Use of Nutraceutical in Leukemia

Abstract

Leukemia, a heterogeneous group of hematological malignancies, remains a major clinical challenge despite advancements in chemotherapeutic and targeted approaches. Conventional treatments are often associated with significant side effects and drug resistance, necessitating the exploration of alternative or complementary therapies. Nutraceuticals—naturally derived bioactive compounds found in foods and medicinal plants—have gained attention for their potential anti-leukemic properties. These compounds, including curcumin, resveratrol, quercetin, and epigallocatechingallate, exhibit anti-inflammatory, antioxidant, pro-apoptotic, and anti-proliferative effects through modulation of critical signaling pathways implicated in leukemia pathogenesis. This review provides a comprehensive analysis of various nutraceuticals studied in the context of leukemia, summarizing their mechanisms of action, preclinical and clinical evidence, and therapeutic potential. Additionally, challenges such as bioavailability, safety, and regulatory concerns are discussed, along with future directions including nanocarrier-based delivery and personalized therapy. The integration of nutraceuticals into leukemia management holds promise, but requires further validation through rigorous scientific and clinical research

Introduction

Overview of Leukemia:
Leukemia is a group of blood cancers marked by uncontrolled growth of abnormal white blood cells, disrupting normal blood functions. It is classified into four major types based on cell origin and progression speed:

• Acute Myeloid Leukemia (AML): Rapid, common in adults.

• Acute Lymphoblastic Leukemia (ALL): Common in children.

• Chronic Myeloid Leukemia (CML): Slow progression, linked to Philadelphia chromosome.

• Chronic Lymphocytic Leukemia (CLL): Affects older adults, often asymptomatic early on.

These subtypes differ in behavior, treatment, and prognosis.

Epidemiology and Treatment Challenges:
Leukemia causes over 474,000 new cancer cases and 311,000 deaths globally each year. Current treatments (chemotherapy, radiation, targeted therapies, immunotherapy, stem cell transplant) face issues like severe side effects, drug resistance, relapse, and high costs, especially impacting low-income regions. This necessitates exploring safer, cost-effective adjunct therapies.

Nutraceuticals and Their Role in Cancer:
Nutraceuticals are food-derived bioactive compounds (e.g., vitamins, herbal extracts, polyphenols) with health benefits including cancer prevention and therapy. They work by:

• Acting as antioxidants

• Reducing inflammation

• Inducing apoptosis (programmed cell death)

• Inhibiting tumor growth and metastasis

• Modulating key cellular signaling pathways (e.g., PI3K/AKT, NF-κB)

Nutraceuticals have low toxicity, making them good candidates for combined use with conventional cancer treatments.

Molecular Pathophysiology of Leukemia:
Leukemia arises from genetic mutations, chromosomal abnormalities, and epigenetic changes disrupting cell growth and death control. Key molecular targets include:

• BCR-ABL fusion gene (CML)

• FLT3 mutations (AML)

• TP53 mutations

• NOTCH1 and JAK-STAT pathways (ALL)

• Overexpression of anti-apoptotic proteins like BCL-2

Nutraceutical Modulation of Leukemic Pathways:
Certain nutraceuticals can target these molecular abnormalities, enhancing apoptosis and inhibiting proliferation:

• Curcumin: Blocks NF-κB and STAT3, promotes apoptosis.

• Resveratrol: Suppresses PI3K/Akt, induces apoptosis.

• EGCG (green tea): Inhibits BCR-ABL, induces apoptosis.

• Quercetin: Targets BCL-2, induces apoptosis.

• Sulforaphane: Epigenetic modulation, induces oxidative stress and apoptosis.

• Genistein: Tyrosine kinase inhibition, promotes apoptosis.

Key Nutraceuticals with Evidence in Leukemia:

• Curcumin: Anti-inflammatory, pro-apoptotic; poor oral bioavailability is a limitation.

• Resveratrol: Induces apoptosis, sensitizes resistant cells; limited clinical data.

• EGCG: Reactivates tumor suppressors, inhibits telomerase; possible hepatotoxicity at high doses.

• Quercetin: Induces apoptosis, synergizes with chemo; low solubility.

• Sulforaphane: Epigenetic effects, enhances chemosensitivity; heat sensitive.

• Omega-3 Fatty Acids: Anti-inflammatory, improve chemosensitivity; oxidation prone.

• Genistein: Kinase inhibition, supports chemo efficacy; estrogenic effects caution.

• Garlic Compounds (Allicin, DADS): Increase ROS, induce apoptosis; instability and GI irritation possible.

Conclusion

Nutraceuticals offer a novel and promising avenue in the management of leukemia. Through a variety of mechanisms—ranging from epigenetic modulation to apoptotic induction—natural compounds like curcumin, EGCG, and quercetin have demonstrated efficacy in preclinical and early clinical studies. However, their use is currently limited by poor bioavailability, lack of standardization, and regulatory gaps. While some compounds show synergistic potential with chemotherapy, comprehensive clinical validation is essential before they can be adopted widely.Going forward, advancements in nanotechnology and personalized medicine could revolutionize the role of nutraceuticals in leukemia treatment. A coordinated effort in research, clinical trials, and policy development will be critical to unlocking their full therapeutic potential.10

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Copyright

Copyright © 2025 Jayesh Patil, Suresh Padvi, Nivrutti Deore, Prof. Pallavi N. Patil, Principal Ms. Vaishali.D. Shewale. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.