Regression of follicular lymphoma with alternative therapy using Devil's Claw (DC); Coincidence or causation?
Bibliographic record
Abstract
e19560 Background: Alternative therapies are used by c 30% of cancer pts (Ernst and Cassileth, Cancer 2000). Two follicular lymphoma (FL) pts who had objective tumor regression after taking the herb DC without cytotoxic therapy are reported here. Methods: This was a retrospective chart review. In January 2000, pt #1 presented with co-existent IgG plasma cell dyscrasia and stage 3A grade 2 FL with 5 cm cervical and R/P nodes. CT scan 10 months later showing partial regression of adenopathy. On enquiry, he was taking DC and Essiac. He developed overt myeloma in Aug 2001, when he stopped DC/Essiac and received HDCT/ASCT following which there has been no clinical progression of lymphoma. In November 2003, pt #2 presented with stage 3A grade 1 FL. CT scan showed widespread adenopathy (2.5 cm max.). He learned of pt #1 through the local Lymphoma Patient Support Group and started DC alone. CT scan 11 months later showed decreased adenopathy and splenomegaly which has been sustained. Results: CT images at baseline and follow-up confirm objective regression. Conclusions: DC (Harpagophytum procumbens) tuberous root contains Harpagoside and Beta sitosterol and has anti-inflammatory properties probably by suppressing COX-2 and iNOS expression (Jang et al, J Pharmacol Sci, 2003). There is good evidence for its use in osteoarthritis ( http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-devilsclaw.html ) but it has not been reported to have anticancer activity. COX-2 inhibition has an accepted role in cancer prevention (Steinbach et al, NEJM 2000), has been implicated in lymphomagenesis (Wun et al, Leuk Res 2004) and associated with both stage of lymphoma and response to standard treatment (Hazar et al, Leuk Lymphoma 2004). However, spontaneous regression in low grade lymphoma has been reported in 7 of 44 pts on observation only (Krikorian et al, 1980); none were on herbal medications or COX-2 inhibitors. The key issue in both these patients is whether or not the disease regression was “spontaneous” or causally related to DC therapy, but the timing of response suggests a potential therapeutic benefit. Considering the role of COX-2 inhibitors and the relation between components of DC and COX-2, further investigation is warranted, preferably with a COX-2 inhibitor of known purity. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".