Herbs in hemato-oncological care: an evidence-based review of data on efficacy, safety, and drug interactions

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Abstract
Herbal remedies are clearly a complementary and alternative modality used frequently by patients with hemato-oncological neoplasias during the course of their specific treatment. This review focuses on the potential safety and efficacy of herbs which are either used often or even on a daily basis by patients with hematological malignancies or indicated in the herbal pharmacopeias utilized by various traditional systems of medicine, in order to improve the well-being of patients with these cancers. Traditional medicine worldwide is a source for ongoing laboratory research related to the activity of herbs on cultured cell lines derived from patients with leukemia, lymphoma, and myeloma. Although the number of clinical studies in the field of hemato-oncology is limited, there appears to be potential efficacy in studies of mistletoe (Viscum album), green tea, Indian and Middle-Eastern spices, and some traditional Chinese, American, and European herbs. In addition to the potential efficacy of herbs, safety issues are also reviewed here, particularly, the documented and potential side effects, herb-drug interactions, and matters of quality control. Based on the above issues, the authors suggest enhancing doctor-patient communication regarding herbal use by adopting a patient-centered attitude based on scientific perspective.