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Leukemia: A New Prevention and Treatment Paradigm

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Leukemia is a term applied to a variety of cancers of the blood or marrow (blood cell production), as well as the lymph. The main characteristic of leukemia, as the name implies (leukocytes, or white blood cells), is an abnormal increase in immature white blood cells, or leukoblasts. The outcomes for the various and diverse types of leukemia range from 100 percent survival at 10 years to less than 40 percent survival at 5 years, and the treatment protocols vary considerably as well. Some leukemias, such as T-cell, are viral in origin, and about 90 percent of all leukemias are diagnosed in adults, with over 200,000 deaths per year attributed worldwide. In the United States, in 2003, it was estimated that over 30,000 new cases of leukemia were diagnosed each year (American Cancer Society), with the number growing to nearly 45,000 by 2009, and nearly 15,000 deaths per year. It is now universally agreed upon that the cause of these various leukemias relate to a variety of health factors that are within the control of patients and their holistic physicians, and preventive measures should be pursued, especially as most of these cancers occur later in life.

The majority of cases of leukemia are of a chronic, slowly developing nature, and guidelines of the American Cancer Society now stress that most of these chronic cases should be handled with monitoring by standard medicine if asymptomatic, not aggressive treatment. The adverse effects of anti-cancer therapies have proven more harmful than the cancer itself at early stages of chronic leukemia, but the adjunct cancer treatment protocols of Complementary Medicine are without adverse effects, and can help greatly in maintaining the ability to keep these chronic leukemias in check. For symptomatic leukemias, and acute types, Complementary Medicine can help to recover from harsh anti-cancer therapies in standard medicine, and in all types, Preventive Medicine is important. To utilize Preventive Medicine, or to successfully incorporate Complementary Medicine into the integrative treatment protocol, patient understanding is the key to success.

Diagnosis of leukemias is based upon a number of tests, and a careful analysis. Complete blood counts (CBC), bone marrow biopsy, lymph node biopsy, MRI, and ultrasound may be used in the evaluation, but often these tests produce unclear results, and should be correlated with actual symptoms and signs. This means that when leukemia is suspected, a competent specialist should be found. Since many of the symptoms of these various leukemias are vague and unspecific, the American Cancer Society estimates that at least one-fifth of all people with leukemia are undiagnosed. In addition, some of the types of leukemia commonly go into remission, and testing during remission is unclear. While standard medicine believes that a finding of more than 10,000 lymphocytes per cubic millimeter in circulating blood suggests a strong possibility of chronic lymphocytic leukemia, more specialized tests are absolutely needed to confirm the diagnosis before harsh therapies are prescribed. In Chronic Myeloid Leukemia, too many white blood cells with too many immature cells suggests leukemia, but is not a definitive diagnostic test. Many different health problems may alter the white blood cell count. Biopsy of lymph node, bone marrow, lumbar puncture, and cytology analysis of cells is used for this diagnostic confirmation. Evaluation of immunoglobulins and antibodies, with genetic evaluation, can help the oncologist know how aggressive the Chronic Lymphocytic Leukemia is, and guide the integrated therapy. MRI is useful to see if the brain and spinal cord is significantly affected, and ultrasound is useful to examine lymph nodes and organs. Polymerase chain reaction testing is a very sensitive test for identifying specific oncogenes in leukemia cells, to both identify the type of cancer, and monitor progression.

General signs and symptoms of leukemia include easy bruising and bleeding (lack of quality platelets due to high number of immature leukoblasts), frequent infections, anemia, fatigue, night sweats, epigastric fullness, nausea, and weight loss, all of which are not unique to leukemia. Leukemias are divided clinically into acute and chronic types, with acute lymphocytic and myeloid (marrow) distinguished as types that are more likely to show early symptoms. These symptoms may include fatigue, fullness or discomfort below the ribs (enlarged spleen or liver), easy bruising, loss of appetite, low-grade fever, joint pain, frequent infections, pale complexion, and petechiae (tiny red spots of blood) on the abdomen. Most cases of chronic leukemia at the time of diagnosis do not show significant symptoms. With chronic leukemia, the diagnosis is usually made during routine testing rather than symptom complaints, but the chronic milder symptoms of tiredness, weight loss, and night sweats are not uncommon. Chronic leukemias are much more common than acute types, but acute leukemias are often fast-growing and require quick diagnosis and more aggressive treatment. Acute lymphocytic leukemia, the least prevalent of leukemias, occurs mainly in children and young adults, with 2,887 cases aged 0-19 years old in 2006. Like many cancers, there is a very broad spectrum of threat in the disease, but most patients have the time to work on their underlying health problems to slow or reverse the disease, or maintain remission. Patient understanding is the key to developing an effective protocol of healthy treatment that is individualized and based on sound research.

Acute Leukemias

Acute myeloid leukemia (bone marrow) is the most common type of acute leukemia, with more than 1200 cases each year in the United States, and with an average age of onset at 65 years old. Prevention should be the focus in Complementary and Integrative Medicine (CIM), although much can be done to alleviate side effects of harsh treatments and prevent future health problems that may result. Antineoplastic chemotherapies, immune suppressant drugs, and corticosteroids come with an array of harsh and threatening side effects, and integration of Complementary Medicine can help alleviate these side effects and prevent infection, cardiotoxicity, etc. Diagnosis is confirmed with high numbers of leukemia cell lines in bone marrow biopsy, or blood. As these leukemia cells rapidly increase in numbers, healthy white blood cells decrease and infections easily occur, healthy red blood cells decrease, anemia with fatigue occurs, and healthy platelets decrease, with easy bruising and bleeding noted, as well as petechiae, or tiny blood spots beneath the skin. High leukemic cell counts can also cause pain in the joints or bones. There are 8 subtypes of leukemic cells in acute myeloid leukemia, labeled M 0-7, based on the types of blood cells affected. The spread of these cells throughout the body leads to organ and CNS dysfunction, and abdominal ultra-sound or MRI, and lumbar puncture, are used to evaluate this spreading. Harsh chemotherapy and bone marrow transplants are commonly used in treatment, and Complementary Medicine is very useful to alleviate the harsh effects of these therapies and provide energetic health and recovery of healthy blood cell production and immune boost after or during therapy.

Often, harsh chemotherapies produce no benefit for patients with acute myeloid leukemia. In 2008, a University of Wisconsin researcher, Dr. Matt Vanderhoek, told Reuters Health that nearly a third of these leukemia patients do not respond to chemotherapy, and suggested that a better way to evaluate the immediate efficacy of chemotherapy was needed to spare these sick patients the toxic adverse effects of therapy that was not effective. He suggested that we utilize immediate FLT PET scans in evaluation of chemotherapy efficacy rather than bone marrow biopsies. Dr. Vanderhoek stated: “The problem with bone marrow biopsy is that it is an insensitive and weak predictor of treatment response. A lot of patients will be told that their treatment was successful when in fact it wasn't." This research was presented to the 50th annual meeting of the American Association of Physicists in Medicine. Research since the 1980s in Japan, Korea and China has demonstrated that Chinese herbal medicine is potentially effective in enhancing the effects of chemotherapy, as well as ameliorating the harsh adverse effects, but only discouragement of this integrative protocol has been seen in standard medicine, despite the low cost and absence of any side effects.

Newer types of therapy, such as all-trans retinoic acid (ATRA), a form of Vitamin A (Retin-A), are useful when applicable. ATRA is proven useful for acute promyelocytic leukemia (15 percent of all cases of acute non-lymphatic leukemia), but was blamed for producing a 'retinoic acid syndrome', with threatening dyspnea (difficulty breathing), fever, low blood pressure, lung congestion, and weight gain, although recent evidence indicates that treatment with arsenic trioxide was the cause of so-called 'retinoic acid syndrome' in most, if not all, of these patients, not ATRA. Arsenic trioxide, a long-standing treatment in Traditional Chinese Medicine in its natural form, called Pi shuang, was proven effective to treat acute promyelocytic leukemia by researchers at the University of Hong Kong in 1997, and was approved by the U.S. FDA in 2001, who also approved all-trans retinoic acid for this treatment in 2004. These 2 natural medicines were combined in an oral pill at the University of Hong Kong, and later the U.S. rights to a generic form of the biologic was purchased by the biopharmaceutical Cephalon in the U.S. and called Trisenox. All-trans retinoic acid is able to induce complete remission in almost all patients with Acute Promyelocytic Leukemia (APL) (Institute Universitaire d'Hematologie, Paris, France, and Shanghai Second Medical University, China, 2001). ATRA was first developed as treatment for acute promyelocytic leukemia in Shanghai, in 1988. The human body manufactures this natural retinoic acid from retinol, mainly in the gonads, but a high-dose form of retinoic acid is used in treatment. Sources of retinol include cod liver oil. In many cases of Acute Promyelocytic Leukemia, all-trans retinoic acid alone may induce remission. Combining ATRA with arsenic trioxide provides greater effectiveness but needs monitoring to prevent toxicity, although toxic side effects of cancer chemotherapy are nothing new. The main difference between this biologic cancer treatment and others is that this one is a naturally derived medicine and cannot be patented for enormous profits. While medical application of arsenic trioxide, long used in treatment worldwide for many centuries, is highly discouraged in the West and derided as too toxic, despite its history of safe use, we may assume that this is due to the consistent discouragement of all natural medicines since the patent system was created. Presently, arsenic trioxide, a byproduct of mineral mining, as well as a product now reproduced in chemical laboratories in various forms, is widely used in industry, found in wood preservatives, dyes, electronics, glass production, paint color, and animal feed additives (Roxarsone), but when approved in medical treatment is widely denounced as too toxic and dangerous. This seems at best very cynical.

In 2015, researchers at the Wenzhou Medical University School of Medicine, in Wenzhou, China, found that a chemical in the Chinese herb Magnolia officianalis (Hou pou), honokiol, found to have anticancer effects, could provide significant help in treating or preventing Acute Myeloid Leukemia. These researchers found that honokiol decreased the metabolic activity of histone deacetylasees in leukemic cells, inducing cancer cell apoptosis, and decreased the spread of leukemic blood cells in bone marrow, without affecting health blood cells (PMID: 25187418). As research progresses we are sure to find proof of more herbal chemicals that could serve as effective adjunct cancer care in the treatment of this difficult disease. Research in 2000, at Hunan Medical University, in Changsha, China, found that the Chinese herb Sophora flavescens, or Ku shen, induced apoptosis in HL-60 leukemic cells in a dose-dependent manner, also without affecting health blood cells in bone marrow. The potential for effective adjunct treatment with ATRA, Pi shuang, Hou pou, Ku shen, and other herbs and nutrients is significant, and should not be denied to patients with Acute Myeloid Leukemia, as well as the herbs, nutrient medicines and acupuncture the could reduce the adverse effects of standard treatment and improve quality of life.

Prior chemotherapy treatment and exposure to radiation, especially radiation in testing or treatment, increases the risk of developing acute myelocytic leukemia (AML), as well as the other common types of acute and chronic leukemia. A prior history of myelodysplastic syndrome, a side effect of some immune suppressant drugs, also increases the risk. The subtype of AML is important to the prognosis, and immunophenotyping, a type of blood cell analysis, is used to identify the AML subtype, as is polymerase chain reaction test, reverse transcription (RT-PCR). With AMS in remission, the complete blood count (CBC) is normal. To achieve remission, chemotherapy is used, sometimes combined with radiation therapy, and often stem cell transplant is used to help restore the healthy blood cells after this harsh treatment. Newer therapies, such as monoclonal antibody therapy is now used to target specific subtypes of AML, with less adverse effects. Some of these biologic therapies show much promise, but confirmation of safety and efficacy are years away. Once standard harsh therapies are used, the patient must work to recover, and help their body to maintain remission of the cancer. This is where Complementary Medicine is especially useful.

Acute Lymphoblastic Leukemia (ALL) is a cancer of the white blood cells, or lymphocytes, characterized by excess growth of the lymphoblasts, which is an immature lymphocyte that is activated by an antigen. Normally, these immature lymphocytes are confined to the bone marrow, but in Acute Lymphoblastic Leukemia they spread uncontrolled in the peripheral blood circulation, crowding out healthy blood cells, and often resulting in death in a relatively short time span. Treatment includes bone marrow replacement, chemotherapy, radiation before bone marrow transplant, and steroids. In relapsing ALL, biologics may be used for some subtypes, as well as immunosuppressant drugs. Newer drugs have used modified HIV virus RNA to spur the immune system to attack malignant blood cells, and stem cell therapy has been developed as well, but this type of immunotherapy is years away from passing human clinical trials, and has worked on just a few patients in experimental trials to date. The main biologic drugs now used to treat ALL are tyrosine kinase inhibitors, or TKIs. Herbal and plant chemicals that are proven to be mild tyrosine kinase inhibitors are found in garlic, onion, Uva ursi, tea, saffron, soy, licorice root, Kudzu (Ge gen), Rododendron dauricum, black currant seed oil, and mastic, and this avenue of research is uncovering a number of applications of herbal chemicals in the treatment of cancer. The prognosis of ALL has been raised over the decades to a 20-75 percent 5-year survival rate, depending upon the subset of ALL patients studied. Research in 2014, cited below in Additional Information, from the Polish Academy of Sciences Ludwik Hiszfeld Institute and the Medical University of Wroclaw, Poland, showed in a controlled human clinical trial that adding a Chinese herbal extract, Baicalin, from the well known herb Scutellaria baicalensis (Huang qin) to this standard therapy, increased the rate of apoptosis of the cancerous leukocytes in circulation from 11 percent to 24 percent, and the expression of beneficial annexin V from just 6 percent to 52 percent, providing a host of immunomodulatory effects for these children with ALL, with no adverse effects noted. Such dramatic findings show that the discouragement of Complementary and Integrative Medicine in these cases of life-threatening cancer has been very misguided (PMID: 25448499).

In recent years, research is finding therapies that utilize shorter or lower dosage of a combination of drugs to more effectively treat ALL without such severe side effects and long-term quality of life problems. Aspariginases have become a cornerstone for therapy, improving clinical outcomes with less immunosuppression and toxic chemotherapy. Asparaginases are enzymes derived from natural sources, such as bacteria, that catalyze the hydrolysis of asparagine to aspartic acid. Asparagine is a common amino acid found in starches that converts to a carcinogen when the starchy food is fried or broiled, creating that crispy brown crust on french fries, potato chips, etc. To decrease cancer risk, the food industry has used asparaginases to convert the aspargine to aspartic acid before cooking. Researchers found that leukemia cells are unable to synthesize aspargine, and require high amounts to survive. By utilizing asparaginases, the circulating or local asparagine produced by cells, or derived from starchy food, is converted to aspartic acid and ammonia, leading to cancer cell death in leukemia. Common side effects include allergic reaction, decreased protein synthesis and coagulation factors in the blood, with a decrease in fibrinogen as well, pancreatitis, and immune suppression. In 2011, the U.S. FDA approved an asparaginase derived from Erwinia chrysanthemi, or Dicykeya dadantii, a gram-negative bacteria of the enterobacteriacieae family (symbiotic gut bacteria), to decrease the allergic reactions seen with the use of aparaginases derived from E. coli bacteria. To counter excess ammonia from treatment with asparaginase, the amino acid L-arginine and Vitamin B6 (P5P) is helpful.

Acute Lymphoblastic Leukemia, unlike Acute Myeloid Leukemia, often is seen in young children, and with older patients often in a subset that includes the Philadelphia chromosome. In 2013, a public controversy surfaced that shed new light on children with Acute Lymphoblastic Leukemia. A mother from Portland, Oregon, concerned about her 6-year old daughter Mykayla Comstock, and her failure to enter full remission after standard therapy, as well as the worsening symptoms of chemotherapy side effects, researched study of chemicals in Cannabis, or marijuana, to both relieve these side effects as well as promote programmed cell death (apoptosis) of certain lines of leukemia cells. Study of these effects from University research facilities in the U.S. and abroad has shown promising results in the laboratory. After this mother gave her daughter Mykayla a Cannabis oil extract, her symptoms improved dramatically, restoring the little girl to an active life, free from constant fatigue and nausea, and able to eat normally again. Mykayla quickly adapted to the small amount of THC in the Cannabis extract, and reportedly was not bothered by any sense of drug euphoria after a week or two. Her father and her oncologist objected to this treatment, though, and Mykayla's treating doctor refused to treat her if the therapy continued. Her father was impressed with the results, though, and the parents finally found a new oncologist, who was also impressed with the progress, further testing the now 7-year old girl, and was surprised to find that she was in complete remission from cancer. The father of the child was quoted in interviews as stating that Mykayla's original oncologist “called us, basically, criminals', but was alarmed at the level of pain following bone marrow biopsies and lumbar punctures, and the prescription of narcotic pain relievers, such as Vicodin and OxyContin, which she was able to avoid when taking the Cannabis oil. The mother of Mykayla was simply using researched medicine as an adjunct to standard care, yet the mere mention of the use of a Complementary Medicine led to her oncologist refusing to treat the little girl and publicly calling her mother a “criminal".

One of the few research studies published of the effects of a chemical or chemicals in Cannabis promoting programmed cell death, or apoptosis, in leukemia cells, and read by Mykayla Comstock's parents, was a 2006 study from Virginia Commonwealth University Medical College, published in the journal Molecular Cancer Research (see study link below). This study found that delta-9-tetrahydrocannabiol (THC) and other cannabinoids induced apoptosis, or programmed cell death, in Jurkat leukemia T cells. The exact mechanisms of this effect are still being studied, but appear to be related to inflammatory mediator pathways of ERK/MEK, and the downregulation of Bcl-2 antagonists of cell death (BAcD) by cannabinoids. Other studies in recent years, at the University of Bristol School of Medical Science, United Kingdom, and the University of Rostock, Germany, also confirmed that potential of cannabinoids to aid in treatment of various cancers to induce cancer cell apoptosis. It appears that the demonization of marijuana may have prevented research that would have saved many cancer patients over the last several decades. This is not to suggest that standard drug protocol should be abandoned in the treatment of acute lymphocytic leukemia, and it is hard to find anyone suggesting such a thing. Nevertheless, the mention of therapies such as cannibinoid oil, or other herbal medicine, prompts harsh response in standard medicine.

In 2013, an 11 year old girl, Claire Dickson, in Spencer, Ohio, withdrew from more chemotherapy after months of treatment and failure to achieve remission, as the child and her parents feared the mounting negative health effects of treatment. The girl responded with improved health, and the parents continued with Complementary Medicine. The response from her hospital in Akron, Ohio, was to have a judge take away parental custody and assign a guardian, Maria Schimer, to oversee her care. When the parents and child went into hiding, Ms. Schimer, an attorney who was a registered nurse, decided to drop the effort to legally force the child to take more chemotherapy. The hospital responded by asking that Ms. Schimer be removed from the case. An attorney for the family stated that they feared that further treatment with harsh drugs would potentially kill the child. Alarming health threats, such as occurrence of pancreatitis in 4-18 percent of children treated with aparaginases, as well as the effects of immune suppression, are real threats to health, often downplayed. Hospital attorneys stated that the family was Amish and presented the case as a family that endangered their child's life due to religious convictions, but the parents stated that they obviously did not object to modern pharmaceutical medicines, as they had already and readily allowed a long course of these drugs to treat their child. This is not the first case of Americans being forced to continue to take pharmaceutical treatment regimens in cancer therapy when they feel that the risks outweigh the benefits. There is no cure for cancer, only therapies to help induce remission, and long-term remission may occur with or without drug therapies. Hopefully, these issues of care and choice of integrative medicine to achieve better outcomes and less adverse effects will soon be resolved.

Prevention of acute lymphocytic leukemia in children is of paramount importance. As we see from numerous studies, a variety of environment and dietary factors have been proven to be implicated in the disease. The use of asparaginases in therapy point to the potential that children's diet with a high amount of commercially produced food with asparagine, resulting from frying or high-heat baking or broiling of starchy foods, creating that delicious crispy brown crust, may be implicated. In 2007, parents in Houston, Texas noticed that an unusual number of children in a particular neighborhood were getting acute lymphocytic leukemia, and the University of Texas found in study that children living within two miles of a shipping channel owned by a petrochemical company had a 56 percent increased risk of getting leukemia. Chemicals in the air, such as benzene and butadiene, from oil refineries and manufacture of oil products, were linked to this leukemia, respiratory diseases, and birth defects. The researchers, and Professor Tom McGarity, who teaches environmental law at the University of Texas, noted that these chemicals could be cleaned from the air, but often the measures needed weren't instituted in areas with poor communities. Such environmental choices are believed to be responsible for the higher rates of these diseases in poor minority communities. Many experts now label this “environmental racism". In this case, a 2006 Rice University study showed that Houston had a higher concentration of benzene and 1-3 butadiene than anywhere else in the United States. Progress had been made in recent years to reduce this threat, but it is clear that more needs to be done.


Chronic Leukemias, the important role for Complementary Medicine when diagnosed with chronic lymphocytic and myelogenic leukemias

There are 2 main types of chronic leukemia, the most common being Chronic Lymphocytic Leukemia (CLL), with more than 15,000 new cases per year diagnosed in the United States, and most of these patients being over age 55 when diagnosed, constituting more than 30 percent of all newly diagnosed leukemias, with a male to female ration of 1.7/1.0. CLL affects the B-cell lymphocytes, which originate in the bone marrow and mature in the lymph nodes. In about 98 percent of cases, CD5+ B cells undergo malignant transformation. In CLL, the cancerous B-cells grow faster than the normal B-cells, and fail to properly function in their immune role. Chronic Myeloid Leukemia (CML), involving the bone marrow, also mainly affects adults, and accounts for about 5000 new cases per year. Less usual types of chronic leukemia account for about 6000 new cases per year, and include Hairy Cell Leukemia, Human T-cell Leukemia / Lymphoma (Virus Type 1), chronic myelomonocytic, etc. The National Cancer Institute states that often chronic leukemia without symptoms, which accounts for the majority of cases, is not treated with standard medicine, and a watch and wait protocol is followed. This slowly developing cancer can be held in check with improved health, and Complementary Medicine is essential to maintaining the health of the immune response and blood quality that is required to keep up with cell mutation.

The University of California San Francisco Medical Center states on its website that “Most patients with early-stage chronic lymphocytic leukemia do not need any treatment when the disease is first diagnosed." These experts cite extensive evidence that “early treatment offers no advantage" for most patients, but this applies to standard medicine, and the harsh array of chemotherapies and immune suppressant with steroids that are used, not to adjunct care with Integrative and Complementary Medicine. More and more, we see such esteemed cancer treatment centers offering patients a wide array of adjunct therapies, and the knowledgeable Licensed Acupuncturist and herbalist may be the source for the best adjunct leukemia care. To fully utilize these adjunct cancer care therapies a thorough diagnostic workup should be utilized, and the results of all tests should be obtained and brought to the Complementary Medicine physician to allow more specific treatment protocols based on current research.

Because of the variations of leukemias and subtypes, and individual needs within an often slowly developing disease course, the National Cancer Institute highly recommends a thorough diagnosis and treatment by specialists with experience treating leukemia. The National Cancer Institute recommends asking for an explanation of the type of leukemia diagnosed, obtaining a pathology report, discussing treatment options carefully, understanding the expected benefits and risks, and the impact of treatments on normal activities of life and work. The choices in treatment are always the patient's, and increased understanding are needed to make these important decisions. Patient understanding of the minimal requirements for sound diagnosis will prevent unnecessary harsh treatment. A simple elevation of white blood cells is not enough to arrive at a clear diagnosis of chronic leukemia, and a watch and wait approach, with improved health and avoidance of infection is usually recommended. In a slowly developing chronic lymphocytic leukemia, symptoms are not apparent for a majority of patients. Mild symptoms of enlarged lymph nodes, fatigue and night sweats occur in other patients, but these could be attributed to other common diseases. If the treating doctor does not order a bone marrow biopsy, he or she is not doing their job. Treatment usually begins when the patient shows signs of advanced disease, or shows very enlarged lymph nodes, or rapidly rising lymphocyte counts in circulating blood.

The Merck Manual of clinical medicine, one of the most used, and standard in practice, states that diagnosis of Chronic Lymphocytic Leukemia (CLL) is made by examination of peripheral blood smear and bone marrow aspirate. This manual states that standard treatment is delayed until symptoms develop, and the goal of treatment is the lengthening of life and decreasing of symptoms, not a cure of the disease. Often, these guidelines are not followed, though, and chemotherapies, antibiotics and steroid hormones are prescribed early. Although standard therapy should be delayed till symptoms develop, Complementary Medicine should be instituted and a workable individualized protocol should be developed as quickly as possible.

Significant aspects of these chronic leukemia diseases include defects in the functions of T and B cells, autoimmune complications, and deficient gammaglobulins. The incidence of hypogammaglobulinemia is reported to be about 8 percent at the time of initial diagnosis in most cases, but increases to over 65 percent of the patient population as the disease progresses. Gamma globulins are typically called antibodies, and identified on blood tests as IgE, IgA, IgM, IgG and IgD. A number of chronic infections can lead to acquired immune deficiency with deficient antibodies, including Epstein-Barr virus, fungal infections such as candidiasis, chronic hepatitis, cytomegalovirus, and lingering low-grade chickenpox and measles. Of course, chemotherapy and radiation therapy may also induce hypogammaglobulinemia, complicating assessment. Complementary medicine can help the patient overcome this immune deficiency by both clearing these opportunistic low-grade infections and supporting immune function. Comorbid autoimmune diseases with chronic lymphocytic leukemia included autoimmune hemolytic anemia (11 percent of advanced cases), idiopathic thrombocytopenia (2-3 percent of cases), and pure red cell aplasia (6 percent of cases). Immune support therapies could prevent these autoimmune complications.

It is believed that over 98 percent of cases of Chronic Lymphocytic Leukemia involves malignant mutation of the CD5+ B cells, which express IgM, an immune antibody involved in early response to infection, and in further exposure or resurgence of the infection. It is believed that IgM antibodies that bind to red blood cell A and B antigens are formed early in life with exposure to bacterial endotoxins that resemble these red blood cell substances. About 75 percent of T-cell cancer cells express CD5 as well, and CD5 T cells are affected in small lymphocytic leukemia, hairy cell leukemia, and mantle cell leukemia. T cells express higher levels of CD5 than B cells, and this cluster of differentiation might lead to directions in therapeutic protocol. Supporting immune health and function, clearing low-grade bacterial infection and superantigens, and achieving balance of T cell responses, especially T-helper cells types 1 and 2, might be crucial to prevention and treatment. T cell cytokines have been found to be integral to regulation of CD5 expression on B cells, and achieving an improved T cell complement homeostasis might be the key to preventing CD5+ B cell malignancy. To date, research into the role of CD5 in the disease process has produced unclear results, suggesting that CD5 could be expressed to control the disease, or could be linked to cause. It is likely that these mechanisms in the immune response are fluid, suggesting once again that restoration of natural homeostatic immune mechanisms is the best course to pursue. Complementary Medicine works mainly by restoration of homeostatic response.

Standard medicine is realizing the need for integrating Complementary Medicine in early stages of chronic leukemia, and human clinical trials of some of these protocols are now being conducted. For instance, the American Society of Clinical Oncology completed a phase 2 trial of green tea extract, epigallocatechin 3 gallate (EGCG), in 2010. This trial, of a common simple immune support and antioxidant, showed that 67 percent of patients with Chronic Lymphocytic Leukemia showed a positive biological response, with 66 percent of patients with enlarged lymph nodes showing at least a 50 percent reduction in the sum of measurable products of all nodal areas, 31 percent of patients experiencing a measurable reduction of absolute lymphocyte count (ALC), and one of 42 patients experiencing a partial remission (National Cancer Institute Working Group criteria)(J Clin Oncol 28:15s, 2010). If green tea extract can produce such impressive results, the patient must consider what a complete holistic professional protocol can achieve. It is vitally important that when looking at scientific studies like this, that patients and doctors realize that these single medication protocols being studied in Complementary Medicine do not represent the entire treatment protocol, but only a small portion of an individualized and comprehensive treatment protocol. The outcome of a successfully integrated Complementary Medicine protocol would be much greater than the outcome seen in a clinical trial of a single component of this symbiotic protocol.

Chronic Myeloid Leukemia, affecting mainly the bone marrow function, rather than primarily the lymphatic system, is a much more threatening type of leukemia, and is more predominant in young patients, although this type of chronic leukemia is also seen in older adults. More aggressive symptoms are often seen in the younger patients, though, such as an enlarged spleen, enlarged liver, higher white blood cell counts, and lower hemoglobin levels, but a 2013 study at the University of Mannheim, Mannheim, Germany (Kalmanti L et al), showed in a study of 1,524 patients that long-term outcomes and rates of remission or progression were not significantly different for these age groups at a median observation time of 67.5 months. Often, a diagnosis of Myelodysplastic Syndrome is assumed to be a precursor to a Myeloproliferative Disorder, and grouped with Chronic Myeloid Cancers, even though a great majority of these syndromes will not proceed to actual cancer. A 2013 statement of current study of this problem by experts at the Will-Cornell Medical School in New York, New York, U.S.A. tried to clarify these distinctions, noting that patients with a Myelodysplastic Syndrome (improper bone marrow production of specific blood cells) with essential thrombocythemia (excess platelets produced), for example, would rarely progress to cancer, and a number of studies show that only 1.1 percent of all Mylodysplastic Disorders present as Chronic Myeloid Leukemia. These experts note that a number of causes of Myelodysplastic Syndrome are usually overlooked in the rush to treat cancer that has not occurred, and even when a wait and see monitoring occurs. Overlooked causes include iron overload toxicity (see the article on this website that explains this complex pathology), nutritional deficiencies, radiation exposure, and responses to various pharmaceuticals or environmental chemicals. To see this assessment, just click here: http://www.hindawi.com/journals/ah/2013/309637/ . While herbal causes are always mentioned by Medical Doctors, there are almost no scientific studies that show that herbal medicines actually induce Myelodysplasia. Resolution of bone marrow dysfunction with CIM/TCM could prevent any chance of advancing to actual cancer in the future, and should be tried if so chosen by the patient.

In October of 2013, a new type of biologic drug developed to treat chronic myeloid leukemia, Ponatinib (Iclusig), which works by inhibiting tyrosine kinase, had its 2012 approval suspended due to studies that showed that 24 percent of patients developed a serious and adverse cardiovascular event within 1.3 years of use, such as blood clots, thrombosis, congestive heart failure, thrombocytopenia with hemorrhage, and hypertension. Worse, 48 percent had a serious and adverse cardiovascular event attribute to the drug with an average of 2.7 years of use. Liver toxicity was also a concern in follow-up studies that was worse than expected, as well as pancreatitis. This highlights a concern for fast-tracking approval for new drugs when there are few pharmacological treatment options. Review of other tyrosine kinase inhibitors used to treat chronic myeloid leukemia are also currently under way, including imatinib (Gleevec), dastinib and nilotinib. These drugs come with similar rates of the same adverse effects, as well as serious fluid retention and edema commonly seen, anemia, neutropenia, gastrointestinal irritation, kidney failure, immunosuppression, and muscle and joint pain. Often, a harsh regimen of chemotherapy and the corticosteroid prednisone, which produces immunosuppresion and anemia as well, is used in the treatment of chronic leukemia to control white blood cell counts, and recombinant interferon therapy is commonly used to produce antiviral and immunological rescue of the hematological damage. The interferon therapy itself came with serious adverse effects, and worked for only about 50 percent of the targeted patients. These adverse effects have prompted a reconsideration of the guidelines in treatment, and an increased acceptance of first trying a safer protocol with Complementary Medicine if possible. While the advent of tyrosine kinase inhibitors has had a positive impact on patients with chronic myeloid leukemia, the length of the course of therapy, the dosage needed, and the individual typing of patients to find the best treatment protocol is obviously needed. The selling of a particular therapeutic protocol to all patients without individual consideration is not sensible, especially when the long-term side effects may be devastating. Complementary Medicine may be successfully integrated into the treatment to achieve this safer and more individualized treatment protocol that results in better outcomes, and especially better quality of life outcomes.

Currently, the only standard treatment option associated with complete remission in chronic myeloid leukemia is allogeneic bone marrow transplant, but treatment-related mortality from infection, bleeding, and graft versus host disease, as well as the difficulty in finding a matched donor, and the expense, have discouraged more widespread use of allogeneic bone marrow transplant. We now do have a number of rather harsh therapies that have extended survival time for chronic myeloid leukemia to 5 years or more for 90 percent of patients, but we obviously need to work on quality of life. This is where integration of Complementary Medicine presents the most promise, not as a competing treatment protocol, but as an integrated treatment that offers a wide variety of proven therapies to treat side effects, promote health, and hopefully afford the patient and primary doctor the options to reduce dosage and length of treatment of pharmaceutical medications when the the side effects become too severe.

Current herbal research in the adjunct integrative treatment of leukemia

B-cell Chronic Lymphocytic Leukemia is the most common form of leukemia in the western world, and is considered incurable. This most prevalent form of leukemia results in a relentless accumulation of small malignant mature monoclonal lymphocytes, with a selective survival advantage to their normal B-cell counterparts (Kitada et al 1998). This advantage is believed to derive from defective programmed cell death, or apoptosis. Herbal medicines have been shown to have much promise with inducing pro-apoptotic responses in these cancer cells, and helping the body to restore homeostatic regulation of normal cell apoptosis. One chemical found in research to achieve this restoration of normal programmed cell death in leukemic cancerous B-cells is parthenolide, which is found in a number of medicinal herbs, such as Tanacetum parthenium (Feverfew, or Xiao bai ju), Eupatorii formosanum (Taiwan Pei lan, or Boneset), Magnolia grandiflora (Guang yu lan), and others. Feverfew, much studied in its ability to help resolve temporal arteritis in migraine syndromes, is found around the world and used in many cultures medicinally. It has more than 11 different names currently, including wild chamomile, chrysanthemum parthenium, altamisa, febrifuge, and midsummer daisy, and was used by ancient Greek physicians. The active herbal chemicals in feverfew decrease the release of polymorphonuclear leukocytes, exerting anti-inflammatory effects, and a 2006 study at the National University of La Plata Medical School in La Plata, Argentina (GH Marin; J.Appl.Biomed 2006(4):135-139) showed a potent apoptotic effect on B-cell Chronic Lymphocytic Leukemia cells in laboratory in vivo studies.

Much follow-up study of Feverfew has been conducted, including positive research at the University of California at Davis, California, under the guidance of the U.S. Department of Agriculture, Western Human Nutrition Research Center (cited below), which showed significant pro-apoptotic effects in acute lymphoblastic leukemia as well. Also, in 2010, research at the Yonsei University School of Medicine in Seoul, South Korea (also cited below) showed that Parthenolide in Feverfew, Taiwan Pei lan, and Guang yu lan also induced significant cell apoptosis in cancer cells in acute myelogenic leukemia, dependent on the level of myeloperoxidase, an antioxidant. Myeloperoxidase is most abundantly expressed in neutrophils, a type of white blood cell that is considered the first responder of the innate immune system to cancer, environmental toxins, and infections, following such cytokines and chemokines as IL-8, fMLP, and Leukotriene B4. Herbs such as Gingko biloba have been researched to increase myeloperoxidase activity. Such herbal research is expanding as the world is looking for new therapeutic tools to treat this prevalent and difficult disease, and a number of such studies are cited and linked below. The integration of such herbal therapies in treatment presents no contraindications to standard therapy or adverse effects in most cases. Of course, to effectively utilize herbal medicine as an adjunct therapy for leukemia, working with a competent Licensed Acupuncturist and herbalist is highly recommended. This type of therapy depends upon thoughtful individualized treatment and professional herbal medicines to insure quality and effectiveness. In addition, obtaining a thorough diagnostic evaluation, and bringing these cytology reports and other test results to the professional herbalist is also very important in guiding individualized therapy.

Besides inducing, or aiding, apoptosis, or normal programmed timely cell death in blood cells that undergo excess mutation and lead to chronic or acute leukemia, and aiding the anti-inflammatory mechanisms that drive these mutations, arresting the cell cycle abnormal growth of developing leukemic blood cells is a way to treat leukemia. In 1999, researchers at the renowned University of Oxford, in the United Kingdom, at the Oxford Centre for Molecular Sciences, in coordination with the University of Kaiserlautern, in Germany, and the University of Science and Technology at Lille, in France, found that an active chemical in perhaps the most commonly used anticancer herb in Traditional Chinese Medicine, Indigo naturalis, or Qing Dai, called indirubin, exerted such effects. These researchers also noted that various herbal precursors in a formula called Dang gui Long hui Wan contributed to creating an effective isomer of indigo, or indirubin. This anti-leukemia herbal chemical was derived both from the herb Indigo naturalis, and from chemical effects created by the combination of other anticancer Chinese herbs, Isatis indigotica (Da Qing Ye), Polygonum tinctorium (Ban lan gen), Indigoferra suffrutticoas (Qing Dai), and Baphicacanthus cusia (Ban Lan Gen). The combination of these herbs, all related to the plant chemical indigo, which was well known in South America and brought originally to Europe because of its medicinal effectiveness, before being used as a dye in blue jean denim, was shown to produce indirubin and an isomer of indirubin that worked together to inhibit cyclin-dependent kinases to inhibit the proliferation and spread of various cancer cell lines, as well as leukemia (Ralph Hoessel et al; Nature Cell Biology; Vol 1; May, 1999). These experts at 3 of the world's finest Universities found that this Chinese Herbal Formula, routinely used to treat leukemia in China, contained specific chemicals that were proven to lead to G2/M cell cycle arrest in almost all leukemia cell types studied, and G1/S arrest in Jurkat cells, the most sensitive cell line, and one that is associated with a large percentage of cases of leukemia. Despite this evidence, in the next 15 years, we do not see a recommendation for the use of this formula, and in fact a growing warning of potential negative drug effects related to Dang Gui was published, despite no actual proof of a single case of adverse health effects and injury from the use of Dang Gui in treatment of a cancer patient.

The scientific proof of the efficacy of a number of herbal medicines in the treatment of leukemia is growing (see the study links cited below). While there is no cure for the most prevalent form of leukemia, B-cell chronic lymphocytic leukemia, and of course, no single herb that can be called a cure, the integration of a variety of these proven herbs as adjunct treatment is now accepted as a sound approach, especially since the standard treatment, with harsh immunosuppressant drugs and chemotherapy, has been proven to be counterproductive in the early stages of this disease. Utilizing quality medicinal herbal products is very important, though, and only the professional herbalist can assure that the medicines that are used are of high quality and correct form and dosage. The Licensed Acupuncturist and herbalist is thus an excellent choice in this realm.

A New Paradigm of Prevention and Treatment Proposed

In 2012, Harvard Medical University and Brigham and Women's Hospital Department of Pathology, published an article a medical journal calling for a new paradigm of prevention, classification and treatment of cancers. In recent years, molecular diagnostics and tumor biomarkers have generated new excitement in the field of cancer, but we still see that tumor evolution and behavior cannot be accurately predicted in the allopathic model of conventional classification and tumor understanding (see the link below to this article summary). The suggestion is what many cancer experts have been proposing since about 2005, namely the exploration of the holistic microenvironment of the cancer cells with molecular diagnostics. The way that tumor cells interact with other non-tumor cells, epigenetic changes, hormonal balance, environmental exposures, dietary and even lifestyles changes and habits, should guide modern medicine to a better personalized cancer medicine and prevention.

Integration with Complementary Medicine is obviously important in this paradigm, and this is long overdue. For the last 50 years, modern medicine has been looking for the specific oncogenes and targeted cellular dysfunctions that would lead to miraculous therapy. While new and promising cancer therapies continue to be developed, the actual success is very discouraging. A cure for any of the cancers has not been found. By focusing on a broader picture of health, cancerous cell mutation can be prevented, and treated with less adverse effects, and more effective individualized protocols. The success with Chinese herbal medicine is now well documented, and some of this research is shown below, linked to the NIH database of medical research summaries, PubMed. Not only herbal medicine, but nutrient medicine and acupuncture, is important in this holistic paradigm, though, along with increased dietary and lifestyle intelligence on the part of patients, and even effective physiotherapies to improve health and function. Traditional Chinese Medicine, an integrative Complementary Medicine, can supply such a complete package of care and prevention. Of course, standard medicine must develop holistic molecular diagnostics, and integrate with Complementary Medicine to make this work. Only public demand will make this happen, not economic incentive.

In 2010, the esteemed Memorial Sloan-Kettering Cancer Center, in New York City, New York, published a report supporting Complementary Medicine in the treatment protocol for leukemia as well. These experts emphasized that professional Complementary Medicine in adjunct cancer care should be distinguished from so-called “alternative" therapies, and stated that research supports acupuncture and physiotherapy for symptom management without adverse effects, and that mind-body medicine is always appropriate. The most prominent mind-body medicine in TCM involves the practices of Qi gong. In addition, Memorial Sloan-Kettering Cancer Center recommended that improved physical fitness and improved dietary habits can significantly decrease side effects of cancer therapies, as well as prolong survival. They cautioned that herbal and nutrient medicines should be prescribed by a competent professional and discussed with the oncologist. Traditional Chinese Medicine, or the holistic protocol from a Licensed Acupuncturist and herbalist, can provide all of this treatment, advice and instruction. Choosing an experienced and competent physician with a TCM specialty is very important.

Prevention of Leukemia

Understanding and avoiding the known causes of leukemia is the most important aspect of prevention, although health maintenance may be very important as well. The main risk factors for leukemia are excess cumulative radiation exposure, exposure to certain environmental chemicals, long-term use of certain chemotherapy agents, and deep chronic viral infections. Avoiding excess exposure by choosing other forms of testing rather than CT or CAT scan when possible is very important, as this type of testing, using many X-ray slices for one scan, is much overused now and is generating considerable warnings. Other types of radiation in testing and treatment may be used in excess as well, with little consideration for the amount of future cancer risk. Less potent radiation, such as large high-definition television, proximity to high-power lines, and excess use of cell phones are questioned, but the risk is still not adequately assessed. Workplace exposure to harmful chemicals, and even exposure to chemical pesticides and hair dyes come with warnings. Benzenes, formaldehyde, and other industrial chemicals have been clearly linked (see study links below). Benzenes are common organic molecules found in crude oil, and increased environmental benzenes may be produced in fracking (newer types of drilling processes), as well as an array of industrial petroleum products. Common sources include cigarette smoke and car exhaust. Benzenes are also found in styrofoam, certain soft plastics, resins, adhesives, dyes, detergents, pesticides, and drugs. Formaldehyde, another ubiquitous chemical linked to leukemia risk, is increasingly found in industrial products as well, especially resins, adhesives, wood and paper products, plastics, synthetic textile fibers, agricultural products, disinfectants, and preservatives. Environmental regulation is important to insure that this industrial risk is minimalized. In many studies, Acute Lymphoblastic Leukemia is clearly linked to greater exposure to viral illnesses, and both clearing of viral illness quickly, and enhancing immune responses are important in prevention of leukemia. Since standard medicine does not have effective anti-viral therapies, and Complementary Medicine does, as well as proven immune enhancement therapies, integrating Traditional Chinese Medicine into the preventive protocol seems important, if not indeed crucial to success.

Most people who develop leukemia do not have the most common risk factors in their history, though, and standard medicine is loathe to emphasize the high risk of common tests and treatments, for fear of discouraging medical diagnosis and treatment. Not enough emphasis has been put on alternatives to these tests and treatments, such as utilizing newer MRI technology instead of CT scans, and decreasing the dosage and use of radiation therapies when applicable, until recently. Humans have evolved the ability to handle a set amount of natural radiation, correcting the resultant mutations, but exceeding this comes with risk of cancerous mutations that the body cannot handle. Some studies have indicated that as little as 1-5 rads (10-50 mGy, or milliGrays) of X-ray radiation could lead to leukemia, and this type of radiation is accumulative over time. Over 90 percent of radiation from manmade sources comes from medical devices, primarily CT scans and X-ray. The gray is a measurement of absorbed radiation, while the seivert is a measurement of emitted radiation. The average radiation dose from CT scan is 3.2 mSv (milliSeiverts), but a typical CT scan can involve 10-20 mGy for specific organs, and may go up as high as 80 mGy for specialized scans. In comparison, the average worldwide yearly dose average from natural background radiation sources is about 2.4 mSv per year, but the amount of absorbed radiation from natural sources is thought to be much lower, usually, than that from gamma ray (X-ray and CT). Multiple CT scans, especially early in life, poses considerable risk, and stricter guidelines have been initiated due to the propensity in the last decade to perform CT on children and youth too readily.

In addition, not enough research has explored the role of immune health in the prevention of leukemia, as well as other cancers. Also, epidemiological research is only now exploring the environmental risks of heavy metal toxins and other pollutants from mining, power generation, metal industrial production and processing, and drilling (see European studies cited below). Detoxification and toxin chelation therapies may be very valuable in prevention of leukemia and other cancers. Also, a 2012 report from the Warren Alpert Medical School of Brown University, in Providence, Rhode Island, hypothesized that diabetes type 2 (Metabolic Syndrome) is associated with increased risk of leukemia, lymphoma and myeloma. Further research is needed to identify the physiological causes, but with the enormous increase in diabetes type 2 and Metabolic Syndrome in the United States, the fear is that rates of incidence of leukemia may increase. As patients consider prevention, all of these factors should be considered. Besides chelation, research has uncovered significant benefits from specific herbal chemicals to prevent cellular and tissue damage caused by ionizing radiation and chemotherapy drugs. These therapies, as part of health maintenance and prevention in Complementary Medicine and TCM, are effective, safe, simple and inexpensive, and the only side effects are better overall health.

Information Resources: Additional Information and Links to Scientific Studies

  1. In 2012, the esteemed Harvard Medical College and Brigham and Womens Hospital proposed that a new cancer concept and paradigm of individualized treatment needs to be developed, emphasizing restoration of the tumor microenvironment, interaction of cancer cells with non-cancer cells, hormonal health, environmental exposures, diet and lifestyle. This recognition of holistic medicine, in light of the failure of standard medicine to accurately predict tumor evolution and behavior with the current allopathic model: http://www.ncbi.nlm.nih.gov/pubmed/22845482
  2. In 2012, the esteemed Massey Cancer Center at Virginia Commonwealth University released a meta-review study of cancer outcomes, revealing that over half of cancer survivors died from other health complications, rather than a return of their malignant cancer. The lead researcher, Dr. Yi Ning MD, stated that it is obvious that a more comprehensive treatment strategy is needed in cancer care, with 32.8 percent of patients attaining cancer remission dying from another condition within 5 years. A more holistic approach to treatment, especially with the stress of harsh cancer treatments and fear of cancer experienced by patients, needs to be considered: http://wp.vcu.edu/masseynews/2012/04/03/study-finds-nearly-half-of-cancer-survivors-died-from-conditions-other-than-cancer/
  3. In 2009, the esteemed Memorial Sloan-Kettering Cancer Center, in New York City, New York, concluded that Traditional Chinese Medicine, or Complementary Medicine, has a clear place in adjunct cancer care with leukemia, emphasizing the benefits of acupuncture, mind-body medicine, physiotherapies, dietary medicine, and meditation. They caution that some herbs and nutrient medicines could potentially interfere with standard therapy, and that consultation with the physicians, and professional guidance in this therapy is very important: http://www.ncbi.nlm.nih.gov/pubmed/19761428
  4. A 2010 study by The Ohio State University College of Pharmacy, found that the study of Chinese herbal medicine to treat leukemias and lymphomas, as many types still remain incurable and emerging drug resistance is pervasive. These researchers point out that nearly half of the agents used in cancer therapy today are either natural products or derived from natural products, and the study of the rich field of plant biologics in herbal medicine needs to be further researched and integrated in the treatment of leukemias and lymphomas. One area of their research focuses on an herbal chemical called silvestrol, a rocoglate derivative isolated from Alaia foveolata, a rainforest tree found in Malaysia, on the island of Borneo. These researchers found that silvestrol has B-cell selectivity, making this a good candidate to treat chronic lymphocytic leukemia: http://www.ncbi.nlm.nih.gov/pubmed/20370646
  5. All-trans retinoic acid (ATRA), a form of Vitamin A, was found to successfully treat most cases of acute promyelocytic leukemia to remission in most cases, and is used with anthracycline-based chemotherapy to eliminate the cancer: http://www.nature.com/onc/journal/v20/n49/full/1204763a.html
  6. A 2007 review of standard treatment protocols for Chronic Myeloid Leukemia is presented by the Indiana University Cancer Center, U.S.A., showing the successes with newer protocols, but also the harsh adverse effects: http://www.ncbi.nlm.nih.gov/pubmed/17970609
  7. A 2011 review of the use of asparaginases as a foundation in treatment of acute lymphocytic leukemia (ALL) is presented here experts from the University of Colorado, Erasmus MS-Sophia Children's Hospital in the Netherlands, the Dana-Farber Cancer Institute in Boston, Massachusetts, and other renowned institutions: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000881/
  8. A 2011 study by leukemia experts in the Chernobyl region outlined the extent of health problems in acute leukemia, as demonstrated by the large number of children that suffered acute leukemia as a result of high radiation dosage in the environment around this site of a nuclear meltdown. Years of scientific study have allowed us to understand that the adverse health effects in acute leukemias are broad, affecting endocrine health, calcium regulation, metabolic concerns, and collagen construct in bone, requiring a holistic approach to restoration of health after treatment of acute leukemia: http:/www.ncbi.nlm.nih.gov/pubmed/22768735
  9. A 2006 study at Virginia Commonwealth University Medical College found that plant-derived cannabinoids, including THC, induced apoptosis in certain Leukemia cell lines, and the pathway of this effect appears to be the modulation of the inflammatory pathways induced by antigens or radiation, with downregulation of the Raf-1/MEK/ERK/RSK-mediated genetic expression of mitochondrial signaling proteins Akt and BAD (Bcl-2 antagonist of cell death), key regulators of cell apoptosis: http://www.ncbi.nlm.nih.gov/pubmed/16908594
  10. The National Cancer Institute recommends watchful waiting for asymptomatic chronic leukemia when possible, and describes a number of newer targeted therapies: http://www.cancer.gov/cancertopics/wyntk/leukemia/page7
  11. Radiation from medical devices, primarily CT scans and X-ray, accounts for over 90 percent of the manmade radiation exposure in the United States. This report from Stanford University NDT Resource Center confirms the evidence of radiation as a cause of leukemia: http://www.ndt-ed.org/EducationResources/
  12. In 2012, the Cancer and Epidemiology Unit of the National Center for Epidemiology in Madrid, Spain, showed that leukemia and other cancer mortalities were significantly associated with proximity to coal and other open pit mining, even up to a 50 kilometer zone: http://www.ncbi.nlm.nih.gov/pubmed/22846765
  13. In 2010, the Cancer and Epidemiology Unit of the National Center for Epidemiology in Madrid, Spain, showed that leukemia mortality risk was significantly increased in populations within 5 kilometers of industrial metal production and processing: http://www.ncbi.nlm.nih.gov/pubmed/20576291
  14. In 2012, the National Institute of Radiological Sciences in Chiba, Japan, showed that radiation-induced leukemia was linked to overexpression of an iron storage protein, H-ferritin, which itself may be linked to problems with iron deficiency, iron overload toxicity, and irritable bowel syndrome: http://www.ncbi.nlm.nih.gov/pubmed/22843505
  15. In 2012, the Asan Medical Center of the University of Ulsan College of Medicine, in Seoul, South Korea, released a report outlining the known causes of malignant lymphoma, which is increasing in incidence worldwide by 3-4 percent a year. These causes include viral infections, immunodeficiency, autoimmune disease, exposure to environmental chemical toxins, and pharmaceuticals: http://www.ncbi.nlm.nih.gov/pubmed/22783355
  16. In 2012, the University of California at Berkeley, Division of Environmental Health Sciences, School of Public Health, showed that benzenes were linked to a number of leukemias: http://www.ncbi.nlm.nih.gov/pubmed/22643707
  17. In 2010, the National Toxicology Program produced a comprehensive report on formaldehyde toxicity, including causative links to leukemia. Formaldehyde is now found in many commercial products, such as resins, adhesive, wood binders, paper products, plastics, synthetic fibers, and textile finishing products, as well as agricultural products, disinfectants and preservatives. Since normal formaldehyde metabolizes quickly in the human body, altered forms in industrial use, and health problems in patients that do not metabolize these toxins efficiently are important considerations: http://www.ncbi.nlm.nih.gov/pubmed/20737003
  18. A 2012 study at Brown University School of Medicine, in Providence, Rhode Island, identified diabetes type 2 as a probable associated risk factor in developing leukemia: http://www.ncbi.nlm.nih.gov/pubmed/22496152
  19. A 2016 nationwide cohort study of the integration of Chinese Herbal Medicine as an adjunct treatment for chronic myeloid leukemia, conducted by experts at the China Medical University, Chang Gung University and the Taipei Veterans General Hospital, in Taiwan, found that adverse health effects to treatment and overall outcomes were significantly improved for those patients integrated Chinese Herbal Medicine, and that this was dose-dependent: http://www.ncbi.nlm.nih.gov/pubmed/26773538
  20. A study at the Singapore General Hospital and the Yueyang Hospital, in Shanghai, China, found that the past reports that the common Chinese herbs used to treat blood disorders, cancer and inflammation, Coptidis (Huang lian) and Phellodendri (Huang bai), were the subject of conflicting reports of potential to cause neonatal jaundice or other complication, but that a thorough review of all studies combined with clinical observation concluded that traditional dosage and utilization of these common herbs presented no potential for adverse effects and were safe: http://dev.vintedge.com/baozhongtang/website/Content/research/Uploaded/2011_Linn_Berberine-induced_Haemolysis_Revisited.pdf
  21. Among the many Chinese herbs found to contain chemicals that successfully treat leukemia as an adjunct therapy, even medicinal gingers, such a Boesenbergia pandurata, or Suo shi, were found cytotoxic to certain leukemia cell lines: http://psasir.upm.edu.my/7526/
  22. Research in 2012, at Sichuan University State Key Laboratory of Biotherapy, in Chengdu, China, found that 6 Chinese herbs showed significant ability to inhibit 5 cell lines in human leukemia. These herbs studied were Dan shen (Salvia miltiorrhiza), Han fang ji (Stephania tetrandra:), Hou pou (Magnolia officianalis), E zhu (Curcuma zedoaria), Dong ling cao (Rabdosia rubescens), and Mu dan pi (Paeonia suffruticosa). Of these, Dan shen, Hou pou, E zhu, and Dong ling cao were most effective: http://www.ncbi.nlm.nih.gov/pubmed/22812238
  23. Research in 2010, at the National University of La Plata, Buenos Aires, Argentina, found that the herb Magnolia Grandiflora (similar to the Chinese herb Magnolia officianalis, or Hou po), significantly induced cancer cell apoptosis, or cell death, in B-cell chronic lymphocytic leukemia: http://www.ncbi.nlm.nih.gov/pubmed/21358081
  24. Research in 2005, at the Dana-Farber Cancer Institute of Boston, Massachusetts, found that an active chemical ingredient of the Chinese herb Magnolia officianalis, honokiol, is a potent inducer of cancer cell apoptosis (cell death) in B-cell chronic lymphocytic leukemia, and should be integrated into the treatment protocol: http://www.ncbi.nlm.nih.gov/pubmed/15802533
  25. Research in 2015, at the Wenzhou University School of Medicine, in Wenzhou, China, found that the chemical honokiol, in Magnolia officianalis, or Hou pou, inhibited acute myeloid leukemia by decreasing the histone deacetylase activity in leukemic cells, inducing apoptosis, without affecting healthy blood cells in the bone marrow: http://www.ncbi.nlm.nih.gov/pubmed/25187418
  26. Research in 2003, at Fujian Medical University, in Fuzhou, China, found that the Chinese herb E zhu (curcuma zedoaria) inhibited the proliferation of K562 cancer cells and should be further evaluated as a potent chemotherapeutic agent to treat Chronic Myelogenic Leukemia: http://www.ncbi.nlm.nih.gov/pubmed/14627502
  27. Research in 2014, from the Medical University of Wroclaw, Poland, and the Polish Academy of Sciences Ludwik Hiszfeld Institute of Immunology and Experimental Therapy, showed that the main active chemical in the Chinese herb Scutellaria baicalensis (Huang qin), Baicalin, was proven to significantly induce apoptosis (programmed cell death) in cancerous blood leukocytes in Acute Lymphocytic Leukemia in children, a very threatening type of cancerous Leukemia. The immunomodulatory effects of this herbal extract increased the cell death of these leukemia cells to 24 percent of the total, compared to just 11 percent in control subjects receiving standard treatment, and did not affect healthy leukocytes. The herbal extract, administered in a high dose, also showed a number of beneficial effects, such as the increase in cells expressing beneficial annexin V from just 6 percent of total, to 52 percent, and a variety of immunomodulating effects that could improve quality of life and overall health. No adverse effects were noted, and this proves that denial of patients such Complementary and Integrative Medicine has perhaps generated much harm for no good reason: http://www.ncbi.nlm.nih.gov/pubmed/25448499
  28. Research in 2015, at the Lebanese American University, in Beirut, Lebanon, found that an extract of seed oil from Daucus carota, commonly called Queen Ann's Lace, or wild carrot, was cytotoxic to cancer cells in Acute Myeloid Leukemia (AML), inducing cell apoptosis, or programmed cell death, and that activation of the MAPK pathway (mitogen activated protein kinase) of the complement immune system, which is associated with excess cancer cell growth when mutated, was linked to this apoptotic mechanism, showing that chemicals in Daucus seed exert effects that may correct this MAPK cell mutation to help the body stop the growth of this devastating cancer of the bone marrow: http://www.ncbi.nlm.nih.gov/pubmed/25684522
  29. Research in France in 2006 found that St. Johns' Wort, or Hyperforin, was effective ex vivo in achieving dose dependant nontoxic cell death of cancerous B-cells in chronic lymphocytic leukemia, and also inhibiting the cancer cell capacity to secrete a chemical that stimulates the cancerous creation of new blood vessels: http://www.nature.com/leu/journal/v20/n4/abs/2404134a.html
  30. Research in 2000, at Hunan Medical University, in Changsha, China, found that chemicals in the Chinese herb Sophora flavescens, or Ku shen, showed a dose-dependent anti-leukemic effect on HL-60 cancer cells, inducing apoptosis in the cancer cells without harming healthy blood cells:http://www.ncbi.nlm.nih.gov/pubmed/12212113
  31. Research in 2008, at the Department of Radiation Biology at Korea Atomic Energy Research Institute, in Daejeon, South Korea, found that combining 2 common Chinese medicinal herbs with radiation therapy for leukemia, at the proper dosages, significantly enhanced the effect of radiation therapy, increasing cancer cell suppression and apoptosis, as well as new formation of HL-60 cancer cells. The 2 herbs were Ganoderma lucidum (Ling zhi, or Reishi mushroom), and Duchesna chrysantha (Zhouguo Shemei) : http://www.ncbi.nlm.nih.gov/pubmed/18360695
  32. Research in 2007 at the Department of Radiation Biology in Daejeon, South Korea, had established that the 2 herbs mentioned above, Ling zhi and Zhouguo Shemei, created a synergistic array of effects that induced cell death in leukemia HL-60 cancer cells, without damage to normal blood cells, by downregulation of Bcl-2 expression and activation of caspase-3 and mitochondrial cytochrome C: http://www.ncbi.nlm.nih.gov/pubmed/16574319
  33. Research in 1983, published in the Journal of Pharmacobiodynamics, performed by Japanese researchers, showed that a common Chinese herbal formula, consisting of Huang qi, Gui zhi, Sheng di huang, Bai shao, Cang zhu, Dang gui, Xi yang shen, Fu ling, Gan cao, and She chuang zi significantly prolonged the survival time of laboratory animals with induced leukemia that received the chemotherapy mitomycin C, as well as improving the leukopenia and weight loss that are adverse effects of the toxic chemotherapy. Unfortunately, there has been almost no interest in expanding this research in standard medicine in the West, but rather discouragement of such integrative therapies: http://www.ncbi.nlm