Introduction
Blood disease is a primary disease of the hematopoietic system, or a disease that affects the hematopoietic system, accompanied by blood abnormalities and characterized by anemia, bleeding, and fever. The hematopoietic system includes blood, bone marrow mononuclear phagocyte system, and lymphoid tissue. All that involves hematopoietic system pathology and physiology and its main manifestations of the disease belongs to the scope of hematologic diseases. Blood disease is clinically divided into three types: RBC disease, WBC disease, and bleeding and thrombotic disease. Common clinical diseases are leukemia, aplastic anemia, myelodysplastic syndrome, thrombocytopenia, multiple myeloma, lymphoma, bone fibrosis, hemophilia, thalassemia, and so on. Hematologic diseases mostly are refractory diseases. The incidence is insidious and symptoms are occult. Even if the patient is ill, he or she is often not aware of it. It is found mostly when the patient seeks medical treatment for other diseases or through health examination. Many hematologic diseases were considered incurable in the past due to the lack of effective therapy.
Hormones and chemotherapy are commonly used for the treatment of hematologic diseases, but the side effects are great, with low cure rates and easy recurrence. In recent years, the use of herbal medicines for the treatment of hematologic diseases has obtained certain beneficial effects. The use of hyperthermia combined with chemotherapy for the treatment of hematologic diseases is also under study.
Treatments
1.Etiological Treatment
If etiology is clear, timely separate the effect of etiological factors. Etiology of some diseases is unclear or unavoidable, and treatment effect may be affected.
2.Maintaining Normal Blood Components and Functions
Supplementary hematopoietic substances: for nutritional megaloblastic anemia, supplement with folic acid or vitamin B12; for iron deficiency anemia, supplement with iron; and for vitamin K deficiency, supplement with vitamin K. Stimulate hematopoiesis: for chronic aplastic anemia, androgen and herbal medicine treatments are applied. Cytokines: erythropoietin (EPO) is used in the treatment of renal anemia and granulocyte-macrophage colony-stimulating factor accelerates the recovery of leukopenia. Splenectomy has an exact effect on patients by hereditary spherocytosis cell histiocytosis and idiopathic thrombocytopenic purpura. Component trans- fusion: for severe anemia or blood loss, erythrocyte should be transfused. For thrombocytopenia with bleeding risk, supplement with blood platelets. For hemophilia A with active bleeding, factor VIII should be supplemented.
3.Chemotherapy
Over the years, combined chemotherapy has been widely used, in which herbal medicines are mostly used for medication in combination with chemotherapy or at the intermission periods of chemotherapy. A growing number of clinical studies have shown that combination therapy of Chinese medicine with Western medicine is superior to chemotherapy alone.
4.Induced Differentiation and Induced Apoptosis
Chinese researchers have applied all-trans retinoic acid to induce differentiation and arsenic trioxide to accelerate apoptosis; they provide very good results for treating acute promyelocytic leukemia, thus creating new ways for the treatment of cancer.
5.Plasma Exchange and Therapeutic Hemapheresis
Selectively remove some dysplasia ingredients in blood through a blood cell separator and achieve therapeutic purposes. For example, plasmapheresis is used for the treatment of multiple myelomas.
6.Immunosuppression
Use immunosuppressive agents such as glucocorticoids and cyclosporine for the treatment of autoimmune hemolytic anemia, aplastic anemia, and so on.
7.Antithrombotic and Thrombolytic Therapy
For disseminated intravascular coagulation, use heparin to prevent further coagulation. Use heparin to prevent further consumption of clotting factor. To prevent platelet aggregation, use aspirin, and so on. In addition, urokinase, tttt-PA, and so on can be applied to dissolve fresh thrombus to restore blood flow.
8.Hematopoietic Stem Cell Transplantation
It is a major advancement in treatment in modern hematology. It uses chemoradiotherapy of super high doses to maximize the removal of abnormal cells from the patient’s body and then uses the donor’s or autologous hematopoietic stem cell to rescue or reconstruct the patient’s hematopoietic and immune function. It is a method for radical hematologic malignancies and some solid tumors and is widely applied currently in clinical practice. In addition, it can be used to treat aplastic anemia, myelodysplastic syndrome, genetic hereditary diseases, autoimmune diseases, and so on. According to the source of hematopoietic stem cells, it can be divided into bone marrow transplantation, peripheral blood stem cell transplantation, and cord blood transplantation. According to the difference in source of donor and immunology, it is divided into allogeneic transplantation, homogenic transplantation, autograft, and xenotransplantation.
9.Hyperthermia
Studies have shown that whole-body hyperthermia can significantly improve the quality of life of patients with hematologic malignancies, clinical symptoms, and signs, and when combined with chemotherapy it can improve clinical efficacy.
10. Chelation Detoxification Therapy
Modern researches show that hematologic diseases are associated with ionizing radiation, exposure to chemicals, and poisons or drugs. The majority of patients with hematologic diseases have excessive heavy metals. Chelation detoxification formulas made of vitamins and chelating agents can get rid of toxic substances from their bodies. Chelation detoxification has a synergistic effect with chemotherapy and reduces chemotherapy-induced nausea and vomiting, diarrhea, loss of appetite, fatigue, and other side effects. It especially has significant attenuation for chemotherapy-induced skin pigmentation, and oral and gastrointestinal mucositis.
11.Medical Ozone Therapy
When medical ozone enters the body, it can be decomposed into oxygen ions, thus improving the oxygen carrying capacity of RBCs and anemia and, at the same time, stimulating hematopoiesis. Medical ozone therapy can reduce the side effects of chemotherapy, such as fatigue and insomnia. Be cautious when applying this therapy to patients with signs of bleeding; when platelets are less than 20 × 109/L, it is not recommended.
12.Traditional Chinese Medicine
The syndromes are mainly retention of heat toxicity, retention of damp heat, as well as stagnation of phlegm toxin in the body before chemotherapy. The treatment focuses on eliminating pathogens. Products for clearing away toxic substances as well as cooling blood are mostly selected. The prescriptions recommended are modified Xijiaodihuang Decoction, modified Ganlu Xiaodu Decoction, and modified Taohong Siwu Decoction. The syndrome of damp heat and deficiency coexistence is mainly manifested during chemotherapy. The treatment focuses on eliminating pathogens to support healthy qi. Products for moisturizing and preventing dryness and resolving dampness with aromatic drugs are mostly selected. The prescriptions recommended are Yiguan Decoction and modified Erchen Decoction. The syndrome of deficiency of qi and blood is mostly manifested after chemotherapy. The treatment focuses on strengthening body resistance. The prescription recommended is Bazhen Decoction or Radix Ophiopogon Decoction. For patients with low blood, it is suitable to reinforce the liver and kidney, nourish blood, and promote blood circulation. The prescriptions recommended are Bazhen Decoction, Dangui Siwu Decoction, and modified Renshen Yangrong Decoction.
13.Acupuncture
The main syndrome of leukemia is deficiency of both qi and yin, or yin deficiency of liver and kidney. The therapeutic principle should focus on supplementing qi and nourishing yin, tonifying liver and kidney, as well as invigorating qi and blood.
14.Medicated Diet, Nutrition, and so on
Utilize medicated diet of TCM and modern nutrition knowledge to guide and regulate the patient’s diet, and give individualized nutritional support programs. During chemotherapy, the patient should mainly keep a light diet, accompanied by Semen Coicis, Poria Cocos, and Pericarpium Citri Reticulatae boiled into soup to remove dampness and reduce phlegm; after chemotherapy, the diet should be accompanied by Astragalus Radix, Radix Adenophorae, jujube, and donkey-hide gelatin boiled into soup to supplement qi and nourish yin. If the patient has significant reaction on the day before chemotherapy or during chemotherapy, total parenteral nutrition can be given to strengthen the nutritional support therapy.
15.Others
Eliminate the psychological barriers of cancer patients and their families, such as pessimism, despair, and so on. These negative emotions often affect treatment and prognosis. Health-care workers should frequently communicate with patients, conduct psychological counseling, and encourage patients to actively face the disease. At the same time, ask patients to practice qigong, regulate breathing and move qi for smooth systemic blood flow, and strive for peace and calmness of mind so as to achieve synergistic therapy and improvement of efficacy.
Typical Case
60 year old male patient Zhou experienced paroxysmal abdominal pain after taking heated red rice wine more than 20 days before admission to the hospital. He exhibited secondary limb ecchymosis, fever, and intermittent nausea. At that time, symptoms were relatively mild. On date of admission, his abdominal pain intensified, accompanied with diarrhea, watery stools, tenesmus, nausea, vomiting, and a fever which reached 39℃.
Diagnosis: acute nonlymphoblastic leukemia (M2).
Integrative treatment prescription: after admission, a team of specialists consultation was held to develop an individualized treatment plan, which consisted of chemotherapy in combination with non-toxic integrative treatment. Anti-infection treatment was given for intestinal infection. Rectal medical ozone insufflation and abdominal hyperthermia were applied.
Treatment outcome: Patient was hospitalized for 70 days. After non-toxic integrative treatment and chemotherapy of TA program, myelogram was completely remissed and proliferation of bone marrow nucleated cell was obviously active. Grain: red = 2.24:1. Myeloid hyperplasia was active, accounting for 56%; and erythroid hyperplasia was active, accounting for 25%. After symptomatic and supportive treatment, his body temperature and white blood cell count returned to normal. Patient recovered spontaneously, his symptoms of abdominal pain, diarrhea, tenesmus, nausea, vomiting, and fever dissipated. Cervical lymph node and liver enlargement as well as abdominal mass disappeared. No obvious abnormalities were seen by abdominal CT review. Outpatient TCM and nutritional treatment were continued after discharge. In addition, for 6 months, patient returned to the hospital monthly for 1 week of integrative treatment which included hyperthermia, chelation and detoxification therapy, and medical ozone therapy and after a half year, every 3 months for 1 week of treatment. Follow-up was carried out for more than 4 years after discharge. Patient’s condition was relatively stable, without any discomfort, and white blood cells maintained at 2.5-4.7×109/L. The KPS was 100.
