|Table of Contents|

Treatment of acute lymphoblastic leukemia secondary to multiple myeloma with traditional Chinese medicine:One case and literature review

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 17
Page:
3252-3257
Research Field:
Publishing date:

Info

Title:
Treatment of acute lymphoblastic leukemia secondary to multiple myeloma with traditional Chinese medicine:One case and literature review
Author(s):
CHE Minglu; ZHANG Yayue; YAN Xiang; ZHAO Qian; XU Yamei
Department of Hematology and Oncology，Dongzhimen Hospital，Beijing University of Chinese Medicine,Beijing 100700,China.
Keywords:
multiple myeloma; traditional Chinese medicine; lenalidomide; SPM; refractory acute lymphoblastic leukemia
PACS:
R733.3
DOI:
10.3969/j.issn.1672-4992.2023.17.020
Abstract:
Objective:This case report verifies the remarkable efficacy of compound Zhebei granules in the treatment of acute leukemia,in order to provide reference for the clinical diagnosis and treatment of integrated Chinese and western medicine.Methods:This paper reported a case of secondary acute leucogenous leukemia in an elderly patient with multiple myeloma who sustained CR for 4 years.Combined with relevant literature at home and abroad,the pathogenesis of lenalidomide secondary tumor was analyzed,and the syndrome differentiation of refractory acute lymphoblastic leukemia treated by traditional Chinese medicine was analyzed.Results:After traditional Chinese medicine alone,flow cytometry showed that abnormal naive cells decreased from 41.3%(November 2021) to 1.25%(February 2023).The mechanism of secondary SPM associated with long-term lenalidomide use was summarized,but overall the benefit of treatment outweighed the risk of SPM,and most patient deaths were due to disease progression rather than SPM.Conclusion:This case suggests that clinicians should follow up patients regularly when using immunomodulatory drugs to be alert to the occurrence of SPM.Compound Zhebei granules take "Relieve phlegm" and " Promote blood circulation" as the treatment principle,and a large number of clinical studies have confirmed that compound Zhebei granules combined with chemotherapy can reduce the clinical symptoms of patients with acute leukemia and improve the clinical remission rate.

References:

[1]中国医师协会血液科医师分会,中华医学会血液学分会.中国多发性骨髓瘤诊治指南(2022年修订)［J］.中华内科杂志,2022,61(05):480-487. Hematology Branch of Chinese Medical Doctor Association,Hematology Branch of Chinese Medical Association.Chinese Guidelines for diagnosis and treatment of multiple myeloma(revised 2022) ［J］.Chinese Journal of Internal Medicine,2022,61(05):480-487.
[2]TZENG HE,LIN CL,TSAI CH,et al.Time trend of multiple myeloma and associated secondary primary malignancies in Asian patients:a Taiwan population-based study［J］.PLoS One，2013,8(7):e68041.
[3]YANG J,TEREBELO HR,ZONDER JA.Secondary primary malignancies in multiple myeloma:an old NEMESIS revisited［J］.Adv Hematol,2012,2012:801495.
[4]POH C,KEEGAN T,ROSENBERG AS.Second primary malignancies in multiple myeloma:A review［J］.Blood Rev,2021,46:100757.
[5]王珺,陈信义,董青,等.难治性急性白血病中西医诊疗研究进展［J］.世界中医药,2013,8(08):979-984. WANG J,CHEN XY,DONG Q,et al.Advances in the diagnosis and treatment of refractory acute leukemia ［J］.World of Traditional Chinese Medicine,2013,8(08):979-984.
[6]吴心语,李和根.中医扶正治疗肺癌对免疫调节作用的研究进展［J］.世界中西医结合杂志,2022,17(08):1691-1696. WU XY,LI HG.Research progress of the effect of traditional Chinese medicine on the immune regulation of lung cancer ［J］.World Journal of Integrated Traditional Chinese and Western Medicine,202,17(08):1691-1696.
[7]苏鑫.浙贝黄芩汤对淋巴细胞白血病小鼠骨髓微环境炎性因子的影响［D］.北京：北京中医药大学,2020. SU X.Effects of Zhebei Huangqin Decoction on bone marrow microenvironmental inflammatory factors in mice with lymphocytic leukemia ［D］.Beijing:Beijing University of Chinese Medicine,2020.
[8]褚雨霆.复方浙贝颗粒对难治性急性白血病外周血Treg细胞及骨髓细胞影响的临床观察［D］.北京：北京中医药大学,2012. CHU YT.Clinical observation of the effect of Compound Zhebei Granules on peripheral blood treg cells and bone marrow cells in refractory acute leukemia ［D］.Beijing:Beijing University of Chinese Medicine,2012.
[9]李雅竹.浙贝黄芩汤干预Wip1-p38MAPK-p53通路逆转白血病细胞耐药的机制［D］.北京：北京中医药大学,2021. LI YZ.The mechanism of Zhebei Huangqin Decoction interfering Wip1-p38MAPK-p53 pathway to reverse drug resistance in leukemia cells ［D］.Beijing:Beijing University of Chinese Medicine,2021.
[10]孙红,李凌云,周湘明,等.莪术醇对体外多发性骨髓瘤细胞生物学行为的影响［J］.中国中西医结合杂志,2016,36(10):1229-1234. SUN H,LI LY,ZHOU XM,et al.Effects of curcuma curcumin on the biological behavior of multiple myeloma cells in vitro［J］.Chinese Journal of Integrated Traditional and Western Medicine,2016,36(10):1229-1234.
[11]王雪莲,孟亚红,孙丽华.人参皂苷Rh4调控ERK和AKT信号通路对T-ALL细胞凋亡的影响［J］.中国免疫学杂志,2021,37(10):1186-1190. WANG XL,MENG YH,SUN LH.Effect of ginsenoside Rh4 on apoptosis of T-ALL cells ［J］.Chinese Journal of Immunology,2021,37(10):1186-1190.
[12]王河春.温补脾肾法对急性白血病化疗后临床观察及免疫球蛋白、白介素-6的影响［D］.郑州：河南中医药大学,2019. WANG HC.Clinical observation and effect of warming spleen and kidney on acute leukemia after chemotherapy and immunoglobulin and interleukin-6［D］.Zhengzhou:Henan university of Chinese medicine,2019.
[13]PALUMBO A,BRINGHEN S,KUMAR SK,et al.Second primary malignancies with lenalidomide therapy for newly diagnosed myeloma:a meta-analysis of individual patient data［J］.Lancet Oncol,2014,15(3):333-342.
[14]LANDGREN O,MAILANKODY S.Update on second primary malignancies in multiple myeloma:a focused review［J］.Leukemia,2014,28(7):1423-1426.
[15]THOMAS A,MAILANKODY S,KORED N,et al.Second malignancies after multiple myeloma:from 1960s to 2010s［J］.Blood,2012,119:2731-2937.
[16]LIU Y,HOU HA,QIU H,et al.Is the risk of second primary malignancy increased in multiple myeloma in the novel therapy era? A population-based,retrospective cohort study in Taiwan［J］.Sci Rep,2020,10(1):14393.
[17]RIFKIN RM,ABONOUR R,SHAH JJ,et al.Connect MM- the multiple myeloma disease registry:incidence of second primary malignancies in patients treated with lenalidomide［J］.Leuk Lymphoma,2016,57(9):2228-2231.
[18]MAILANKODY S,PFEIFFER RM,KRISTINSSON SY,et al.Risk of acute myeloid leukemia and myelodysplastic syndromes after multiple myeloma and its precursor disease(MGUS)［J］.Blood,2011,118:4086-4092.
[19]陈信义,杨文华.中医血液病学（全国中医药行业高等教育“十三五”创新教材）［M］.北京:中国中医药出版社,2019:207-215. CHEN XY,YANG WH.Hematology of traditional Chinese medicine ［M］.Beijing:China Traditional Chinese Medicine Press,2019:207-215.
[20]李冬云,陈信义,侯丽,等.从痰瘀论治难治性白血病［J］.中国中医基础医学杂志,2009,15(05):365-367. LI DY,CHEN XY,HOU L,et al.Treatment of refractory leukemia from phlegm stasis ［J］.Chinese Journal of Basic Medicine of Traditional Chinese Medicine,2009,15(05):365-367.
[21]全日城,郭小青,周霭祥,等.周霭祥治疗血液病思想探析［J］.中华中医药杂志,2022,37(08):4507-4509. QUAN RC,GUO XQ,ZHOU AX,et al.Discussion on Zhou Aixiang's thought of treating blood diseases ［J］.Chinese Journal of Traditional Chinese Medicine,2022,37(08):4507-4509.
[22]赵欢.复方浙贝颗粒逆转小鼠急性淋巴细胞白血病多药耐药的研究［D］.北京：北京中医药大学,2020. ZHAO H.Study of Compound Zhebei Granules reversing multidrug resistance in mice with acute lymphoblastic leukemia ［D］.Beijing:Beijing University of Chinese Medicine,2020.

Memo

Memo:
National Natural Science Foundation of China（No.81703903）;国家自然科学基金青年科学基金项目(编号：81703903)
Last Update: 2023-07-31