Leukemia Wellness Protocol
Leukemia is relatively rare compared to most other cancers, and is currently the 11th most common. According to the SEER 2008-2010 data, about 1.4 percent of men and women will be diagnosed with leukemia at some point during their lifetime.[1]
Leukemia is a type of blood cancer that begins in the bone marrow and affects the white blood cells or leukocytes (which include neutrophils, basophils, eosinophils, monocytes, and lymphocytes).
Although rare compared to other cancers, acute leukemia is the most common cancer among children. The 5 year survival rate of leukemia (overall) is 57.2%.
Leukemia can be classified into 2 basic groups—the acute and the chronic leukemias.
Acute types include:
Acute myeloid leukemia (AML), Acute lymphoblastic leukemia (ALL), and Adult T-cell Leukemia/Lymphoma.
Chronic types include:
Chronic lymphocytic leukemia (CLL), Chronic myelogenous leukemia (CML), and Hairy Cell leukemia.
HEALTHY DIET
Maintain a healthy body weight, as obesity can worsen the prognosis of leukemia, and increase drug resistance.[2]
Among the most well-established risk factors include:
- A history of leukemia in the family, particularly a first degree relative.
- Treatment for other cancers that used chemotherapy and radiation, especially as a child.
- Additionally exposure to radiation in the environment as found in certain industries and from x-rays.[3][4]
- Exposure to polycyclic aromatic hydrocarbons (PAHs). A human trial looked at PAH exposure and risk of childhood acute lymphoblastic leukemia (ALL) using concentrations in residential dust as an exposure indicator, and it was found that ALL risk was increased with higher exposure to PAHs.[5]
- Leukemia occurs in clusters, which suggests that outbreaks of infections, especially in children, may be a contributing cause of the disease. It is also likely that a pre-existing immune abnormality exists, and exposure to infection is only a surrogate for immune stimulation.[6]
Other risk factors include:
- Genetic disorders, such as Down syndrome, are associated with increased risk of leukemia.
- Having a diagnosis of certain blood disorders, such as myelodysplastic syndromes, is associated with an increased risk of leukemia.
- Smoking cigarettes increases the risk of several types of leukemia, and may be influenced by specific gene variants.[7][8]
ENVIRONMENT MATTERS Move away from areas of high radiation, such as near power plants and limit X-ray exposure.
Labs will likely be ordered by your physician to assess red and white blood cell status and platelet count.If leukemia is suspected then a bone marrow aspiration and biopsy may be performed, which is a test that looks for malignant cells in the bone marrow as well as certain changes in the cell chromosomes from a sample of blood or bone marrow (cytogenetic analysis).
A test to look for genes that are "turned on" in several types of leukemia, such as acute myelogenous leukemia (AML) called reverse transcription-polymerase chain reaction test, or RT-PCR.
A test that compares the cancerous cells to normal blood cells to find the specific kind of leukemia, or immunophenotyping.
STAY ACTIVE Incorporate regular physical activity – the risk for cardiovascular disease is increased in survivors of leukemia, but may be mitigated by regular exercise.[9][10]
Emphasize:
- Brightly colored, fresh vegetables, leafy greens and fresh fruits (choose organic if possible)
- Cruciferous vegetables, such as broccoli, cauliflower, cabbage, which have high levels of DIM & isothiocyanates
- Whole foods (foods that are as close to their natural form as possible)
- Low sugar/low glycemic diet (Glycemic index (GI) and glycemic load (GL) are measures of the effect on blood glucose level after a food containing carbohydrates is consumed)
- Omega-3 fatty acids, found in cold water fish such as sardines, wild-caught salmon, cod, mackerel, tuna
- High fiber, from whole grains, beans, vegetables and fruits
- Healthy fats, from avocados, nuts, seeds, olive oil, coconut oil, cold water fish
- For animal protein, choose lean poultry and fish over red meat, and aim to view meat as a condiment rather than a staple. Try to choose grass fed and organic meats and eggs whenever possible. Eat no fish larger than a salmon to minimize environmental contaminants, including mercury.
Avoid:
- Processed and grilled meats. Also, try to limit intake of red meat
- Fast foods, fried foods, baked goods and packaged, processed foods
- Sugar, sweeteners and artificial sweeteners
- Vegetable oils, shortening, margarine and anything with hydrogenated or partially hydrogenated oils
Multiple nutritional supplements have been associated with reduced cancer incidence and/or cancer progression. This list contains those with the greatest evidence-based benefit.
Green Tea Extract
Catechins, antioxidants found in green tea, particularly EGCG (epigallocatechin-3-gallate), are known to have many anti-tumor affects. In human adult T-cell leukemia cells, ECGC reduced cancer cell proliferation.[25] In animal studies of leukemia cells, a similar mechanism of tumor cell death was found.[26]
Suggested dose:
1g EGCG and mixed catechins.
Olive Leaf Extract
Olive leaf contains the antioxidants oleuropein and hydroxytyrosol, which are believed to have anti-cancer affects. Olive leaf extracts induced apoptosis (programmed cell death) as well as induction of differentiation (moving them toward a more normal phenotype) of human leukemia cells.[23],[24]
Suggested dose:
250 to 500 mg of a standardized extract, 1-3 times per day.
Pycnogenol
Grape seed extract used on leukemia cell lines decreased uncontrolled cell proliferation and survival and increase cell death in leukemia cells.[14],[15] Other studies indicate that the antioxidant in grape seeds called proanthocyanidins are likely to induce monocytic differentiation in leukemia cells (which prevents proliferation).[16],[17]
Suggested dose:
500 mg of a 90% OPC extract.
Vitamin D
Human trials have shown that low levels of vitamin D are related to a higher risk of developing leukemia and also with a worsening prognosis following a diagnosis of AML.[11] Increased vitamin D level was associated with higher survival rate in elderly patients with acute myeloid leukemia.[12] Individuals with a history of lymphoma should also monitor 1,25 dihydroxy-vitamin D levels, as rapid conversion to this active form has been observed in patients with lymphoma.
Suggested dose is that sufficient to raise vitamin D blood levels to >40 ng/mL, which may require 5000 IU per day or more.[13]
Milk Thistle
Silymarin and silibinin from milk thistle have anti-proliferative and anti-metastatic properties, and may reduce the liver damaging effects of chemotherapy, especially in children. In children with ALL and liver toxicity, milk thistle was associated with a trend toward significant reductions in liver toxicity.[27]
Suggested dose:
At least 500mg silymarin per day.
Diindolylmethane (DIM)
Isothiocyanates, which are abundant in cruciferous vegetables, like broccoli, cauliflower and cabbage, have shown anti-tumor activity as well as DIM (3,3′-Diindolylmethane), also found in these same vegetables. Treatment of the T-ALL human cell lines CCRF-CEM, CCRF-HSB2, SUP-T1 and Jurkat with DIM in vitro significantly reduced cell proliferation and viability.[18] Other animal cell studies demonstrated that DIM induced cell death in myeloid cell leukemia.[19]
Suggested dose:
DIM 250mg & Isothiocyanates 600mcg per day.
Curcumin Phytosome
The active extract from the spice turmeric, curcumin, has been shown to cause cell death in a variety of cancer cell lines. In trials with the human acute leukemia cell line THP-1, curcumin inhibited proliferation and induced apoptosis of these cancer cells.[20]
Suggested dose:
1-2g per day of Meriva® or Longvida® curcumin.[21],[22]
[1] http://seer.cancer.gov/statfacts/html/leuks.html Accessed August 2014
[2] Sheng X1, Mittelman SD2. The role of adipose tissue and obesity in causing treatment resistance of acute lymphoblastic leukemia. Front Pediatr. 2014 Jun 5;2:53. doi: 10.3389/fped.2014.00053. eCollection 2014.
[3] Shih TY, Wu J, Muo CS, Kao CH. Association between leukaemia and X-ray in children: A nationwide study. J Paediatr Child Health. 2014 Aug;50(8):615-8. doi: 10.1111/jpc.12605. Epub 2014 Jun 9.
[4] Gillies M, Haylock R. The cancer mortality and incidence experience of workers at British Nuclear Fuels plc, 1946-2005. J Radiol Prot. 2014 Jul 22;34(3):595-623.
[5] Deziel NC, Rull RP, Colt JS, Reynolds P, Whitehead TP, Gunier RB, Month SR, Taggart DR, Buffler P, Ward MH, Metayer C. Polycyclic aromatic hydrocarbons in residential dust and risk of childhood acute lymphoblastic leukemia. Environ Res. 2014 Aug;133:388-95. doi: 10.1016/j.envres.2014.04.033. Epub 2014 Jun 17.
[6] Wiemels J. Perspectives on the causes of childhood leukemia. Chem Biol Interact. 2012 Apr 5;196(3):59-67. doi: 10.1016/j.cbi.2012.01.007. Epub 2012 Feb 2.
[7] Milne E1, Greenop KR, Scott RJ, et al. Parental prenatal smoking and risk of childhood acute lymphoblastic leukemia. Am J Epidemiol. 2012 Jan 1;175(1):43-53. doi: 10.1093/aje/kwr275.
[8] Lee KM1, Ward MH, Han S, et al. Paternal smoking, genetic polymorphisms in CYP1A1 and childhood leukemia risk. Leuk Res. 2009 Feb;33(2):250-8. doi: 10.1016/j.leukres.2008.06.031. Epub 2008 Aug 8.
[9] Järvelä LS1, Niinikoski H, Heinonen OJ, et al. Endothelial function in long-term survivors of childhood acute lymphoblastic leukemia: effects of a home-based exercise program. Pediatr Blood Cancer. 2013 Sep;60(9):1546-51. doi: 10.1002/pbc.24565. Epub 2013 Apr 20.
[10] Chiang J, Huang YW, Chen ML, Wang SY, Huang AC, Chen YJ. Comparison of anti-leukemic immunity against U937 cells in endurance athletes versus sedentary controls. Int J Sports Med. 2000 Nov;21(8):602-7.
[11] Lee HJ, Muindi JR, Tan W, Hu Q, Wang D, Liu S, Wilding GE, Ford LA, Sait SN, Block AW, Adjei AA, Barcos M, Griffiths EA, Thompson JE, Wang ES, Johnson CS, Trump DL, Wetzler M. Low 25(OH) vitamin D3 levels are associated with adverse outcome in newly diagnosed, intensively treated adult acute myeloid leukemia. Cancer. 2014 Feb 15;120(4):521-9. doi: 10.1002/cncr.28368. Epub 2013 Oct 25.
[12] Paubelle E, Zylbersztejn F, Alkhaeir S, Suarez F, Callens C, Dussiot M, Isnard F, Rubio MT, Damaj G, Gorin NC, Marolleau JP, Monteiro RC, Moura IC, Hermine O. Deferasirox and vitamin D improves overall survival in elderly patients with acute myeloid leukemia after demethylating agents failure. PLoS One. 2013 Jun 20;8(6):e65998. doi: 10.1371/journal.pone.0065998. Print 2013.
[13] Garland CF, French CB, Baggerly LL, et al. Vitamin D supplement doses and serum 25-hydroxyvitamin D in the range associated with cancer prevention. Anticancer Res. 2011 Feb;31(2):607-11.
[14] Espino J, González-Gómez D, Moreno D, Fernández-León MF, Rodríguez AB, Pariente JA, Delgado-Adámez J. Tempranillo-derived grape seed extract induces apoptotic cell death and cell growth arrest in human promyelocytic leukemia HL-60 cells. Food Funct. 2013 Dec;4(12):1759-66.
[15] Gao N, Budhraja A, Cheng S, Yao H, Zhang Z, Shi X. Induction of apoptosis in human leukemia cells by grape seed extract occurs via activation of c-Jun NH2-terminal kinase. Clin Cancer Res. 2009 Jan 1;15(1):140-9. doi: 10.1158/1078-0432.CCR-08-1447.
[16] Wang M, Wang L, Pan XJ, Zhang H. Monocytic differentiation of K562 cells induced by proanthocyanidins from grape seeds. Arch Pharm Res. 2012 Jan;35(1):129-35.
[17] Hu H, Qin YM. Grape seed proanthocyanidin extract induced mitochondria-associated apoptosis in human acute myeloid leukaemia 14.3D10 cells. Chin Med J (Engl). 2006 Mar 5;119(5):417-21.
[18] Shorey LE, Hagman AM, Williams DE, Ho E, Dashwood RH, Benninghoff AD. 3,3′-Diindolylmethane induces G1 arrest and apoptosis in human acute T-cell lymphoblastic leukemia cells. PLoS One. 2012;7(4):e34975. doi: 10.1371/journal.pone.0034975. Epub 2012 Apr 13.
[19] Gao N, Cheng S, Budhraja A, Liu EH, Chen J, Chen D, Yang Z, Luo J, Shi X, Zhang Z. 3,3′-Diindolylmethane exhibits antileukemic activity in vitro and in vivo through a Akt-dependent process. PLoS One. 2012;7(2):e31783. doi: 10.1371/journal.pone.0031783. Epub 2012 Feb 21.
[20] Guo Y, Shan Q, Gong Y, Lin J, Shi F, Shi R, Yang X. Curcumin induces apoptosis via simultaneously targeting AKT/mTOR and RAF/MEK/ERK survival signaling pathways in human leukemia THP-1 cells. Pharmazie. 2014 Mar;69(3):229-33.
[21] Marczylo TH, Verschoyle RD, Cooke DN, et al. Comparison of systemic availability of curcumin with that of curcumin formulated with phosphatidylcholine. Cancer Chemother Pharmacol. 2007 Jul;60(2):171-7.
[22] DiSilvestro RA1, Joseph E, Zhao S, Bomser J. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutr J. 2012 Sep 26;11:79. doi: 10.1186/1475-2891-11-79.
[23] Samet I, Han J, Jlaiel L, Sayadi S, Isoda H. Olive (Olea europaea) leaf extract induces apoptosis and monocyte/macrophage differentiation in human chronic myelogenous leukemia K562 cells: insight into the underlying mechanism. Oxid Med Cell Longev. 2014;2014:927619.
[24] Abaza L, Talorete TP, Yamada P, Kurita Y, Zarrouk M, Isoda H. Induction of growth inhibition and differentiation of human leukemia HL-60 cells by a Tunisian gerboui olive leaf extract. Biosci Biotechnol Biochem. 2007 May;71(5):1306-12.
[25] Harakeh S, Diab-Assaf M, Azar R, Hassan HM, Tayeb S, Abou-El-Ardat K, Damanhouri GA, Qadri I, Abuzenadah A, Chaudhary A, Kumosani T, Niedzwiecki A, Rath M, Yacoub H, Azhar E, Barbour E. Epigallocatechin-3-gallate inhibits tax-dependent activation of nuclear factor kappa B and of matrix metalloproteinase 9 in human T-cell lymphotropic virus-1 positive leukemia cells. Asian Pac J Cancer Prev. 2014;15(3):1219-25.
[26] Huang AC, Cheng HY, Lin TS, Chen WH, Lin JH, Lin JJ, Lu CC, Chiang JH, Hsu SC, Wu PP, Huang YP, Chung JG. Epigallocatechin gallate (EGCG), influences a murine WEHI-3 leukemia model in vivo through enhancing phagocytosis of macrophages and populations of T- and B-cells. In Vivo. 2013 Sep-Oct;27(5):627-34.
[27] Ladas EJ, Kroll DJ, Oberlies NH, Cheng B, Ndao DH, Rheingold SR, Kelly KM. A randomized, controlled, double-blind, pilot study of milk thistle for the treatment of hepatotoxicity in childhood acute lymphoblastic leukemia (ALL). Cancer. 2010 Jan 15;116(2):506-13.
Green Tea Extract
Olive Leaf Extract
Pycnogenol
Vitamin D
Multiple nutritional supplements have been associated with reduced cancer incidence and/or cancer progression. This list contains those with the greatest evidence-based benefit.