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Different routes of application in mistletoe therapy - effect on bone marrow and blood profile. Clinical significance.

Background: For cancer patients, the absolute lymphocyte count in peripheral blood has well-substantiated prognostic potential for recurrence free survival and survival following chemotherapy. A low absolute neutrophil count during chemotherapy reflects bone marrow toxicity and thus limits further treatment. The question is considered how different routes of application of mistletoe therapy (Iscador[R]) effect these cell populations.

Method: The effect of subcutaneous mistletoe therapy in 231 patients on leukocytes, neutrophils and lymphocytes is compared with that of 19 intravenous applications and complemented with the effects of the concurrent humoral reaction in the patients' serum. Different kinds of solid tumors were treated, treatment modality included mistletoe preparations of Iscador[R] from different host trees in a dose range from 0.01 to 20 mg in subcutaneous and 10, 20 and 30 mg in intravenous application.

Results: Subcutaneous mistletoe therapy has a statistical significant numeric stimulant effect on leukocytes, absolute neutrophils and absolute lymphocytes, which is apparent after 30 days of treatment with injections three times per week. The intravenous route has a distinctly greater stimulant effect on these cell populations. The reaction kinetics reflect a process compressed into 24 h which in cellular and humoral terms takes several days in acute inflammatory conditions. The humoral reaction relates to increased cytokine production, especially of granulocyte-colony stimulating factor (G-CSF), which showed serum levels between 34.9 and 892 ng/ml 2 h after a 3 h infusion. The degree of G-CSF production depends on the resulting rise in temperature: low levels in low temperature (37.7 C) and high levels in high temperature (39.7 C). The cellular reaction - especially of neutrophils - correlates with increased production of G-CSF in the same way. This results in an increased release of juvenile neutrophils, indicative of bone marrow stimulation. This effect can be utilizing during chemotherapy as it can limit the risk of neutropenia and neutropenic fever (case report).

Keywords: Mistletoe; Treatment in oncological patients; Subcutaneous and intravenous application; Additional application in chemotherapy; Effect on leukocytes; Neutrophils and lymphocytes; G-CSF; Survival

doi: 10.1016/j.phymed.2011.09.026

Jurgen Johannes Kuehn *

Lukas Klinik, Specialist Oncology Clinic, Arlesheim, Switzerland

* Corresponding author at: Lukas Klinik Arlesheim, Switzerland. Tel.: +41 61 7067171; fax: +41 61 7067313. E-mail address:

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Author:Kuehn, Jurgen Johannes
Publication:Phytomedicine: International Journal of Phytotherapy & Phytopharmacology
Article Type:Report
Geographic Code:4EXSI
Date:Oct 15, 2011
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