Systematic Review of Adverse Events Associated with Herbal Medicine Use in Pediatric Oncology

Abstract

Introduction: The use of herbal medicine is common among pediatric cancer patients, often without disclosure to the oncology team. This creates a risk of adverse events and herb-drug interactions. This review aims to systematically identify and characterize adverse events related to herbal use in this vulnerable population.

Methods: A systematic search of MEDLINE, Embase, and toxicology databases was performed for case reports, case series, and observational studies. We included reports of any adverse event in a pediatric cancer patient where concurrent herbal medicine use was documented.

Results: The search identified 45 relevant reports. The most common adverse events included hepatotoxicity, nephrotoxicity, and hematological abnormalities. Significant herb-drug interactions were also reported, particularly those involving the alteration of chemotherapy drug metabolism (e.g., with St. John’s Wort), leading to either increased toxicity or therapeutic failure.

Discussion: The use of herbal medicine in pediatric oncology is not without risk. The lack of regulation and quality control for herbal products exacerbates these dangers. Open communication between families and clinical teams is essential for patient safety.

Conclusion: Herbal medicine use in pediatric oncology is associated with a risk of significant adverse events and drug interactions.