Combination Therapy with Korean Medicine and Filgrastim on Neutropenia: A Retrospective Study

Objectives: Neutropenia is a complication due to chemotherapy or radiotherapy that can limit clinical outcomes. Previous systematic reviews and meta-analysis have suggested that traditional Asian medicine may relieve neutropenia. This study investigated the effect of the combination therapy of Korean Medicine (KM) and filgrastim on neutropenia.Methods: A total of 336 subjects were included, with 167 in the only filgrastim treatment group and 169 in the filgrastim with KM treatment group. Absolute neutrophil count (ANC) was calculated by multiplying the white blood cell count by the total percentage of neutrophils. ANC was observed on the day of filgrastim and up to 6 days with hospital medical records.Results: The clinical characteristics of the participants in the filgrastim with KM treatment group tended to have higher age. Comparing the two groups, by the linear mixed-effects model, ANC mean was significantly different on the 3rd day. A linear mixed effect model was performed to estimate difference in slope of ANC over time after treatment between the two groups. The slope difference was significant in neutropenia grade 3 patients. The mean of ANC increment after initial treatment tends to increase with the number of days of KM treatment but not statistically significant. During the follow-up period, the average blood levels of patients in the filgrastim with KM treatment group were within the normal range.Conclusions: The combination treatment with filgrastim and KM can be effective for patients with neutropenia.