Lindsay Julian, Kabir Masrura, Gilroy Nicole, Dyer Gemma, Brice Lisa, Moore John, Greenwood Matthew, Hertzberg Mark, Gottlieb David, Larsen Stephen R, Hogg Megan, Brown Louisa, Huang Gillian, Tan Jeff, Ward Christopher, Kerridge Ian
Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Westmead Hospital, Sydney, New South Wales, Australia.
Cancer Med. 2016 Dec;5(12):3606-3614. doi: 10.1002/cam4.889. Epub 2016 Oct 27.
In addition to prescribed conventional medicines, many allogeneic hematopoietic stem cell transplant (HSCT) survivors also use complementary and alternative medical therapies (CAM), however, the frequency and types of CAMs used by allogeneic HSCT survivors remain unclear. Study participants were adults who had undergone an allogeneic HSCT between 1st January 2000 and 31st December 2012. Participants completed a 402-item questionnaire regarding the use of CAM, medical complications, specialist referrals, medications and therapies, infections, vaccinations, cancer screening, lifestyle, and occupational issues and relationship status following stem cell transplantation. A total of 1475 allogeneic HSCT were performed in the study period. Of the 669 recipients known to be alive at study sampling, 583 were contactable and were sent study packs. Of 432 participants who returned the completed survey (66% of total eligible, 76% of those contacted), 239 (54.1%) HSCT survivors used at least one form of CAM. These included dietary modification (13.6%), vitamin therapy (30%), spiritual or mind-body therapy (17.2%), herbal supplements (13.5%), manipulative and body-based therapies (26%), Chinese medicine (3.5%), reiki (3%), and homeopathy (3%). These results definitively demonstrate that a large proportion of HSCT survivors are using one or more form of CAM therapy. Given the potential benefits demonstrated by small studies of specific CAM therapies in this patient group, as well as clearly documented therapies with no benefit or even toxicity, this result shows there is a large unmet need for additional studies to ascertain efficacy and safety of CAM therapies in this growing population.
除了使用处方常规药物外,许多异基因造血干细胞移植(HSCT)幸存者还使用补充和替代医学疗法(CAM),然而,异基因HSCT幸存者使用CAM的频率和类型仍不清楚。研究参与者为2000年1月1日至2012年12月31日期间接受异基因HSCT的成年人。参与者完成了一份包含402个项目的问卷,内容涉及CAM的使用、医学并发症、专科转诊、药物和治疗、感染、疫苗接种、癌症筛查、生活方式、职业问题以及干细胞移植后的关系状况。在研究期间共进行了1475例异基因HSCT。在研究抽样时已知存活的669名接受者中,有583名可以联系上并收到了研究包。在432名返回完整调查问卷的参与者中(占总合格人数的66%,占被联系者的76%),239名(54.1%)HSCT幸存者至少使用了一种形式的CAM。这些包括饮食调整(13.6%)、维生素疗法(30%)、精神或身心疗法(17.2%)、草药补充剂(13.5%)、手法和身体疗法(26%)、中药(3.5%)、灵气疗法(3%)和顺势疗法(3%)。这些结果明确表明,很大一部分HSCT幸存者正在使用一种或多种形式的CAM疗法。鉴于针对该患者群体的特定CAM疗法的小型研究显示出潜在益处,以及有明确记录显示某些疗法无益处甚至有毒性,这一结果表明,对于进一步研究以确定CAM疗法在这一不断增长的人群中的疗效和安全性,存在很大的未满足需求。