Effect Comparison of different formulation of Dang-Gui-Bu-Xu-Tang on myelosuppression mouse

Objective: To compare effect of different formulation of Dang-Gui-Bu-Xu-Tang(DCBXT) on myelosuppression mouse. Methods: HPLC was used to measure active ingredients of two DCBXT formulations. Hemopoesic function of bone marrow was measured by hemopoietic progenitor cell culture and peipheral blood count. And hemopoietic factors in bone marrow were tested by ELISA. Results: The content level of astragaloside A in granule formulation was higher than that in decoction and the content ratio of active ingredient was close to 5 : 1. Two DGBXD formulations could significantly improve amount of peripheral blood cells, and bone marrow cells of bone marrow suppression mice (P < 0.05). DGBXD granule formulation significantly increased the colony quantity of all progenitor cell lines and amount of G(2)/M and S phase cells (P < 0.05). It also significantly decreased amount of G(0)/G(1) phase cells in the bone marrow and was more effective (P < 0.05). Conclusions: DGBXT decoction and the granule formulation all can improve the hematopoietic function of bone marrow suppression mouse. They can improve quantities of peripheral blood and nucleated bone marrow cells, and yield of the hematopoietic stem/progenitor cells in vitro colony; balance the expression of cytokine (EPO, TPO and GM-CSF) in bone marrow microenvirement. They can also facilitate hematopoietic stem/progenitor cells to enter the cell cycle. And the effect of granule formulation is more satisfactory.

Chemotherapy-Induced Myelosuppression in Esophageal Cancer Patients:Risks and Suggestions for Its Management

Objective The influential factors of chemotherapy-induced myelosuppression in esophageal cancer in central China are unclear.This study aimed to investigate the effect of commonly used chemotherapy regimens on the incidence of myelosuppression in clinical treatment of esophageal cancer.Methods In this retrospective study,624 patients with esophageal cancer who received six different chemotherapy regimens between 2013 and 2020 at our institute were included.Chemotherapy consisted of lobaplatin,5-fluorouracil(5-F),lobaplatin and 5-F,nedaplatin,nedaplatin and paclitaxel(PTX),cisplatin and PTX.Multivariable logistic regression analysis was used to explore the risk of myelosuppression among the six different chemotherapy regimens.Results Compared with lobaplatin group,the incidence of myelosuppression in patients treated with chemotherapy regimens of lobaplatin and 5-F,nedaplatin,nedaplatin and PTX and cisplatin and PTX were significantly ameliorated.The dose of lobaplatin was significantly reduced(P=0.007)when lobaplatin was combined with 5-F,and the combination could significantly reduce the risk of myelosuppression(P=0.022).Furthermore,chemotherapeutic regimens,the dose of platinum,hemoglobin and uric acid levels,age,sex,total bilirubin and immune-enhancing drugs were found to be strong predictors of developing myelosuppression.Conclusion Targeted preventive interventions that enhance immune function,reduce uric acid levels and choose combined medication during chemotherapy should be implemented for high-risk patients to reduce the occurrence of myelosuppression.In addition,the dose of lobaplatin should be adjusted when combined with other chemotherapy drugs to reduce the incidence of myelosuppression.

Chronic colchicine poisoning with neuromyopathy,gastric ulcers and myelosuppression in a gout patient:A case report

Colchicine has been widely used as an anti-gout medication over the past decades.However,it is less commonly used due to its narrow therapeutic range,meaning that its lethal dose is close to its therapeutic dose.The lethal dose of colchicine is considered to be 0.8 mg/kg.As chronic colchicine poisoning has multiple manifestations,it poses a challenge in the clinician’s differential diagnosis.Historically,the drug was important in treating gout;however,clinical studies are currently underway regarding the use of colchicine in patients with coronavirus disease 2019 as well as its use in coronary artery disease,making this drug more important in clinical practice.CASE SUMMARY A 61-year-old male with a history of gout and chronic colchicine intake was admitted to our Emergency Department due to numbness and weakness of the lower limbs.The patient reported a history of colchicine intake for 23 years.After thorough examination,he was diagnosed with colchicine poisoning,manifesting as neuromyopathy,multiple gastric ulcers and myelosuppression.We advised him to stop taking colchicine and drinking alcohol.We also provided a prescription of lansoprazole and mecobalamin,and then asked him to return to the clinic for re-examination.The patient was followed up for 3-mo during which time his gout symptoms were controlled to the point where he was asymptomatic.CONCLUSION Colchicine overdose can mimic the clinical manifestations of several conditions.Physicians easily pay attention to the disease while ignoring the cause of the disease.Thus,the patient’s medication history should never be ignored.

The effect of acupuncture and selection of acupoints on myelosuppression after chemotherapy

Objective:To evaluate the effect of acupuncture on myelosuppression after chemotherapy and summarize its acupoint selection strategy.Methods:After a systematic search,an acupoint database on myelosuppression after chemotherapy was constructed.A meta-analysis was conducted to assess the efficacy of acupuncture.On this basis,association analysis and cluster analysis were performed to explore the distribution of acupoints in SPSS Modeler18.0 and SPSS 22.0.Results:40 studies with 2988 patients were included.The white blood cell count,platelet count,red blood cell count,and hemoglobin were significantly higher in patients receiving acupuncture versus convention therapy exclusively.The two groups,however,did not differ in neutrophils count.Most acupoints,mainly distributed in the limbs and the back,were from the bladder meridian,the stomach meridian,and the spleen meridian.The lower sea and transport points were the most preferred specific points,in which ST36 and SP6 ranked highest in use.ST36-RN6,SP6-SP10,and ST36-SP10 turned out to be the most significant correlations in association rule mining.In cluster analysis,LI4-RN12,ST36-RN4-RN6 were grouped for their high similarity.Conclusion:For patients with myelosuppression after chemotherapy,acupuncture significantly inhibited the decline in blood cell components(white blood cell count,platelet count,red blood cell count,and hemoglobin)except for neutrophils.As the central combination of acupuncture prescriptions for this population,ST36-SP6-RN6-SP10-RN4 presented promising prospects and deserved more exploration for clinical use.

Chinese Medicine Combined with Adjuvant Chemotherapy for Improving Myelosuppression in Colorectal Cancer Patients:A Systematic Review and Network Meta-Analysis

Objective To assess the effectiveness of Chinese herbal medicine(CHM)combined with adjuvant chemotherapy on myelosuppression for colorectal cancer(CRC)patients using network meta-analysis(NMA).Methods Literature searches in both international(PubMed,Embase,Web of Science,and Cochrane Library)and Chinese(China Science and Technology Journal Database,Wanfang Data,China National Knowledge Infrastructure)databases for relevant randomized controlled trials(RCTs)were conducted from inception until October 10,2022.We included RCTs of patients who received CHM combined with chemotherapy,including FOLFOX,XELOX,FOLFIRI,and other relevant regimens in the CHM treatment group.The outcomes included the incidence of myelosuppression,leukopenia,hemoglobin reduction,and thrombocytopenia.Two reviewers independently screened the databases,extracted the data,and assessed the risk of bias and credibility of evidence.RevMan 5.4.1 software and STATA 14.0 were used to perform the NMA.Results A total of 31 RCTs were included,published from 2008 to 2021 in Chinese.Among these,2,314 participants comparing the following 9 CHMs were identified:Shengbai Recipe(SBR),Bazhen Decoction(BZD),Jianpi Jiedu Recipe(JJR),Jianpi Recipe(JR),Compound Cantharis Capsule(CCC),Zaofan Pill(ZFP),Guilu Erxian Gel(GL),Buzhong Tiaogan Decoction(BZ),and Qiamagu Capsule(QM).The results of NMA found an indirect comparison.Based on the surface under the cumulative ranking curve(SUCRA),the ZFP+chemotherapy group had the lowest incidence of myelosuppression,with an odds ratio(OR)of 0.08[95%confidence interval(CI):0.01,0.76],whereas the GL+chemotherapy group had the lowest incidence of leukopenia,hemoglobin reduction,and thrombocytopenia,with an OR of 5.25(95%CI:2.41,11.43),4.66(95%CI:2.23,9.72),and 0.27(95%CI:0.13,0.54),respectively.Moreover,BZD+chemotherapy could alleviate leukopenia,hemoglobin reduction,and thrombocytopenia(P<0.01).Pairwise comparison showed that there was no difference in the efficacy among the 8 CHMs+chemotherapy group.The comparison and adjustment funnel plot indicated that small-study effect had no impact on these outcomes.Conclusions This NMA provided evidence to support that patients with CRC benefit from receiving different combination of CHM chemotherapies.Among these,GL plus chemotherapy and BZD plus chemotherapy were the more effective for myelosuppression in patients;however,as the qualtiy of evidence is insufficient,further research is needed.(PROSPERO, No. CRD42022369025.

Effect of ginsenoside Rg1 on hematopoietic stem cells in treating aplastic anemia in mice via MAPK pathway

BACKGROUND Aplastic anemia(AA)presents a significant clinical challenge as a life-threatening condition due to failure to produce essential blood cells,with the current the-rapeutic options being notably limited.AIM To assess the therapeutic potential of ginsenoside Rg1 on AA,specifically its protective effects,while elucidating the mechanism at play.METHODS We employed a model of myelosuppression induced by cyclophosphamide(CTX)in C57 mice,followed by administration of ginsenoside Rg1 over 13 d.The invest-igation included examining the bone marrow,thymus and spleen for pathological changes via hematoxylin-eosin staining.Moreover,orbital blood of mice was collected for blood routine examinations.Flow cytometry was employed to identify the impact of ginsenoside Rg1 on cell apoptosis and cycle in the bone marrow of AA mice.Additionally,the study further evaluated cytokine levels with enzyme-linked immunosorbent assay and analyzed the expression of key proteins in the MAPK signaling pathway via western blot.RESULTS Administration of CTX led to significant damage to the bone marrow’s structural integrity and a reduction in hematopoietic cells,establishing a model of AA.Ginsenoside Rg1 successfully reversed hematopoietic dysfunction in AA mice.In comparison to the AA group,ginsenoside Rg1 provided relief by reducing the induction of cell apoptosis and inflammation factors caused by CTX.Furthermore,it helped alleviate the blockade in the cell cycle.Treatment with ginsenoside Rg1 significantly alleviated myelosuppression in mice by inhibiting the MAPK signaling pathway.CONCLUSION This study suggested that ginsenoside Rg1 addresses AA by alleviating myelosuppression,primarily through modulating the MAPK signaling pathway,which paves the way for a novel therapeutic strategy in treating AA,highlighting the potential of ginsenoside Rg1 as a beneficial intervention.

Protective effects of paeoniflorin and albiflorin on chemotherapy-induced myelosuppression in mice

Paeonia lactiflora root(baishao in Chinese) is a commonly used herb in traditional Chinese medicines(TCM). Two isomers, paeoniflorin(PF) and albiflorin(AF), are isolated from P. lactiflora. The present study aimed to investigate the protective effects of PF and AF on myelosuppression induced by chemotherapy in mice and to explore the underlying mechanisms. The mouse myelosuppression model was established by intraperitoneal(i.p.) injection of cyclophosphamide(CP, 200 mg×kg^(–1)). The blood cell counts were performed. The thymus index and spleen index were also determined and bone morrow histological examination was performed. The levels of tumor necrosis factor-α(TNF-α) in serum and colony-stimulating factor(G-CSF) in plasma were measured by Enzyme-Linked Immunosorbent Assays(ELISA) and the serum levels of interleukin-3(IL-3), granulocyte-macrophagecolony- stimulatingfactor(GM-CSF), and interleukin-6(IL-6) were measured by radioimmunoassay(RIA). The levels of m RNA expression protein of IL-3, GM-CSF and G-CSF in spleen and bone marrow cells were determined respectively. PF and AF significantly increased the white blood cell(WBC) counts and reversed the atrophy of thymus. They also increased the serum levels of GM-CSF and IL-3 and the plasma level of G-CSF and reduced the level of TNF-α in serum.. PF enhanced the m RNA level of IL-3 and AF enhanced the m RNA levels of GM-CSF and G-CSF in the spleen. PF and AF both increased the protein levels of GM-CSF and G-CSF in bone marrow cells. In conclusion, our results demonstrated that PF and AF promoted the recovery of bone marrow hemopoietic function in the mouse myelosuppression model.

Therapeutic observation of grain-sized moxibustion for chemotherapy-induced myelosuppression for non-small cell lung cancer

Objective: To observe the clinical efficacy of grain-sized moxibustion in treating chemotherapy-induced myelosuppression for non-small cell lung cancer (NSCLC) and its effect on quality of life (QOL). Methods: Eighty NSCLC patients admitted to the Inpatient Department of Zhejiang Cancer Hospital between September 2016 and March 2018 were recruited and divided into an observation group and a control group by random number method, with 40 cases in each group. The two groups both received chemotherapy with paclitaxel plus cisplatin (TP regimen). The control group received oral administration of leucogen tablets starting from the first day of chemotherapy, 20 mg each time, three times a day, for consecutive 14 d;the observation group was additionally given grain-sized moxibustion, once a day, five days per week at a two-day interval, until the fourteenth day. The myelosuppression severity was observed and compared between the two groups prior to chemotherapy, at the 3rd, 7th and 14th days of chemotherapy;the QOL in the two groups was evaluated before chemotherapy, at the 14th and 21st days of chemotherapy. Results: Regarding myelosuppression, the peripheral blood indicators increased significantly at the 3rd day of chemotherapy in both groups (P<0.05 or P<0.01);at the 7th and 14th days of chemotherapy, the peripheral blood indicators presented a decreasing tendency in the two groups, but the level in the observation group was still significantly higher than that before chemotherapy (P<0.01);at the 3rd, 7th and 14th days of chemotherapy, the peripheral blood indicators in the observation group were higher than those in the control group (P<0.05 or P<0.01);the occurrence rate of myelosuppression in the observation group was significantly lower than that in the control group (P<0.01). The QOL score in the observation group was markedly higher than that in the control group at the 14th and 21st days of chemotherapy (both P<0.05). Conclusion: Grain-sized moxibustion can effectively improve myelosuppression after chemotherapy for NSCLC, reducing its occurrence and enhancing the patient's QOL.

Protective Effects of Tannins in Sanguisorbae Radix on Myelosuppression Mice

Objective To explore the protective effects of tannins in Sanguisorba Radix （TSR） on myelosuppression mice induced by cyclophosphamide （CTX）. Methods TSR was ig given at the dose of 20 mg/kg for 10 d after ip administration of CTX （200 mg/kg）. Results TSR could significantly increase the numbers of white blood ceils, red blood cells, and platelets of myelosuppression in mice. And it could accelerate bone marrow haemopoietic stem/progenitor cells （HSPCs） in myelosuppression mice and enhance cell proliferation by promoting cell cycles from G0/G1 phase to access into S and G2/M phases, then the reduced number of HSPCs induced by CTX was reversed. Moreover, TSR could increase the mRNA and protein expression levels of O（6）-methylguanine- DNA methyltransferase （MGMT） in HSPCs of myelosuppression mice. Concision TSR has a protective function against CTX-induced myelosuppression. The mechanism might be related to protecting hematopoietic stem cells of bone marrow, stimulating hematopoiesis recovery, as well as preventing the apoptosis of hematopoietic stem cells induced by CTX.

Effect of Zishenshengxue capsule on myelosuppression in mice induced by cyclophosphamide

OBJECTIVE:To explore the inhibitory effect of Zishenshengxue capsule(ZSC) on myelosuppression in mice induced by cyclophosphamide.METHODS:Kunming mice were randomly assigned into a control group,myelosuppression group,or groups for mice with myelosuppression receiving high dose ZSC,middle dose ZSC,low dose ZSC or Yixuesheng.Myelosuppression was induced by peritoneal injection of cyclophosphamide.ZSC and cyclophosphamide were administered simultaneously.The numbers of peripheral blood cells and bone marrow karyocytes were counted.Cell proliferation activity and colony formation of granulocyte-monocyte series hemopoietic progenitor cells(C-GMs) and cell cycle were detected.RESULTS:The numbers of white blood cells in the middle and high dose ZSC groups were significantly increased at the 12th and 13th day(P<0.01) and bone marrow karyocytes and cell proliferation activity increased in the high dose ZSC group(P<0.01) compared with the myelosuppression group.C-GMs of middle and high dose ZSC groups significantly increased(P<0.01).The percentage of G 1 phase in the high dose ZSC group decreased(P< 0.01) and the percentage of S and G 2 phase increased(P<0.01).CONCLUSION:ZSC increased the numbers of peripheral white blood cells,bone marrow karyocytes and C-GMs.ZSC also increased cell proliferation activity and removed the G 1 phase block.Thus,ZSC could reduce myelosuppression in mice induced by cyclophosphamide.

Clinical Observation of Shuanghuang Shengbai Granule(双黄升白颗粒) on Prevention and Treatment of Myelosuppression Caused by Chemotherapy in Cancer Patients

Objective： To study the efficacy and safety of Shuanghuang Shengbai Granule（双黄升白颗粒, SSG）, a traditional Chinese herbal medicine, on myelosuppression of cancer patients caused by chemotherapy. Methods： A total of 330 patients were randomly assigned to the treatment group（220 cases, analysed 209 cases） and the control group（110 cases, analysed 102 cases） with a 2：1 ratio by envelope method. The patients in the treatment group at the first day of chemotherapy started to take SSG for 14 days, while the patients in the control group took Leucogon Tablets. The changes of the blood routine, clinical symptoms and immune function in both groups were observed for safety and efficacy evaluation. Results： At the 7th day of chemotherapy, the white blood cells（WBCs） level in the treatment group was significantly higher than that in the control group（P〈0.05）. After treatment, the WBCs rate in the normal range accounted for 50.2% in the treatment group, the myelosuppression of WBCs and neutrophil were mainly grade Ⅰ, while 8.1% and 5.7% of patients emerged grade Ⅲ and grade Ⅳ myelosuppression, respectively. The incidence of myelosuppression of the treatment group was significantly lower than that of the control group（P〈0.05）. The total effective rate of Chinese medicine syndrome in the treatment group was significantly higher than that in the control group（84.2% vs. 72.5%, P〈0.05）. The immune cell levels in both groups were maintained in the normal range. Compared with that before treatment, the levels of CD3~＋ and CD4~＋ cells were significantly increased in the treatment group after treatment（P〈0.05）. The discrepancy of CD3~＋ and CD4~＋ cell activity before and after treatment in both groups were significantly different（P〈0.05）. No obvious adverse event occurred in both groups. Conclusion： SSG had a protection effect on bone marrow suppression, and alleviated the clinical symptoms together with clinical safety.

First platelet transfusion refractoriness in a patient with acute myelocytic leukemia: A case report

BACKGROUND Platelet transfusion is of great significance in the treatment of thrombocytopenia caused by myelosuppression during intensive chemotherapy in patients with acute leukemia.In recent years,with platelet transfusion increasing,ineffective platelet transfusion has become increasingly prominent.Generally speaking,platelet antibodies can be produced after repeated transfusion,thus rendering subsequent platelet transfusion ineffective.We report a case of first platelet transfusion refractoriness(PTR)in a patient with acute myelocytic leukemia(AML).Due to the rarity of such cases in clinical practice,there have been no relevant case reports so far.CASE SUMMARY A 51-year-old female patient attended the hospital due to throat pain and abnormal blood cells for 4 d.Her diagnosis was acute myelocytic leukemia[M2 type Fms related receptor tyrosine kinase 3,Isocitrate Dehydrogenase 1,Nucleophosmin 1,Neuroblastoma RAS viral oncogene homolog(+)high-risk group].She was treated with"IA"(IDA 10 mg day 1-3 and Ara-C 0.2 g day 1-5)chemotherapy.When her condition improved,the patient was discharged from the hospital,instructed to take medicine as prescribed by the doctor after discharge,and returned to the hospital for further chemotherapy on time.CONCLUSION We report a rare case of first platelet transfusion failure in a patient with AML during induction chemotherapy,which may be related to the production of platelet antibodies induced by antibiotics and excessive tumor load.This also suggests that we should consider the influence of antibiotics when the rare situation of first platelet transfusion failure occurs in patients with AML.When platelet antibodies are produced,immunoglobulins can be used to block antibodies,thereby reducing platelet destruction.For patients with PTR,both immune and non-immune factors need to be considered and combined in clinical practice along with individualized treatment to effectively solve the problem.

Local signals in stem cell-based bone marrow regeneration

The cellular basis of bone marrow （BM） tissue development and regeneration is mediated through hematopoietic stem cells （HSCs） and mesenchymal stem cells （MSCs）. Local interplays between hematopoietic cells and BM stromal cells （BMSCs） determine the reconstitution of hematopoiesis after myelosuppression. Here we review the BM local signals in control of BM regeneration after insults. Hematopoietic growth factors （HGFs） and cytokines produced by BMSCs are primary factors in regulation ofBM hematopoiesis. Morphogens which are critical to early embryo development in multiple species have been added to the family of HSCs regulators, including families of Wnt proteins, Notch ligands, BMPs, and Hedgehogs. Global gene expression analysis of HSCs and BMSCs has begun to reveal signature groups of genes for both cell types. More importantly, analysis of global gene expression coupled with biochemical and biological studies of local signals during BM regeneration have strongly suggested that HGFs and cytokines may not be the primary local regulators for BM recovery, rather chemokines （SDF- 1, FGF-4） and angiogenic growth factors （VEGF-A, Ang- 1） play instructive roles in BM reconstitution after myelosuppression. A new direction of management of BM toxicity is emerging from the identification of BM regenerative regulators.

Myelophil, a mixture of Astragali Radix and Salviae Radix extract, moderates toxic side effects of fluorouracil in mice

AIM: To evaluate the efficacy of Myelophil, an extract containing Astragali Radix and Salviae Radix, for reducing complications induced by 5-fluorouracil (5-FU) in a gastrointestinal cancer model. METHODS: We injected 5-FU into mice and then administered Myelophil to examine the ability of the drug to treat the side effects of 5-FU in mice. Peripheral blood counts, histological examinations, and colony-forming assays of bone marrow were conducted, followed by swimming tests and assessment of survival times. RESULTS: Myelophil restored red and white blood cells and platelets in blood, and recovered cell density in bone marrow to levels comparable to those observed within the control group. In addition, Myelophil significantly increased colony-forming unit granulocyte-macrophage (CFU-GM) and CFU-erythroid (CFU-E) compared to the control group. We confirmed that interleukin-3 gene expression was upregulated by Myelophil in spleen cells. Myelophil administration also doubled the survival rate of mice that were severely myelosuppressed as a result of 5-FU injection at a lethal dose of 70%. Finally, the swimming performance of mice significantly improved as a result of Myelophil treatment. CONCLUSION: These results provide experimentalevidence in support of clinical applications of Myelophil to minimize 5-FU-induced myelosuppression and improve general post-chemotherapy health.

A Case Report on Canine Transmissible Venereal Tumor

A male Japanese spitz(3 years)was brought at Himalayan Animal Rescue Trust(HART),Pokhara with a complaint of swollen gums and loss of appetite.A lobulated tumorous mass was seen at the gingival region on physical examination.Diagnosis and treatment of condition detected in the dog was the major objective.Impression smear of tumor cell was prepared and was observed under oil immersion microscope(100x).Microscopic examination shows the presence of vacuolations within the cytoplasm and the condition was diagnosed to be CTVT.Chemotherapy was performed using the most effective cytostatic agents I.e.Vincristine sulphate(once a week,I/v).The chemotherapy was repeated for 3 doses till the tumor gets completely regressed.The condition was resolved after third session of chemotherapy.Myelosuppression and gastrointestinal effects like vomiting are the major complications of using vincristine.

Efficacy and Prognosis of Venetoclax Combined with Hypomethylating Agents in the Treatment of Relapsed/Refractory Acute Myeloid Leukemia

Objective:To investigate the efficacy and prognosis of venetoclax combined with hypomethylating agents(HMAs)in the treatment of relapsed/refractory acute myeloid leukemia(AML).Methods:From June 2021 to February 2022,14 patients with relapsed/refractory AML were treated with venetoclax combined with HMAs,among which nine patients were treated with venetoclax+azacytidine,while five patients were treated with venetoclax+decitabine.The efficacy of the treatments was observed,and the patients were followed up.Results:All patients received one to five courses of treatment,in which the median course of treatment was three;four cases achieved CR and another four achieved PR,with NR in six cases;there was no treatment-related death.There were seven deaths up to the end of the follow-up period,all of which were progressive deaths at the end of the disease,and the overall survival rate was 50.00%.All the patients experienced different degrees of nausea,vomiting,and myelosuppression(Grade Ⅱ–Ⅳ),nine patients had Grade 3–4 hematological adverse reactions,and seven patients had infection.Conclusion:Venetoclax combined with hypomethylating agents is effective in the treatment of relapsed/refractory AML,with good prognosis,and some patients may even achieve CR.Although bone marrow suppression is serious with this combination,it is well tolerated.

Effects of Chinese Herbal Compound on the Blood Physiological Indices and Cytokines of Myelosuppressive Mice

[ Objective ] The research aimed to study the effects of Chinese herbal compound on the blcod physiological indices and cytokines of myelosuppressive mice. [ Metho] Myelasuppressive mice model was established by intraperitoneal injection of 80 mg/kg cyclophosphamide. Chinese herbal compound was composed of Houttuynia cordata, Taraxacum mongolicum, Citrus reticulata peel, Atractylodes chinensis, Paeonia sterniana, Atractylodes macrocephala and Angelica sinensis. The effects of Chinese herbal compound and Astragalus polysaccharide at different doses on the blood physiological indices and hematopoietic growth factors of myelosuppressive mice were discussed. [ Result] Myelosuppressive mice medel was successfully established. The total white blood cell count, total nentrephile granulocyte count, total lymphocyte count, total platelet count and the contents of serum interleukin-6 and erythropoietin in myelosuppressive mice were significantly decreased. The total erythrocyte count, the contents of hemoglobin and imerleukin-3 were decreased, without significant difference. The blood physiological indices and the contents of interleukin-3 and erythropoietin in myelosuppressive mice could be improved by intragastric administration of Astragalus polysaccharide and Chinese herbal compound at different doses for 3 days or 7 days. The effect of 20 g/kg Chinese herbal compound was the best after administration for 3 days, and the effect of 10 g/kg Chinese herbal compound was the best after administration for 7 days. The total white blcod cell count, total neutrophile granulocyte count, percentage of neutrephile granulocyte, total lymphocyte count, total count of middle cells, percentage of middle cells, total platelet count, contents of interleukin-3 and erythropoietin in myelosuppressive mice could be extremely significantly improved by intragastric administration of 10 g/kg Chinese herbal compound for 7 days（ P 〈 0. 01 ） , and the reduction of red blood cell count, hematecfit, the contents of hemoglobin and interleukin-6 induced by cyclophesphamide could be inhibited （P 〈 0.01 ）. [ Conclusion ] Chinese herbal compound could improve the hematopoietic function of myclosuppressivc mice induced by cyclophosphamide and its effect was better than Astragalus polysaccharide. 20 g/kg Chinese herbal compound reacted fast and the reaction of 10 g/kg Chinese herbal compound was slow ,but its efficacy was lasting.

Effect of Jianpi Bushen Sequential Formula on Adjuvant Chemotherapy of Colon Cancer:Study Protocol for a Randomized Controlled Trial

Background The side effects of chemotherapy-induced nausea and vomiting(CINV)and myelosuppression reduce the cancer patients’adherence to chemotherapy.Many Chinese patients choose Chinese medicine(CM)during chemotherapy to reduce side effects;however,the evidence is lacking.The efficacy of a CM herbal treatment protocol,Jianpi Bushen Sequential Formula(健脾补肾续贯方,JBSF)will be evaluated on chemotherapy completion rate among patients with colon cancer.Methods A multi-center double-blind randomized controlled trial(RCT)will be conducted on 400 patients with colon cancer who will receive 8 cycles of adjuvant chemotherapy with oxaliplatin and capecitabine(CAPEOX).Patients will be randomized 1:1 to receive the JBSF or placebo formula.The primary outcome is the overall chemotherapy completion rate.The secondary outcomes include individual chemotherapy completion rate,4-cycle completion rate of chemotherapy,time to treatment failure,relative dose intensity and treatment toxicity.Follow-up visits will be scheduled before every and after last chemotherapy.Discussion This study will provide evidence on whether JBSF can improve the chemotherapy completion rate and reduce side effects among patients with colon cancer.(Trial registration:Clinical Trials.gov,No.NCT03716518)。

Ginseng-Derived Panaxadiol Saponins Promote Hematopoiesis Recovery in Cyclophosphamide-Induced Myelosuppressive Mice:Potential Novel Treatment of Chemotherapy-Induced Cytopenias

Objective：To investigate the potential efficacy of panaxadiol saponins component（PDS-C）,a biologically active fraction isolated from total ginsenosides,to reverse chemotherapy-induced myelosuppression and pancytopenia caused by cyclophamide（CTX）.Methods：Mice with myelosuppression induced by CTX were treated with PDS-C at a low-（20 mg/kg）,moderate-（40 mg/kg）,or high-dose（80 mg/kg） for 7 consecutive days.The level of peripheral white blood cell（WBC）,neutrophil（NEU） and platelet（PLT） were measured,the histopathology and colony formation were observed,the protein kinase and transcription factors in hematopoietic cells were determined by immunohistochemical staining and Western blot.Results：In response to PDS-C therapy,the peripheral WBC,NEU and PLT counts of CTX-induced myelosuppressed mice were significantly increased in a dose-dependent manner.Similarly,bone marrow histopathology examination showed reversal of CTX-induced myelosuppression with increase in overall bone marrow cellularity and the number of hematopoietic cells（P〈0.01）.PDS-C also promoted proliferation of granulocytic and megakaryocyte progenitor cells in CTX-treated mice,as evidenced by significantly increase in colony formation units-granulocytes/monocytes and-megakaryocytes（P〈0.01）.The enhancement of hematopoiesis by PDS-C appears to be mediated by an intracellular signaling pathway,this was evidenced by the up-regulation of phosphorylated mitogen-activated protein kinase（p-MEK） and extracellular signal-regulated kinases（p-ERK）,and receptor tyrosine kinase（C-kit） and globin transcription factor 1（GATA-1） in hematopoietic cells of CTX-treated mice（P〈0.05）.Conclusions：PDS-C possesses hematopoietic growth factor-like activities that promote proliferation and also possibly differentiation of hematopoietic progenitor cells in myelosuppressed mice,probably mediated by a mechanism involving MEK and ERK protein kinases,and C-kit and GATA-1 transcription factors.PDS-C may potentially be a novel treatment of myelosuppression and pancytopenia caused by chemotherapy.