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herb-drug interactions and leukaemia

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Hi everyone

A couple of pretty urgent questions; all help most gratefully received.

1. Does anyone have any info about potential interactions between milk

thistle and ARTA (tretinoin), here used to stimulate white cell production

in a patient with acute pro-myelocytic leukaemia? I have started to give him

milk thistle, but his consultant is concerned that it may interfere with the

tretinoin (Vit A derivative), the active part of which is a primary

metabolite via the CYP system.

2. Same patient. Has had first round of chemotherapy (21 yr old, previously

very healthy, rapid onset of APL, family history of leukaemia) and wishes

herbal support for side-effects and general well-being. Nothing remotely

significant in clinical history other than sudden onset heralded by bleeding

from ears and history of nosebleeds. Tongue red with no coating. Some

digestive upset and fungal infections following chemo. All suggestions

welcome. Have started him on Carduus, Echinacea, Chionanthus, Agrimonia and

Calendula.

Many many thanks

Alison Morton MNIMH

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