Garlic for infection prophylaxis in acute myelogenous leukemia

Abstract

Objective : To assess the effectiveness of garlic in preventing infection of acute myelogenous leukemia patients during chemotherapy and the side effect of garlic. Design : A randomized placebo-controlled clinical trial. Setting : First General Hospital of West China University of Medical Sciences, a tertiary care hospital. Patients : Thirty-eight consecutive acute myelogenous leukemia patients diagnosed by clinical pathological evidence without infection or taking antibiotics on admission, were stratified into 3 strata, according to whether they were newly diagnosed, relapsed or in postremission consolidation. Within each stratum, patients were randomly assigned into the treatment (trt grp, n = 19) or control (ctrl grp, n = 19). Intervention : Patients trt grp were treated by 10 ml of aqueous garlic extract (AGE), equivalent to 10 grams of raw garlic, 3 times a day, from the start of chemotherapy till their peripheral white blood cell count exceeded 2x10[superscript 9]/L or till 28 days. Patients in the ctrl grp were given normal saline, according to the same dosage and schedule. Patients in both groups received the same standard chemotherapy regimen. When patients had fever and infection was suspected, antibiotics were given and guided by the detailed guidelines for antibiotics. Results : There was no significant difference between the 2 groups in the incidence of inection, defined as fever plus microbiologically or clinically documented infection and fever when the peripheral neutrophil count was less than 0.5x10[superscript 9]/L. However, patients in the trt grp had significantly less fungal colonization than patients in ctrl grp (1.21+_1.31 for trt grp and 2.32+_1.38 for ctrl grp, p = 0.0156, two-sample Wilcoxon rank-sum test). This decreased number of fungal colonization was not associated with a decreased fungal infection. Conclusion : Compared to placebo, garlic did not decrease the total febrile episodes but it could lower the number of fungal colonization. Further studies on the effectiveness of garlic in preventing infection especially fungal infection of neutropenic patients are warrented.