New research may allow some leukemia patients a pass on chemotherapy

Keep the Kettle On

When he was only 48 years old, my father was diagnosed with chronic lymphocytic leukemia (CLL). And even though CLL is the most common type of leukemia in the U.S., it usually affects people over the age of 60.

If there’s any good news here it’s that CLL is a slow- growing cancer. For patients who are diagnosed when the disease is in an early stage, predicted survival time is usually measured in decades. My father is certainly proof of that. It’s been 21 years since he was first diagnosed.

Hard at work in Rochester

Like my dad, most people with early CLL have no idea they have cancer. Their diagnosis usually shows up after a high white blood cell count is noted in blood test results. But as the disease advances, anemia develops, along with fatigue, shortness of breath, chronic infections, and swollen lymph nodes.

Chemotherapy is the only conventional treatment for CLL, and is typically given only in later stages. But thanks to researchers at the Mayo Clinic, patients with early CLL now have a treatment option that might help them completely avoid chemo.

In the e-Alert “Envy with Green” (4/21/04), I told you about promising Mayo research on epigallocatechin gallate (EGCG), which is a component of green tea. In a laboratory test, the Mayo team showed that EGCG inhibited tumor cell growth by suppressing the ability of cancer cells to produce new blood vessels required for their proliferation.

In the five years since I sent you that e-Alert, Mayo EGCG research has taken a dramatic leap.

Last month, the Mayo team published a new study in which 33 patients with early stage CLL were were given an EGCG extract. Doses ranged from 800 mg to nearly 4,000 mg daily. After just one month, a majority of subjects showed a drop in lymphocyte count, as well as improvement in other markers that measure CLL. In some patients, lymph node size was cut in half.

A new Mayo Clinic trial is already underway to test 4,000 mg doses of EGCG on CLL patients.

Couple of caveats

EGCG use may not be for everyone. Some of the subjects in the Mayo study experienced side effects that included nausea and abdominal pain.

I should also note that a high intake of EGCG might reduce folate levels. The average green tea drinker can address this by increasing dietary sources of folate (chicken liver, lentils, asparagus and spinach) and by taking a folic acid supplement.

Pregnant women, however, should be cautious about green tea intake because low folate levels increase the risk of neural tube disorders. Patients with cardiovascular problems also need to keep folate levels high.

CLL patients should talk to their doctors before using an EGCG extract.

Sources:
“Phase I Trial of Daily Oral Polyphenon E in Patients With Asymptomatic Rai Stage 0 to II Chronic Lymphocytic Leukemia” Journal of Clinical Oncology, Published online ahead of print 5/26/09, jco.ascopubs.org
“VEGF Receptor Phosphorylation Status and Apoptosis is Modulated by a Green Tea Component, Epigallocatechin-3- gallate (EGCG) in B cell Chronic Lymphocytic Leukemia” Blood, Vol. 104, No. 3, 8/1/04, bloodjournal.hematologylibrary.org