Integrative Clinical Efficacy For The Treatment Of Myelodysplastic Syndrome

Objective:To discuss the clinical efficacy of the combined treatment of traditional Chinese Medicine and western medicine for myelodysplastic syndrome (MDS), and try to find a treatment protocol of better efficacy, less side effects, a longer survival and better quality of life, which expect to choose ideal treatment schemes for elder MDS patients or young patients who have lost the chance of hematopoietic stem cell transplantation.Methods:Review 32 cases of MDS from Hematology dept. of the Oriental Hospital of Beijing University of Chinese Medicine during 2000 to 2010, who were ineffective patients on using only western medicine. "Reinforcing spleen and kidney, nourishing and activating blood" traditional Chinese medicine, an agreed prescription of our department with modification on syndrome differentiation, one dose each day for persistent use. All the herbs are taken from Dongfang Hospital, and decoted there. They're divided into the chinese medicine + EPO group (treatment group) and chinese medicine group (control group) to review and analyze the clinical symptoms, efficacy, blood transfusion, the changes of blood cells, survival, etc. Besides, compare median survival time with survival rate for 5 cases of chemotherapy group and 10 cases of non-chemotherapy group (the high-risk group of MDS patients).Results:1.The herbal medicine of reinforcing spleen and kidney, nourishing and activating blood can significantly improve the clinical symptoms (P<0.05), while no obvious improvement in combination with EPO. 2. There is no marked difference between treatment group and control group on the clinical efficacy (P>0.05), but treatment group on reducing blood transfusion volume and extending blood transfusion intervals are obviously superior to control group.3. EPO had no effect for leukocyte and platelet count of MDS patients.4. Treatment group on median survival time, median progression-free survival time and survival rate surpassed control group, but there is no statistical significance between their difference (P>0.05).5. For the high-risk group of MDS patients with non-chemotherapy group, the median survival time was significantly better than the chemotherapy group (P<0.05), the non-chemotherapy group,1-year survival rate,2-year survival rate,3-year survival rate,5-year survival rates were higher than chemotherapy group, but the result of statistical treatment, no apparent difference between the two groups (P>0.05), which may relate to being short of case.Conclusion:1. It proved that the herbal medicine of reinforcing spleen and kidney, nourishing and activating blood have the therapeutic effect of improving symptoms for patients with MDS. 2. TCM of reinforcing spleen and kidney, nourishing and activating blood combined with EPO compard with pure TCM treatment, the previous one significantly extend transfusion-cycle and reduce transfusion volume for MDS patients, thus not only improve their quality of life, but less severe side effect. 3.It can prolong median survival time and improve quality of life for high-risk group of MDS to use non-chemotherapy scheme, but still await to further accumulate cases in the future to obtain more objective and accurate data to see if can improve survival rate of 3-year or 5-year. Therefore, the herbal medicine combined with EPO is an ideal treatment schemes for elder MDS patients or young patients who have lost the chance of hematopoietic stem cell transplantation. Traditional-western Combined Treatment has a good Clinical Efficacy in MDS.