Patient: primary plasma cell leukemia, the main symptom is anemia with decreased whole blood. Currently undergoing phase I chemotherapy. The treatment regimen used is Vanco combined with VAD. I would like to regulate it through Chinese medicine, can you give some advice? I am currently taking Cordyceps daily, I wonder if it will help?
Yang Hongchong, Hematology Specialist, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: Generally speaking, multiple myeloma or plasma cell leukemia are mostly caused by kidney deficiency and stasis, so taking Cordyceps which nourishes the lungs and kidneys is beneficial. But sorry, because Chinese medicine diagnosis needs to look, smell, ask questions, and cut together after the four diagnoses, the diagnosis and treatment, without an interview, it is difficult to determine the specific treatment plan.
Patient: Thank you for your reply! Through chemotherapy, peripheral plasma cells have dropped from 46% at the beginning to 6%. What do I need to pay attention to in terms of diet? What should I not eat? What should be eaten more often, frequently and every day?
Yang Hongchong, Hematology Specialist, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: It is advisable to have a light, nutritious and easily digestible diet; avoid stimulating foods and high purine foods.
Patient: Can the patient undergo autologous stem cell transplantation after chemotherapy? Is the effect of transplantation good? What does the effect depend on? What is the longest survival period for this disease that you have treated? What is the most important thing we need to do as the patient’s family? I look forward to your answer, thank you!
Yang Hongchong, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Hematology Specialists: This disease originates in the bone marrow and autologous transplantation is less effective. The longest survival period can exceed 3 years with general conventional treatment. Family support, including spiritual, financial, life, medication, nursing and other all-round support, is very important for the patient’s treatment.
Patient: Thank you for your answer! The patient has now started the second course of chemotherapy and today is the fourth day. Before chemotherapy, he had a bone aspiration, plasma cells were 0.5%, no plasma cells were found in peripheral blood, hematocrit was 9, platelets were 300, white blood cells were more than 2000, hematocrit was higher than normal, and other indicators were normal. The treating doctor said that the treatment effect is much better than expected. With the current situation, should I still do chemotherapy for a long time? Can I take some Chinese herbal medicine to nourish my Qi and blood during chemotherapy?
Patient: What is the cause of constipation right after chemotherapy?
Yang Hongchong, Hematology Specialist, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: Constipation during chemotherapy is usually related to the anti-emetic drugs used during chemotherapy. It should be considered whether to continue chemotherapy according to the specific condition and physical tolerance. It is recommended to add Chinese herbal medicine for evidence-based treatment.
Patient: Hello, can I eat chicken, duck and fish during my cough? The internal medicine doctor I saw before recommended not to eat fatty things, but mainly to eat lean meat. I would like to hear your advice.
Yang Hongchong, Specialist in Hematology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: It is best not to eat duck and fish during a cold and cough. The patient should see the doctor in person, otherwise the effect will be affected.
Patient: I have constipation after taking the medicine, I don’t know what is the reason?
Yang Hongchong, Specialist in Hematology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine: It is estimated that it is mainly related to thalidomide.
Patient: I am no longer constipated, but I have hair loss. I wonder if there is any way such as taking Chinese medicine to reduce this symptom?
Yang Hongchong, Specialist in Hematology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine.
Did hair loss occur after continuing chemotherapy? How much?
Patient: It should be quite a lot, but today it is slightly better again. Undergoing the third course of chemotherapy, already 20 days, and preparing for autologous transplantation after this course. I’ve been taking medication to lower my white blood cells, and yesterday I got a shot to raise my white blood cells and prepare for blood collection.
Yang Hongchong, Hematology Specialist, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: Hair loss is considered a side effect of chemotherapy.
Patient: After three courses of chemotherapy and ready for transplantation, the doctor here wants our family members to buy 375mg of Mafaram on their own.
Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital Hematology Specialist Yang Hongchong: Sorry, it is difficult to deduce the authenticity of Mafran. It is advisable to buy it from a reputable pharmacy outside of China.
Patient: The autologous transplant started today. I heard that the process of transplantation will bring great adverse reactions to the patient, may I ask: can I continue to take Chinese medicine during the transplantation?
Yang Hongchong, Hematology Specialist, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: Autologous transplantation generally does not cause many side effects, and the medication needs to be decided according to the specific condition whether to continue taking it.
Patient: I have already undergone autologous transplantation, and it is already the 18th day since the transfusion of stem cells, and my white blood cells have risen to more than 2700, but my platelets are very low, hovering around 500. The doctor in charge said it was because of antibodies to other people’s platelets, and it is reasonable to say that by now the hematopoietic system should have been rebuilt and can produce platelets on its own, but the platelets have not been able to rise, resulting in purple spots on the body, and the doctor in charge has difficulty explaining it clearly. I wonder what the reason for this is? Is there any way to make the platelets return to normal as soon as possible?
Yang Hongchong, Specialist in Hematology, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: Is it estimated that the bone marrow has not been reconstructed properly?
Patient: 8 units of platelets have been transfused so far, two of which are matched platelets, but none of them have any effect, and yesterday the doctor asked the family to sign for the “invalid transfusion”. Yesterday’s blood count: hematocrit 7.1, platelets 10,000, white blood cells 1700. very unsatisfactory. What is this situation? Is it useful to eat more red peanuts? Is it possible to regulate by taking herbal medicine?
Patient: Today, the platelet count is 17,000, but I feel weak and my skin is darker than before. Can I take herbal medicine to regulate it? 2. What could be the reason for the darkening of the skin? Is it due to detoxification or the side effects of high-dose chemotherapy?
Yang Hongchong, Hematology Specialist, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: The darkening of the skin is considered to be caused by rejection; it can be treated with Chinese medicine.
Patient: The current blood indicators are very low, especially platelets, which have not reached 20,000, and recently I feel weak and have no appetite, so I asked the doctor in charge if I could see a Chinese medicine doctor, who did not advocate it very much. But the patient’s current condition is completely anemic, so I don’t know what to do?
The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Hematology Specialist Yang Hongchong: It is recommended to use a combination of Chinese and Western medicine or Chinese herbal medicine to treat mainly with evidence-based treatment and patient regulation; strive to make the condition gradually improve.
Patient: The current condition is poor, the white blood cells have been unstable, platelets are around 150,000, hematocrit is around 8, the attending doctor said that we can only slowly recuperate. Can you provide us with some dietary treatments for our reference?
Yang Hongchong, Hematology Specialist, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine: Sorry, diet therapy also requires evidence-based diet; especially after transplantation, the body constitution has changed significantly and should be adjusted appropriately according to the system changes.
Patient: I am sweating a lot at night, and I don’t have much appetite for food, but I can have regular bowel movements every day, and my stools are formed. What herbal medicine can I take to regulate the sweating at night?
Yang Hongchong, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Hematology Specialists: Sorry, as Chinese medicine diagnosis requires a combination of the four diagnoses, diagnosis and treatment, it is difficult to determine the diagnosis and treatment plan without an interview. It is recommended to go to a nearby Chinese medicine hospital to find an experienced TCM doctor for treatment.
Patient: I have two questions for you: 1. The platelets and white blood cells are both low at the moment, so will taking Qingxu Tablet and Yangzheng Pill affect the recovery of platelets and white blood cells? 2. She has been taking compound soap alum pills for more than two months, but her platelets are only over 50,000 now, and the best time was over 70,000, should she continue to take them? Is the medicine really effective?
The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine Yang Hongchong, a specialist in hematology, said: “The Qingxu Tablet and the Yangzheng Tablet do not affect the recovery of blood cells. The compound saponin pill needs to be selected according to the evidence after the examination and diagnosis, not everyone is suitable.
Patient: Yesterday, I had a bone aspiration and found that the plasma cells were recurrent. 60% of the bone marrow had plasma cells and 5% of the peripheral blood.
Yang Hongchong, Hematology Specialist, The First Affiliated Hospital of Guangzhou University of Chinese Medicine: If physical condition allows, it is recommended to continue the combination of Chinese and Western medicine medication first.
Patient: The treating doctor initially decided the VAD program, but at present the white blood cells and platelets are low, the hematocrit is about 10, other discomfort is some leg weakness, appetite and other aspects of life are still okay. Q: 1.I don’t know if this program is available and 2.What methods of treatment are available in Chinese medicine?
Yang Hongchong, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, specializes in hematology: Whether this program can be used depends on the function of the heart, lungs and liver. Chinese medicine needs to support the righteousness and dispel the evil, and the specific treatment should be based on the diagnosis and diagnosis.