A 32-year-old man with non-Hodgkin lymphoma comes to the physician 6 days after finishing the initial chemotherapy regimen. His leukocyte count is 1600/mm3, indicating greater bone marrow suppression than expected. When questioned, the patient says that he has been taking Madagascar periwinkle as an herbal remedy for his condition. He obtains this substance from an herbalist. Which of the following is the most appropriate response by the physician?
(A) Ask the patient to stop using the herbal supplement because supplements are generally ineffective
(B) Continue the patient’s chemotherapy
(C) Explain the adverse effects this herbal supplement has on the patient’s treatment
(D) Report the herbalist to the Food and Drug Administration
(E) Suggest that the patient take daily multivitamin and protein supplements in addition to the herbal supplement
Correct answer : (C) Explain the adverse effects this herbal supplement has on the patient’s treatment
Catharanthus (Madagascar Periwinkle) is the source of the alkaloids vincristine and vinblastine – used in treatment for leukaemia and lymphoma. Hence it will cause additional bone marrow suppression.