Management of Chemotherapy Side Eects

in Childhood Leukemia: Persian Medicine

Experience

Babak Daneshfard1,2, Amir Mohammad Jaladat3, Majid Nimrouzi3

1 Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid

Beheshti University of Medical Sciences, Tehran, Iran

2 Persian Medicine Network (PMN), Universal Scientic Education and Research Network (USERN), Tehran, Iran

3 Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz

University of Medical Sciences, Shiraz, Iran

GMJ.2023;12:e2926

www.gmj.ir

 Correspondence to:

Babak Daneshfard, National Research Institute of Tu-

berculosis and Lung Diseases (NRITLD), Masih Dane-

shvari Hospital, Daar-Abad, Niavaran, Tehran, Iran

Telephone Number: +98 (21) 27128867

Email Address: babakdaneshfard@gmail.com

Received 2023-01-30

Revised 2023-04-16

Accepted 2023-04-17

Dear editor,

Leukemia is the most common (up to 40%)

cancer in children among which, acute

lymphoblastic leukemia accounts for about

80% of them. Although the annual incidence

rate of leukemia is 39 per million children, it

has had an increasing trend during the last de-

cades [1,2].

Various side eects have been reported as

complications of cancer treatment in chil-

dren including gastrointestinal disorders,

oral lesions, peripheral neuropathy, pulmo-

nary infections, neutropenia, hepatotoxicity,

cardiotoxicity, endocrine disturbances, and

thromboembolic complications. These side

eects not only decrease the quality of life but

also negatively aects the response rate of the

treatment [3].

Nowadays, various complementary and al-

ternative medicines are integratively used in

an evidence-based manner in order to shorten

the disease course and decrease treatment-in-

duced complications [4]. Although few stud-

ies have investigated the ecacy of comple-

mentary methods in children with cancer,

integrative pediatric oncology is an emerging

eld that explores the use of complementary

and alternative medicine (CAM) in pediatric

oncology [5].

Persian medicine (PM) is one of the oldest

comprehensive schools of medicine with

thousands-of-years history [6]. In addition

to its preventive health measures which are

considered as its important basics, PM recom-

mends simple useful therapeutic recommen-

dations for various medical conditions includ-

ing cancer [7].

Many of these treatments for cancer patients

have been investigated through clinical trials

with promising results [8,9]. For instance, we

have examined the PM therapeutic approach

for the management of chemotherapy induced

neutropenia and liver toxicity in pediatric leu-

kemic patients.

Chemotherapy induced neutropenia (CIN) is

one of the most common and most serious

complications of cancer treatment. This he-

matologic toxicity predisposes the patients to

other complications including various infec-

tious diseases. In a randomized placebo-con-

trolled trial, we investigated the ecacy of a

natural syrup from chamomile to control this

side eect in pediatric leukemic patients [10].

Comparison of the absolute neutrophil count

(ANC) between the groups revealed a signif-

icant improvement and faster recovery from

neutropenia in the treatment group during and

after one month of concomitant complemen-

tary treatment.

Another frequent complication of chemother-

apy in children is liver toxicity. In addition to

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Daneshfard B, et al. Managing Chemotherapy Side Eects with Persian Medicine

2GMJ.2023;12:e2926

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having no eective preventive measure, this

side eect could be a hindrance of a success-

ful chemotherapy. In line with our clinical ex-

perience in pediatric oncology, we reported a

successful treatment of a 5-year-old girl with

acute lymphocytic leukemia who had been

presented with chemotherapy-induced liver

injury. PM treatment period included 15 days

consumption of Nogho-e-Favakeh or soaked

fruits (a juice consisted of prune, tamarind,

brown sugar, and manna of Hedysarum) fol-

lowed by one-month oxymel and chicory dis-

tilled water complementary to her chemother-

apy regimen. Improvement of liver enzymes

(SGOT and SGPT) continued all through the

3-month follow-up reaching to the normal

range [11].

Fever is also a common complication in chil-

dren with cancer as a result of either their dis-

ease or the received chemotherapy drugs. An

interesting trial on pediatric cancer patients

with febrile neutropenia revealed that using

a topical oil from Viola odorata (rubbing 20

drops of oil on periumbilical area) not only

could dramatically decrease the temperature

only after 30 minutes, but also decrease the

need for rescue treatment with antipyretic

medication [12]. In fact, this nding is prom-

ising for further investigations on the ecacy

of topical dosage forms in cancer patients.

All in all, it seems that there is a great po-

tential in PM for clinical management of

cancer patients in order to (at least) decrease

their complications and consequently, in-

crease their quality of life. Future investi-

gations are guaranteed to evaluate the safe-

ty and ecacy of these recommendations.

[GMJ.2023;12:e2926]

DOI:10.31661/gmj.v12i0.2926

Conict of Interest

None.

Keywords: Chemotherapy; Leukemia; Inte-

grative Oncology; Pediatrics; Persian Medi-

cine

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