American Ginseng Extract in Preventing Respiratory Infection and in Reducing Antibiotic Use in Patients With CLL

OBJECTIVES: Primary * To assess the effect of American ginseng extract on the number of days of acute respiratory infection (ARI) during the peak respiratory illness season (January-March) in patients with chronic lymphocytic leukemia (CLL). * To determine the safety of American ginseng extract in these patients evaluated according to NCI CTCAE v3.0. Secondary * To assess the effect of this treatment on antibiotic use days (AUDs). * To assess the effect of this treatment on the rate of all infections diagnosed by a physician. * To assess the effect of this treatment on the duration and severity of each ARI episode. * To assess the effect of this treatment on major infections defined as infection severe enough to require hospitalization or intravenous antibiotics. * To assess the effect of this treatment on the incidence of herpes zoster infection defined as an episode of physician-diagnosed zoster infection. * To assess the effect of this treatment on CLL disease activity (i.e., serum IgG, total lymphocyte count, platelet count, and Rai staging). * To determine the incidence of ARI and type of illness in an untreated cohort of CLL patients over an entire winter respiratory illness season (January 1- April 30). Tertiary * To determine the effect of this treatment on the incidence of influenza and respiratory syncytial virus confirmed by a physician. OUTLINE: This is a multicenter study. Patients are stratified according to antibiotic prophylaxis with trimethoprim-sulfamethoxazole (yes vs no), serum IgG (≤ 500 mg/dL vs \> 500 mg/dL), and influenza vaccine status (yes vs no). Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive oral American ginseng extract twice daily. * Arm II: Patients receive oral placebo twice daily. Treatment in both arms continues for up to 4 months in the absence of illness or adverse events. After completion of study treatment, patients are followed at 4 weeks by phone.