cells. J Ethnopharmacol 2010; 132: 259-67.
34. Gao QT, Cheung JK, Choi RC, et al. A Chinese herbal decoction prepared from Radix Astragali and Radix Angelicae Sinensis induces the expression of erythropoietin in cultured Hep3B cells. Planta Med 2008; 74: 392-5.
35. Huang GC, Chen SY, Tsai PW, et al. Effects of Dang-GuiBu-Xue-Tang, an herbal decoction, on iron uptake in iron-deficient anemia. Drug Des Dev Ther 2016; 10: 949-57.
36. Yang X, Huang CG, Du SY, et al. Effect of Danggui Buxue Tang on immune-mediated aplastic anemia bone marrow proliferation mice. Phytomedicine 2014; 21: 640-6.
37. Choi EJ, Lee JH, Park HS, et al. Androgen therapy for patients with lower-risk myelodysplastic syndrome and significant cytopenia: a retrospective study. Br J Haematol 2019; 187: e4-7.
38. Copley GB, Schnatter AR, Armstrong TW, et al. Hospital-Based case-control study of MDS subtypes and benzene exposure in Shanghai. J Occup Environ Med 2017; 59: 349-55.
39. Lee YJ, Park SW, Lee IH, et al. Report on outcomes of hypomethylating therapy for analyzing prognostic value of Revised International Prognostic Scoring System for patients with lower-risk myelodysplastic syndromes. Ann Hematol 2016; 95: 1795-804.
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