Milk Thistle May Reduce Chemotherapy-Induced Hepatotoxicity
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The first randomized, controlled clinical study to investigate the feasibility and safety of the dietary supplement milk thistle (Silybum marianum) for the treatment of chemotherapy-induced hepatotoxicity in children with acute lymphoblastic leukemia (ALL) reported a trend toward significant reductions in liver toxicity. The study results were published online December 14, 2009, in Cancer.
The administration of chemotherapy agents to children with ALL frequently must be interrupted because of heptatotoxicity, especially during the maintenance phase of treatment. In this multicenter pilot study, 50 children with ALL and hepatic toxicity received either a weight-based dose of milk thistle (approximately 5.1 mg/kg/day) or placebo orally for 28 days. Hepatic toxicity was measured at days 0, 28, and 56.
At day 56, the children treated with milk thistle had a significantly lower amino transferase and a trend toward a significantly lower amino alanine transferase from baseline, compared with children in the control group. In vitro experiments conducted by the authors revealed no antagonistic interactions between milk thistle and vincristine or L-asparaginase in an ALL cell line.
The authors observed that future investigations are needed to determine the most effective dose and duration of milk thistle therapy, as well as to identify populations that may gain the largest clinical benefit.