Because all leukemia therapies produce individual responses based on
factors such as the type of leukemia, patient's age, nutritional
status, and the presence of other diseases, monthly blood testing to
monitor progress is recommended. Patients treated for leukemia should
work closely with their physician to follow the results of blood and
other tests to determine the best treatment course.
The following tests are valuable:
Cholesterol levels: low cholesterol return to
normal physiological levels with response to treatment in AML and CML
(Baroni S et al 1994; Baroni S et al 1996; Moschovi M et al 2004).
Total lipid profiles: monitoring of lipids
such as serum albumin and body mass index can play a role in assessing
response to treatment as these lipids are low at leukemia diagnosis
(Fiorenza AM et al 2000; Moschovi M et al 2004).
Cortisol levels: increased levels in AML,
CML, and CLL are associated with immune dysfunction (Everaus H 1992;
Everaus H et al 1997; Singh JN et al 1989). Monitoring cortisol levels
in cancer patients may be useful in observing the psychological impact
of the disease and associated treatment on the individual (Cohen L et
al 2001).
DHEA levels: abnormal levels may be
associated with immune cell dysfunction (Uozumi K et al 1996). Baseline
levels can be determined by radioimmunoassay before DHEA
supplementation, shown to correct impaired immune function in animal
models (Catalina F et al 2003; Inserra P et al 1998).
Coagulation profile: blood-clotting
parameters are usually abnormal in leukemia. Tests may show low levels
of platelets, increased prothrombin time (PT), partial thromboplastin
time (PTT), and/or decreased fibrinogen (Barton JC et al 1986).
Response to therapy is often accompanied by normalization of these
blood tests with increased fibrinogen and decreased PTT (Anders O et al
1988; Higuchi T et al 1997).
Hemoglobin levels: anemia is common in
patients with leukemia, and this can be monitored by periodically
measuring hemoglobin status. Hemoglobin levels less than 11g/dL are
typically seen with leukemia (Quirt I et al 2001b).
Cytokine panel: tests in patients with
leukemia typically reveal that blood levels of pro-inflammatory
cytokines, such as interkeukin-6 (IL-6), interleukin-8 (IL-8),
interleukin-1 beta (IL-1ß), and tumor necrosis factor-alpha (TNF-a) are
elevated.
Genetic profile: p53 (Lian F et al 1999; Melo MB et al 2002; Nakano Y et al 2000) and Bcr-Abl tyrosine kinase (Patlak M 2002).
Blood smears: assessments of blood cell shape
and size show the presence of leukemia cells by highlighting
irregularities in cell shape and structure.
Bone marrow tests: samples taken by aspiration can detect leukemic cells in bone marrow and monitor treatment effectiveness.
X-rays: leukemia progression can be monitored
by X-rays to detect disease spread to the lymph nodes, lungs, bone, and
joints. Magnetic resonance imaging (MRI) can detect brain metastases
(Vera P et al 1999).
Abdominal sonography: this is a diagnostic
imaging method used to monitor the effect of treatment through
detection of enlarged spleen (splenomegaly) and abdominal lymph nodes
(Bessmel'tsev SS et al 1991).
Physical examinations play a very important
role in monitoring the response to treatment and checking for relapse
following leukemia remission, including the presence of enlarged lymph
nodes or an enlarged spleen (Saven A et al 1998).
For More Information…
Leukemia patients may wish to read these chapters and design a
program that will address the full range of their cancer problems:
Cancer Chemotherapy
Cancer Radiation
Complementary Adjuvant Cancer Therapies
Blood Disorders
For general information on all aspects of leukemia: The American Cancer Society, (800) ACS-2345 The Leukemia & Lymphoma Society, (800) 955-4572 http://www.leukemia-lymphoma.org/hm_lls
Vitamin Depot Online.com Foundation Recommendations
Leukemia patients should consult their physicians before starting to
use any nutritional supplements while receiving conventional medical
treatment. In addition, leukemia patients using nutritional supplements
should enlist the assistance of their physicians to ensure the
implementation of blood tests and diagnostic procedures that are
essential for monitoring the effectiveness of any adjuvant therapy for
leukemia.
The Vitamin Depot Online.com Foundation suggests:
Vitamin A— 40,000 to 50,000 IU daily (Kakizoe T 2003; Meyskens FL, Jr. et al 1995)
Vitamin D3— 16,000 IU three times per week (Mellibovsky L et al 1993)
Curcumin— three 800 mg capsules up to three times daily, 2 hours apart from all medications (Gescher A 2004)
Green tea—
725 mg of green tea extract (containing 93% polyphenols, 34%
epigallocatechin gallate) three times daily, or 10 cups of Japanese
green tea (Laurie SA et al 2005; Pisters KM et al 2001)
Soy extract— containing 50 mg of isoflavones twice daily(Anderson GD et al 2003b)
Lipoic acid— 600 mg orally three times daily (Rock E et al 2003)
An aggressive program of dietary supplementation should not be
launched without the supervision of a qualified physician. Several of
the nutrients suggested in this protocol may have adverse effects.
These include:
Curcumin
Do not take curcumin if you have a bile duct obstruction or a
history of gallstones. Taking curcumin can stimulate bile production.
Consult your doctor before taking curcumin if you have
gastroesophageal reflux disease (GERD) or a history of peptic ulcer
disease.
Consult your doctor before taking curcumin if you take
warfarin or antiplatelet drugs. Curcumin can have antithrombotic
activity.
Always take curcumin with food. Curcumin may cause gastric
irritation, ulceration, gastritis, and peptic ulcer disease if taken on
an empty stomach.
Curcumin can cause gastrointestinal symptoms such as nausea and diarrhea.
DHEA
Do not take DHEA if you could be pregnant, are breastfeeding, or could have prostate, breast, uterine, or ovarian cancer.
DHEA can cause androgenic effects in woman such as acne, deepening of the voice, facial hair growth and hair loss
EPA/DHA
Consult your doctor before taking EPA/DHA if you take warfarin
(Coumadin). Taking EPA/DHA with warfarin may increase the risk of
bleeding.
Discontinue using EPA/DHA 2 weeks before any surgical procedure.
Folic acid
Consult your doctor before taking folic acid if you have a vitamin B12 deficiency.
Daily doses of more than 1 milligram of folic acid can
precipitate or exacerbate the neurological damage caused by a vitamin
B12 deficiency.
Garlic
Garlic has blood-thinning, anticlotting properties.
Discontinue using garlic before any surgical procedure.
Garlic can cause headache, muscle pain, fatigue, vertigo,
watery eyes, asthma, and gastrointestinal symptoms such as nausea and
diarrhea.
Ingesting large amounts of garlic can cause bad breath and body odor.
Genistein
Consult your doctor before taking genistein/genistin if you have prostate cancer.
Do not take genistein/genistin if you have estrogen receptor–positive tumors.
Genistein/genistin can cause hypothyroidism in some people.
Ginseng
Consult your doctor before taking ginseng if you have high blood pressure. Overuse of ginseng can increase blood pressure.
Consult your doctor before taking ginseng if you take
nonsteroidal anti-inflammatory drugs (NSAIDs) and/or warfarin
(Coumadin). Taking NSAIDs or warfarin with ginseng can increase the
risk of bleeding.
Consult your doctor before taking ginseng if you have
diabetes. Taking ginseng can cause an extreme drop in your blood
glucose level.
Ginseng can cause breast pain, vaginal bleeding after menopause, insomnia, headaches, and nosebleeds.
GLA
Consult your doctor before taking GLA if you take warfarin
(Coumadin). Taking GLA with warfarin may increase the risk of bleeding.
Discontinue using GLA 2 weeks before any surgical procedure.
GLA can cause gastrointestinal symptoms such as nausea and diarrhea.
Green Tea
Consult your doctor before taking green tea extract if you take
aspirin or warfarin (Coumadin). Taking green tea extract and aspirin or
warfarin can increase the risk of bleeding.
Discontinue using green tea extract 2 weeks before any surgical procedure. Green tea extract may decrease platelet aggregation.
Green tea extract contains caffeine, which may produce a
variety of symptoms including restlessness, nausea, headache, muscle
tension, sleep disturbances, and rapid heartbeat.
Melatonin
Do not take melatonin if you are depressed.
Do not take high doses of melatonin if you are trying to
conceive. High doses of melatonin have been shown to inhibit ovulation.
Melatonin can cause morning grogginess, a feeling of having a
hangover or a “heavy head,” or gastrointestinal symptoms such as nausea
Shark Liver Oil
Do not exceed the maximum recommended dose.
Prolonged use (more than 30 days in a row) causes a rare side
effect known as thrombocythemia (excess platelets), which can cause the
blood to clot.
Shark liver oil can cause rash, breath that smells like
garlic, fatigue, irritability, and gastrointestinal symptoms such as
nausea and diarrhea.
Vitamin A
Do not take vitamin A if you have hypervitaminosis A.
Do not take vitamin A if you take retinoids or retinoid
analogues (such as acitretin, all-trans-retinoic acid, bexarotene,
etretinate, and isotretinoin). Vitamin A can add to the toxicity of
these drugs.
Do not take large amounts of vitamin A. Taking large amounts
of vitamin A may cause acute or chronic toxicity. Early signs and
symptoms of chronic toxicity include dry, rough skin; cracked lips;
sparse, coarse hair; and loss of hair from the eyebrows. Later signs
and symptoms of toxicity include irritability, headache, pseudotumor
cerebri (benign intracranial hypertension), elevated serum liver
enzymes, reversible noncirrhotic portal high blood pressure, fibrosis
and cirrhosis of the liver, and death from liver failure.
Vitamin B12 (cyanocobalamin)
Do not take cyanocobalamin if you have Leber's optic atrophy.
Vitamin C
Do not take vitamin C if you have a history of kidney stones or of
kidney insufficiency (defined as having a serum creatine level greater
than 2 milligrams per deciliter and/or a creatinine clearance less than
30 milliliters per minute.
Consult your doctor before taking large amounts of vitamin C
if you have hemochromatosis, thalassemia, sideroblastic anemia, sickle
cell anemia, or erythrocyte glucose-6-phosphate dehydrogenase (G6PD)
deficiency. You can experience iron overload if you have one of these
conditions and use large amounts of vitamin C.
Vitamin D
Do not take vitamin D if you have hypercalcemia.
Consult your doctor before taking vitamin D if you are taking digoxin or any cardiac glycoside.
Only take large doses of vitamin D (2000 international units or 50 micrograms or more daily) if prescribed by your doctor.
See your doctor frequently if you take vitamin D and thiazides
or if you take large doses of vitamin D. You may develop hypercalcemia.
Chronic large doses (95 micrograms or 3800 international units or more daily) of vitamin D can cause hypercalcemia.
Chronic large dosages of 95 micrograms or 3,800 IU/day or greater may cause hypercalcemia in healthy individuals.
Vitamin E
Individuals taking warfarin/coumadin should be cautious in using
high doses of vitamin E and should do so only under a physician’s
supervision.
Individuals with vitamin K deficiencies, such as those with liver failure, should be cautious in using high doses of vitamin E.
Individuals with any lesions that have a propensity to bleed
(e.g., bleeding peptic ulcers), those with a history of hemorrhagic
stroke and those with inherited bleeding disorders (e.g., hemophilia)
should use Vitamin E with extreme caution.
Vitamin E supplementation should be discontinued one month prior to any surgical procedure.
A genetic profile (e.g. expression of p53 and Bcr-Abl tyrosine kinase) can be determined via Genzyme Genetics http://www.genzymeimpath.com/lymphoma_leukemia.html and may be ordered by a physician telephoning (800) 966-4440.
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