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Emerging Role of Integrative Medicine in Hematologic Malignancies: a Literature Review and Update on Current Trends in Complementary Medical Practices in Hematologic Cancers

  • Health Economics (N Khera, Section Editor)
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Abstract

Purpose of Review

This review discusses the emerging role of integrative hematology. It reinforces the growing interest of CAM among patients, and the importance of provider knowledge and participation in discussions with patients about the subject. The main question asked in this review, “Is there evidence for the use of integrative medicine practices in the field of malignant hematology?” is answered by examining current research and providing relevant summaries.

Recent Findings

Data suggests that practices such as meditative movement, exercise, nutrition and supplements and touch therapy can be used for symptom alleviation, preventive measures, and novel treatment development.

Summary

Integrative hematology is a needed part of complete patient care, and it is the role of providers to be knowledgeable and open to ensure patients are engaging in practices that are evidence-informed and safe. More studies are needed in the field in order to make concrete and robust recommendations.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Rohan EA, Miller N, Bonner F, Fultz-Butts K, Pratt-Chapman ML, Alfano CM, et al. Comprehensive cancer control: promoting survivor health and wellness. Cancer Causes Control. 2018;29:1277–85.

    Article  PubMed  Google Scholar 

  2. Qureshi M, Zelinski E, Carlson LE. Cancer and complementary therapies: current trends in survivors’ interest and use. Integr Cancer Ther. 2018;17(3):844–53.

    Article  PubMed  PubMed Central  Google Scholar 

  3. • Kline RM, Arora NK, Bradley CJ, Brauer ER, Graves DL, Lunsford NB, et al. Long-term survivorship care after cancer treatment - summary of a 2017 National Cancer Policy Forum workshop. J Natl Cancer Inst. 2018. A study sponsored by the National Cancer Policy Forum of the National Academies of Sciences focusing on long-term survivorship care after treatment, which concluded, among other things, that there are substantial obstacles related to the routine delivery of standardized physical and psychosocial care services to patients and their families.;110:1300 10.

    Article  PubMed  Google Scholar 

  4. •• Witt CM, Balneaves LG, Cardoso MJ, et al. A comprehensive definition for integrative oncology. J Natl Cancer Inst Monogr. 2017;2017(52):lgx012 https://doi.org/10.1093/jncimonographs/lgx012. This paper identified that, although there are generally understood definitions of integrative oncology, there was no agreed upon official definition. By using a mixed-methods approach and an interdisciplinary expert panel, a definition was written and adopted.

  5. Deng G, Cassileth B. Integrative oncology: an overview. Am Soc Clin Oncol Educ Book. 2014;34:233–42.

    Article  Google Scholar 

  6. Hack CC, Hüttner NBM, Hackl J, Fasching PA, Beckmann MW. Classification of integrative medicine: overview and significance in oncology. Gynakologe. 2017;50(1):9–14.

    Article  Google Scholar 

  7. Greenlee H, Balneaves LG, Carlson LE, Cohen M, Deng G, Hershman D, et al. Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. J Natl Cancer Inst Monogr. 2014;2014(50):346–58.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Greenlee H, DuPont-Reyes MJ, Balneaves LG, et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA Cancer J Clin. 2017;67(3):194–232.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Abrams DI. An integrative approach to prostate cancer. J Altern Complement Med. 2018;24(9–10):872–80.

    Article  PubMed  Google Scholar 

  10. Oechsle K, Aslan Z, Suesse Y, Jensen W, Bokemeyer C, de Wit M. Multimodal exercise training during myeloablative chemotherapy: a prospective randomized pilot trial. Support Care Cancer. 2014;22(1):63–9.

    Article  PubMed  Google Scholar 

  11. • Cave J, Paschalis A, Huang CY, West M, Copson E, Jack S, et al. A systematic review of the safety and efficacy of aerobic exercise during cytotoxic chemotherapy treatment. Support Care Cancer. 2018. A systematic review that showed that aerobic exercise either maintained or improved patient fitness during chemotherapy, and should be encouraged.;26:3337–51.

    Article  CAS  PubMed  Google Scholar 

  12. • Furzer BJ, Ackland TR, Wallman KE, Petterson AS, Gordon SM, Wright KE, et al. A randomised controlled trial comparing the effects of a 12-week supervised exercise versus usual care on outcomes in haematological cancer patients. Support Care Cancer. 2016;24(4):1697–707 A paper investigating the efficacy of a 12-week exercised rehabilitation program on cancer-related fatigue in patients with hematologic malignancy after receiving chemotherapy showed statistically significant outcomes and clinical improvement.

    Article  PubMed  Google Scholar 

  13. Streckmann F, Kneis S, Leifert JA, Baumann FT, Kleber M, Ihorst G, et al. Exercise program improves therapy-related side-effects and quality of life in lymphoma patients undergoing therapy. Ann Oncol. 2014;25(2):493–9.

  14. Bergenthal N, Will A, Streckmann F, et al. Aerobic physical exercise for adult patients with haematological malignancies. Cochrane Database Syst Rev. 2014;(11):Cd009075. https://doi.org/10.1002/14651858.CD009075.pub2.

  15. Courneya KS, Friedenreich CM, Franco-Villalobos C, Crawford JJ, Chua N, Basi S, et al. Effects of supervised exercise on progression-free survival in lymphoma patients: an exploratory follow-up of the HELP Trial. Cancer Causes Control. 2015;26(2):269–76.

    Article  PubMed  Google Scholar 

  16. van Haren I, Staal JB, Potting CM, et al. Physical exercise prior to hematopoietic stem cell transplantation: a feasibility study. Physiother Theory Pract. 2018;34(10):747–56.

    Article  PubMed  Google Scholar 

  17. Bartels FR, Smith NS, Gorlov JS, et al. Optimized patient-trajectory for patients undergoing treatment with high-dose chemotherapy and autologous stem cell transplantation. Acta Oncol. 2015;54(5):750–8.

    Article  CAS  PubMed  Google Scholar 

  18. Jacobsen PB, Le-Rademacher J, Jim H, et al. Exercise and stress management training prior to hematopoietic cell transplantation: Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 0902. Biol Blood Marrow Transplant. 2014;20(10):1530–6.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Keen C, Skilbeck J, Ross H, Smith L, Collins K, Dixey J, et al. Is it feasible to conduct a randomised controlled trial of pretransplant exercise (prehabilitation) for patients with multiple myeloma awaiting autologous haematopoietic stem cell transplantation? Protocol for the PREeMPT study. BMJ Open. 2018;8(3):e021333.

  20. •• Yun H, Sun L, Mao JJ. Growth of integrative medicine at leading cancer centers between 2009 and 2016: a systematic analysis of NCI-designated comprehensive cancer center websites. J Natl Cancer Inst Monogr. 2017;2017(52):lgx004. https://doi.org/10.1093/jncimonographs/lgx004. An investigation via a systematic review of 45 NCI comprehensive cancer center websites, of the growth of integrative medicine in US academic cancer centers, which finds that more and more cancer centers are providing integrative medicine practices to their patients.

  21. Armstrong K, Lanni T, Anderson MM, Patricolo GE. Integrative medicine and the oncology patient: options and benefits. Support Care Cancer. 2018;26(7):2267–73.

    Article  PubMed  Google Scholar 

  22. Derry HM, Jaremka LM, Bennett JM, Peng J, Andridge R, Shapiro C, et al. Yoga and self-reported cognitive problems in breast cancer survivors: a randomized controlled trial. Psychooncology. 2015;24(8):958–66.

    Article  PubMed  Google Scholar 

  23. Sprod LK, Fernandez ID, Janelsins MC, Peppone LJ, Atkins JN, Giguere J, et al. Effects of yoga on cancer-related fatigue and global side-effect burden in older cancer survivors. J Geriatr Oncol. 2015;6(1):8–14.

  24. Felbel S, Meerpohl JJ, Monsef I, Engert A, Skoetz N. Yoga in addition to standard care for patients with haematological malignancies. Cochrane Database Syst Rev. 2014;(6):Cd010146. https://doi.org/10.1002/14651858.CD010146.pub2

  25. Salhofer I, Will A, Monsef I, Skoetz N. Meditation for adults with haematological malignancies. Cochrane Database Syst Rev. 2016;2:Cd011157.

    PubMed  Google Scholar 

  26. Huberty J, Eckert R, Gowin K, Mitchell J, Dueck AC, Ginos BF, et al. Feasibility study of online yoga for symptom management in patients with myeloproliferative neoplasms. Haematologica. 2017;102(10):e384–8.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Sattin RW, Easley KA, Wolf SL, Chen Y, Kutner MH. Reduction in fear of falling through intense tai chi exercise training in older, transitionally frail adults. J Am Geriatr Soc. 2005;53(7):1168–78.

    Article  PubMed  Google Scholar 

  28. Zeng Y, Luo T, Xie H, Huang M, Cheng AS. Health benefits of qigong or tai chi for cancer patients: a systematic review and meta-analyses. Complement Ther Med. 2014;22(1):173–86.

    Article  Google Scholar 

  29. • Wayne PM, Lee MS, Novakowski J, Osypiuk K, Ligibel J, Carlson LE, et al. Tai Chi and qigong for cancer-related symptoms and quality of life: a systematic review and meta-analysis. J Cancer Surviv. 2018;12(2):256–67 A summary on the effects of tai chi and qigong (TCQ) on quality of life in cancer survivors showing that, although there are noted improvements in areas like fatigue and depression, more studies are needed.

    Article  PubMed  Google Scholar 

  30. Tang YY, Hölzel BK, Posner MI. The neuroscience of mindfulness meditation. Nat Rev Neurosci. 2015;16(4):213–25.

  31. Carlson LE. Distress management through mind-body therapies in oncology. 2017;2017(52):lgx009, https://doi.org/10.1093/jncimonographs/lgx009

  32. Kutner JS, Smith MC, Corbin L, Hemphill L, Benton K, Mellis BK, et al. Massage therapy versus simple touch to improve pain and mood in patients with advanced cancer: a randomized trial. Ann Intern Med. 2008;149(6):369–79.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Frenkel M, Sapire K. Complementary and integrative medicine in hematologic malignancies: questions and challenges. Curr Oncol Rep. 2017;19(12):79.

    Article  CAS  PubMed  Google Scholar 

  34. Mehling WE, Lown EA, Dvorak CC, et al. Hematopoietic cell transplant and use of massage for improved symptom management: results from a pilot randomized control trial. Evid Based Complement Alternat Med. 2012;2012:450150.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Davies E, Campbell S, Fullwood A, Hulbert J, Marks DI. The introduction of a holistic massage service in a combined paediatric and adult BMT unit. Bone Marrow Transplant. 2008;41(4):407–8.

    Article  CAS  PubMed  Google Scholar 

  36. Smith MC, Reeder F, Daniel L, Baramee J, Hagman J. Outcomes of touch therapies during bone marrow transplant. Altern Ther Health Med. 2003;9(1):40–9.

    PubMed  Google Scholar 

  37. Tarantino B, Earley M, Audia D, D’Adamo C, Berman B. Qualitative and quantitative evaluation of a pilot integrative coping and resiliency program for healthcare professionals. Explore (NY). 2013;9(1):44–7.

    Article  Google Scholar 

  38. Marcus DA, Blazek-O’Neill B, Kopar JL. Symptomatic improvement reported after receiving Reiki at a cancer infusion center. Am J Hosp Palliat Care. 2013;30(2):216–7.

    Article  PubMed  Google Scholar 

  39. Birocco N, Guillame C, Storto S, Ritorto G, Catino C, Gir N, et al. The effects of Reiki therapy on pain and anxiety in patients attending a day oncology and infusion services unit. Am J Hosp Palliat Care. 2012;29(4):290–4.

    Article  PubMed  Google Scholar 

  40. •• Alarcão Z, Fonseca JRS. The effect of Reiki therapy on quality of life of patients with blood cancer: results from a randomized controlled trial. Eur J Integr Med. 2016;8(3):239–49 A Portuguese study to assess the effectiveness of Reiki on quality of life in patients with hematologic cancers, which suggests that Reiki may be effective and safe, and incorporable into the national health service.

    Article  Google Scholar 

  41. •• Lyman GH, Bohlke K, Cohen L. Integrative therapies during and after breast cancer treatment: ASCO endorsement of the SIO clinical practice guideline summary. J Oncol Pract. 2018;14(8):495–9 ASCO endorsement of the Society of Integrative Oncology’s guidelines on the use of integrative therapies during and after breast cancer treatment.

    Article  PubMed  Google Scholar 

  42. •• Deng GE, Giralt S, Chung DJ, Landau HJ, Siman J, Search B, et al. Acupuncture for symptom reduction in myeloma patients undergoing hematopoietic stem cell transplantation: a randomized, sham-controlled trial. J Clin Oncol. 2017;35(15). A randomized sham-controlled trial evaluating the efficacy and safety of acupuncture in patients undergoing hematopoietic stem cell transplants that concluded that acupuncture is well tolerated and may reduce pain):8021.

    Article  Google Scholar 

  43. Han X, Wang L, Shi H, Zheng G, He J, Wu W, et al. Acupuncture combined with methylcobalamin for the treatment of chemotherapy-induced peripheral neuropathy in patients with multiple myeloma. BMC Cancer. 2017;17(1):40.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Bao T, Goloubeva O, Pelser C, Porter N, Primrose J, Hester L, et al. A pilot study of acupuncture in treating bortezomib-induced peripheral neuropathy in patients with multiple myeloma. Integr Cancer Ther. 2014;13(5):396–404.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Lu W, Rosenthal DS. Recent advances in oncology acupuncture and safety considerations in practice. Curr Treat Options in Oncol. 2010;11(3–4):141–6.

    Article  Google Scholar 

  46. Fu H, Chen B, Hong S, Guo Y. Acupuncture therapy for the treatment of myelosuppression after chemotherapy: a literature review over the past 10 years. J Acupunct Meridian Stud. 2015;8(3):122–6.

    Article  PubMed  Google Scholar 

  47. Pais I, Correia N, Pimentel I, et al. Effects of acupuncture on leucopenia, neutropenia, NK, and B cells in cancer patients: a randomized pilot study. Evid Based Complement Alternat Med. 2014;2014:217397.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Fortner RT, Katzke V, Kühn T, Kaaks R. Obesity and Breast Cancer. Recent Results Cancer Res. 2016;208:43–65.

    Article  CAS  PubMed  Google Scholar 

  49. Bertrand KA, Giovannucci E, Rosner BA, Zhang SM, Laden F, Birmann BM. Dietary fat intake and risk of non-Hodgkin lymphoma in 2 large prospective cohorts. Am J Clin Nutr. 2017;106(2):650–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Shai A, Morr M, Uzan A, Koren O. Changes in the microbiome induced by adjuvant chemotherapy for breast and gynecological cancer and their association with weight gain. J Clin Oncol. 2018;36(15_suppl):e22113.

    Article  Google Scholar 

  51. • Peled JU, Devlin SM, Staffas A, Lumish M, Khanin R, Littmann ER, et al. Intestinal microbiota and relapse after hematopoietic-cell transplantation. J Clin Oncol. 2017;35(15):1650–9 A retrospective discovery-validation cohort study on patients following allo-HCT, showing that abundance of the gut bacteria, Eubacterium limosum , is associated with decreased risk of disease relapse and progression.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Biagi E, Nylund L, Candela M, Ostan R, Bucci L, Pini E, et al. Through ageing, and beyond: gut microbiota and inflammatory status in seniors and centenarians. PLoS One. 2010;5(5):e10667.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Park EJ, Lee JH, Yu GY, He G, Ali SR, Holzer RG, et al. Dietary and genetic obesity promote liver inflammation and tumorigenesis by enhancing IL-6 and TNF expression. Cell. 2010;140(2):197–208.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Butturini AM, Dorey FJ, Lange BJ, Henry DW, Gaynon PS, Fu C, et al. Obesity and outcome in pediatric acute lymphoblastic leukemia. J Clin Oncol. 2007;25(15):2063–9.

    Article  PubMed  Google Scholar 

  55. Lange BJ, Gerbing RB, Feusner J, et al. Mortality in overweight and underweight children with acute myeloid leukemia. JAMA. 2005;293(2):203–11.

    Article  CAS  PubMed  Google Scholar 

  56. Ligibel JA, Alfano CM, Courneya KS, Demark-Wahnefried W, Burger RA, Chlebowski RT, et al. American Society of Clinical Oncology position statement on obesity and cancer. J Clin Oncol. 2014;32(31):3568–74.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Ammann EM, Drake MT, Haraldsson B, Wallace RB, Johnson KC, Desai P, et al. Incidence of hematologic malignancy and cause-specific mortality in the Women’s Health Initiative randomized controlled trial of calcium and vitamin D supplementation. Cancer. 2017;123(21):4168–77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Chagas TR, Borges DS, de Oliveira PF, Mocellin MC, Barbosa AM, Camargo CQ, et al. Oral fish oil positively influences nutritional-inflammatory risk in patients with haematological malignancies during chemotherapy with an impact on long-term survival: a randomised clinical trial. J Hum Nutr Diet. 2017;30(6):681–92.

    Article  CAS  PubMed  Google Scholar 

  59. Kooti W, Servatyari K, Behzadifar M, Asadi-Samani M, Sadeghi F, Nouri B, et al. Effective medicinal plant in cancer treatment, part 2: review study. J Evid Based Complementary Altern Med. 2017;22(4):982–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. • Bahmani F, Esmaeili S, Bashash D, Dehghan-Nayeri N, Mashati P, Gharehbaghian A. Centaurea albonitens extract enhances the therapeutic effects of vincristine in leukemic cells by inducing apoptosis. Biomed Pharmacother. 2018;99:598–607 A study of the potential cytotoxic effects of Centaurea albonitens extract (CAE) alone and combined with vincristine in leukemic cells that shows that CAE is a potential anticancer agent, and an enhancer of vincristine chemotherapeutic effects.

    Article  CAS  PubMed  Google Scholar 

  61. Shanafelt TD, Drake MT, Maurer MJ, Allmer C, Rabe KG, Slager SL, et al. Vitamin D insufficiency and prognosis in chronic lymphocytic leukemia. Blood. 2011;117(5):1492–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Kubeczko M, Nowara E, Spychalowicz W, et al. Efficacy and safety of vitamin D supplementation in patients with chronic lymphocytic leukemia. Postepy Hig Med Dosw (Online). 2016;70(0):534–41.

    Article  Google Scholar 

  63. Liu P, Holman CDJ, Jin J, Zhang M. Green tea consumption is associated with a reduced risk of adult leukemia. Asia Pac J Clin Oncol. 2014;10:10.

    Article  Google Scholar 

  64. Borutinskaitė V, Virkšaitė A, Gudelytė G, Navakauskienė R. Green tea polyphenol EGCG causes anti-cancerous epigenetic modulations in acute promyelocytic leukemia cells. Leuk Lymphoma. 2018;59(2):469–78.

    Article  CAS  PubMed  Google Scholar 

  65. • Pimentel-GutiéRrez HJ, Bobadilla-Morales L, Barba-Barba CC, et al. Curcumin potentiates the effect of chemotherapy against acute lymphoblastic leukemia cells via downregulation of NF-κ B. Oncol Lett. 2016;12(5):4117–24 Green Tea Catechin epigallocatechin-3-gallate (EGCG) may be able to halt cell proliferation, act as an epigenetic modifier, and even cause apoptosis in acute promyelocytic leukemia.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Herviou L, Kassambara A, Boireau S, Robert N, Requirand G, Müller-Tidow C, et al. PRC2 targeting is a therapeutic strategy for EZ score defined high-risk multiple myeloma patients and overcome resistance to IMiDs. Clin Epigenetics. 2018;10(1):121.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Zhang Y, Kong Y, Liu S, Zeng L, Wan L, Zhang Z. Curcumin induces apoptosis in human leukemic cell lines through an IFIT2-dependent pathway. Cancer Biol Ther. 2017;18(1):43–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Wu C, Ruan T, Liu W, Zhu X, Pan J, Lu W, et al. Effect and mechanism of curcumin on EZH2 - MiR-101 regulatory feedback loop in multiple myeloma. Curr Pharm Des. 2018;24(5):564–75.

    Article  CAS  PubMed  Google Scholar 

  69. Han TJ, Li JS, Luan XT, Wang L, Xu HZ. Dietary fat consumption and non-Hodgkin’s lymphoma risk: a meta-analysis. Nutr Cancer. 2017;69(2):221–8.

    Article  PubMed  Google Scholar 

  70. Briggs J. Building the evidence base for integrative approaches to care of cancer survivors. J Natl Cancer Inst Monogr. 2014;2014(50):288.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We acknowledge Belleh Taku, PharmD, and Ahlam Saleh, MD MLS, for the help they provided towards this paper.

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Correspondence to Onyemaechi N. Okolo.

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Dr. Okolo has nothing to disclose.

Dr. Gowin reports personal fees from Incyte (Speaker Bureau, Scientific Advisory Board).

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Okolo, O.N., Gowin, K. Emerging Role of Integrative Medicine in Hematologic Malignancies: a Literature Review and Update on Current Trends in Complementary Medical Practices in Hematologic Cancers. Curr Hematol Malig Rep 14, 328–336 (2019). https://doi.org/10.1007/s11899-019-00526-8

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