A Research Review on Leukaemia to empower patients with ideas for what compounds and complementary treatments you might use to help yourself increase your personal odds of fighting and even beating the different forms of leukaemia.
Many people face their leukaemia with sheer trepidation - it’s not just the disease, but the extremely strong drugs and bone marrow transplants. There’s no need to. We can help you (writes CANCERactive founder and Oxford University biochemist, Chris Woollams).
Are there really alternatives? Extras you can use? Well, for example, here on our Feedback and Comments page, you will see that Chris recently helped 'M' fight hers to the surprise of all her oncologists with her blast score falling from 36 to below 3, after less than 3 months (and only one round of chemo). Doctors used the word excellent six times to describe her results!
Go to Personal Prescriptions; Feedback and Comments
INTRODUCTION
Leukaemia is a cancer of the body's blood-forming tissues, including the bone marrow and the lymphatic system. Many types of leukaemia exist. Some forms of leukaemia are more common in children. Other forms of leukaemia occur mostly in adults. Most leukaemia starts in early forms of white blood cells, B-lymphocytes, in the bone marrow (as does lymphoma and myleloma). Damage occurs resulting in the body producing too many cells which don't function properly (Mayo Clinic).
The major types of leukaemia are:
* Acute lymphocytic leukaemia (ALL). This is the most common type of leukemia in young children. ALL can also occur in adults. Also called Acute lymphoblastic leukaemia.
* Acute myelogenous or myeloid leukaemia (AML). AML is a common type of leukaemia. It occurs in children and adults. AML is the most common type of acute leukaemia in adults. It does not originate in the B-cells.
* Chronic lymphocytic leukaemia (CLL). With CLL, the most common chronic adult leukaemia, you may feel well for years without needing treatment. Also called chronic lymphoblastic leukaemia. This cancer originates in the B-lymphocytes.
* Chronic myelogenous or myeloid leukaemia (CML). This type of leukaemia mainly affects adults. A person with CML may have few or no symptoms for months or years before entering a phase in which the leukaemia cells grow more quickly.
THE IMMUNE SYSTEM
There are two parts to the immune system
You are born with an Innate Immune System. This is primitive and contains T-lymphocytes that attack any rogue organism entering the body. If they lose the fight, cells such as dendritic cells come along, pick up a piece of the bad guy and hand it on a plate to the B-lymphocytes. These react specifically to that piece and evolve into proteins called antibodies, which are like jigsaw pieces and fit the attacker exactly and neutralise it, be it a bacterium, a virus or a parasite. This is the Adaptive Immune System in action - built in response to infection throughout your life. The vast majority of 'infections' are the members of your microbiome.
T-cells or T-lymphocytes are made in the bone marrow from stem cells and mature in the thymus. There are a number of different types. They tend to operate within cells and protect us from infection.
B cells or B-lymphocytes are also made in the bone marrow from stem cells. They operate outside cells. B-lymphocytes also secrete cytokines, which are chemical messages that can't enter the cells but can direct hormones and other factors to launch an immune attack.
T- and B-lymphocytes are termed white, or immune, blood cells. The bone marrow is part of the lymphatic system, which also includes the lymph nodes (or lymph glands), spleen and thymus.
Thus, your lymphocytes are white immune cells which protect you from infection.
When a B-cell turns rogue, it can be copied over and over again in the bone marrow. If these weak cells stay in the bone marrow the disease is termed multiple myeloma. When the weakened B-cells form in, but leave the bone marrow, this disease is termed lymphoma. Sometimes, the weakened lymphocytes leave the bone marrow as a type of white cell leukaemia - lymphocytic leukaemia.
THE BONE MARROW ENVIRONMENT
First, you need to know that Stem Cells were the blob of cells that first grew when you were an embryo. From your stem cells all body cells 'differentiate' starting after around day 52 - liver, kidneys, eyes, brain etc. You have stem cells throughout your life. Made in your bone marrow, they are your repair cells - blanks that can turn into any cell you need.
Some stem cells get 'stuck' in their rapidly dividing form, usually under the influence of oestrogen. However, research suggests it is possible that, for example, EBV can do this too. These can become Cancer Stem Cells at the heart of a cancer. No conventional drug kills them and in the case of CLL, for example, they generate rapidly dividing irregular B-lymphocytes. They are therefore cells that can lead to recurrence. CLL accounts for approximately 35% of leukaemia; ALL for roughly 10% of cases.
This is not the case for AML, which is approximately 25% of leukaemia and is the result of growth from abnormal myeloid cells. Myeloid tissue is bone marrow tissue, from the actual bone marrow cells.
Bone Marrow Microenvironment understanding is in its infancy. Much of the research on PubMed is in the past 2 years! The bone marrow has its own microbiome. Bone marrow health, bone marrow fat and stem cells, which are formed in the marrow and go onto make osteoclasts, osteoblasts, T-cells, B-cells and others, are all intertwined.
Stem cells and B-cell progenitors are crucial to your health. They both exist in the bone marrow and ensure new healthy blood cells, and B-cells are made. For example, when B-cell lymphoma occurs, it seems that the stem cells are less likely to make fully formed or mature B-cells (8).
In AML, a group of B-cells, called regulatory B-cells or Breg have an immunomodulatory role and seem to prevent autoimmune diseases such as Multiple Sclerosis and Rheumatoid Arthritis. Although AML is not strictly a B-cell cancer, high Breg cell numbers are linked to lower survival (9).
Marrow lipids (fats) are essential to the health of your bone marrow and there is a high turnover of fats in the bone marrow (10) . However, the bone marrow fats have a different composition to blood fats or brown fat in your body.
In one study, (11) 'powering up' the adipocytes (in this case, bone marrow fat cells made from stem cells) powered up the bone marrow lipid content and generated healthier AML blood cells.. How did the researchers power up the Bone Marrow? They gave people Metformin - ordinarily this diabetes drug is used to cut blood sugar. It does it by affecting factors in the liver. In this research it unexpectedly changed the bone marrow lipid profile for the better causing a tsunami of good bone marrow fat to push out the imperfect B-cells.
In another study, the health of the bone marrow was linked to the health of lymphocytes and vice versa (12) This review contains a huge list of research papers on the subject.
LEUKAEMIA CAUSES AND DEVELOPMENT
Almost all Leukaemia (and B-Lymphoma) is caused by Toxins. But there are other contributory factors.
Toxins that increase leukaemia risk come under three headings:
1) From the environment: I've had people working in printing, using benzene, owning a cement factory, playing with a file of mercury, using pesticides, living near electricity pylons/cables, and cancer patients who have been treated with radioactive iodine. Radiation, Electromagnetic radiation and Radon gas have also been linked with leukemia risk, the latter specifically with CLL.
See - Cancer in the workplace
See - Pesticides and cancer
2) Consumed: aspartame doubles risk of leukaemia, (there's research on sucralose too) and radiotherapy and some drugs - like antibiotics, immunosuppressants and PPIs - can increase risk. Even chemotherapy for a cancer may later be shown to have increased leukaemia risk.
People with poor immune systems develop more CLL and lymphoma. Children born by caesarian and/or not breast fed and or to a mother who smoked, took drugs or who was ill at the time of birth, develop more leukaemia.
3) Toxins from infection: Leukaemia can be related to B-cell issues, where they are affected by parasites (food poisoning), Helicobacter pylori, E coli, Campylobacter, Coxiella, yeasts and even viruses such as HIV. There's a link between B-cell strand breaks and Epstein-Barr, and Hepatitis C.
More than 15 percent of people over the age of 60 develop TET2 - it’s a mutation in the stem cells that produce blood cells. Long before a person develops leukaemia, changes in the microbiome are taking place which seem to bring it about. TET2 changes cause changes in the blood cells and leukaemia.
There is evidence of the immune system overworking in cases of Epstein Barr and other viruses and of B-cells then being genetically altered. Viruses can lead to blood and lymph cancer, aided and abetted by a damaged microbiome.
EBV can cause cancer usually by causing double strand breaks in the DNA, rather than actual mutation.
* EBV is a member of the human herpesvirus family (Herpes 1, 8 - cold sores - and HPV are others). Where young people are infected, they are often asymptomatic. EBV has been linked to several forms of Lymphoma, and to Chronic Lymphocytic Leukaemia. Its presence is linked to higher rates of relapse. Its presence is highest in Hodgkin's lymphoma at about one third of patients and it is active in 5% of CLL patients (1).
The virus is a potent lymphotropic agent capable of transforming B-cells in vitro into a state of continuous proliferation called ‘immortalisation’.
Other contributors to Leukaemia risk include:
4) Both diabetes and poor sugar control are associated with a 20% increased risk of leukaemia, for both AML and CLL, and B-cell Lymphoma (2); It is thought, early onset Leukemia and Type 1 diabetes may share a virus.
People with diabetes and CLL have lowered rates of survival (3).
There is evidence that poor sugar control increases risk of ALL (4).
There is evidence that leukaemia cells so desire sugar that they actually rob their healthy neighbours and even alter insulin levels so that the sugar stays higher in the bloodstream.
And there's evidence that fasting can block the development of ALL (5).
Fasting can turn the immune system against almost any cancer (6)
Both Metformin (20) and Berberine have research showing the can target Leukaemia cells. At doses that were totally ineffective on normal lymphocytes, metformin was shown in research to cause apoptosis of quiescent CLL cells. It also caused cell cycle arrest. This cytostatic effect was accompanied by decreased expression of survival, and proliferation-associated proteins, inhibition of CLL signaling pathways involved progression, and decreased levels of glucose inside the cells and available for glycolysis.
5) High cholesterol is not helpful either - cholesterol is closely linked to the abundance and function of numerous growth signalling proteins, strongly affecting the proliferation rate of ALL and CLL cells (7). During chemotherapy, leukaemia cells can even protect themselves by increasing cholesterol levels.
CLL is cholesterol-avid and cholesterol plays an important role in CLL proliferation (21). Statins have little effect on CLL survival according to research, possibly because patients often have low cholesterol with so much uptake by the disease. The research with AML and statins is mixed. However, cholesterol starvation may help. In research from NorthWestern in Chicago, it killed B-lymphoma cells (22).
6) A Poor Microbiome - Scientists have shown (23) that the pathogens identified in CLL included Escherichia coli (24.9 %), Enterococcus faecium (10.7 %), Staphylococcus aureus (9.7%), Streptococcus pneumoniae (9.5 %). There's more bleow in the section on the microbiome.
7) A Poor Diet - A standard 'western' diet increases the risk of CLL, while there is no risk increase found between the colourful Mediterranean Diet (the Rainbow Diet) and CLL. Processed, packaged and refined foods should be avoided. The Ideal diet cancer be found here. Be clear - The Chris Woollams Rainbow Diet is a LIFESTYLE far more than just a Diet.
8) Stress - There's a quite a lot of research on stress and its negative survival effects (for example, 24) by increasing cytokine, chemokine and cancer markers with leukaemia , particularly CLL. Researchers showed that the more stress in the patient, the greater the number of circulating cancer cells.
Stress can also increase your blood sugar levels, cause the production of cortisol and adrenaline which greatly increase inflammation throughout the body; and thirdly stress causes a significant decrease in commensal (good) gut bacteria levels and this would affect other microbiomes including the bone marrow microbiome throughout the body.
We have stress management protocols on CANCERactive - for example, cortisol can be neutralised by endorphins (exercise, yoga) and adrenaline by opioids (meditation, prayer, CBD). Supplements that can help include ashwagandha, boswellia and theanine. We also use EFT, visualization and PSYCH-K.
9) CLL can run in families. Though, at the moment, scientists have not found exactly why.
THE ROLE OF THE GUT MICROBIOME
Not surprisingly, there are several research studies showing that your gut microbiome can affect your bone marrow microenvironment (for example, 13) Be clear; not just the pathogens (parasites, bacteria, viruses) but the commensal (good) bacteria in the gut microbiome too.
Other studies, (for example, 14) show that damage to the gut microbiome by drugs and antibiotics (and food poisoning etc) can CAUSE blood and lymph cancers (obviously by affecting the bone marrow microenvironment).
In 2015 there was a review by UCLA experts on how pathogens in the microbiome of the gut could cause B-cell lymphomagenesis (15). The bottom line from these researchers was that pathogens can directly interact with immune cells causing oxidative stress, and with epithelial cells causing increased Reactive Oxygen Species (bad) and inhibition of NF-κB. Oxidative stress (also bad) is well understood to cause message damage from your DNA and lead to carcinogenesis. For information, Melatonin and Glutathione (the two biggest antioxidants you make yourself) neutralise ROS and Free Radicals in the cellular microenvironment.
Gut bacteria alone can cause an immune response to a pathogen and change the lymphocytes. The researchers made the point that the family Lactobacillus (250 family members or strains) seems to be significantly protective in this change and we have covered research that B-cell problems and blood and lymph cancer risk can be linked simply to lost members.
Loss of good bacteria, gain of 'bad', is a driving force in all cancer.
A few years ago, I created a Heal Your Gut protocol. It is flexible and we change it according to the patient involved. The Heal your gut you need to do four things - Heal the gut wall; kill the pathogens; replenish with trillions of good bacterial feed them right. We have included the HUG PROTOCOL in the references so you can read the full programme (16).
In particular, we use unpasteurised goats' cheese with butyrate to restore the families Lactobacillus and Bifidobacterium. This is a good way of regenerating the full membership of those families, and with them an acidic gut. You need an alkaline body, but you also need an acidic gut for good health.
We know (from 2020 research) that an intact , healthy microbiome protects children from Leukaemia, especially Acute lymphoblastic leukaemia (17). Children who did not have a natural birth, were not breast fed for long, were born to mothers that were taking drugs (prescribed or otherwise), who were ill, or had depression, can all have damaged microbiomes and a heightened risk of Leukaemia.
We know from 2021 research that dysbiosis of the microbiome is linked to benign and cancerous blood and lymph diseases; and, unfortunately, chemotherapy and immunosuppressants may worsen these diseases (18). Leukaemia can arise from chemotherapy and/or radiotherapy for other cancers.
And there is 2016 research showing that the degeneration of the gut wall and lining allows bacteria to 'wander' from the gut around the body and may be a major contributor to leukaemia. These wandering cells can even affect organs. Degeneration of the gut wall increases with age, as does leukaemia risk.
Dysbiosis and gut wall damage doesn’t have to be the result of age, or too many antibiotics, immunosuppressants, or drugs. Binge drinking, smoking, food poisoning and stress can each and all have a negative effect on your gut microbiome, and from there, the bone marrow microbiome. As can excess sugar consumption and not eating enough soluble fibre foods like pulses, nuts and seeds, oats and vegetables.
STEM CELL TRANSPLANTS
There is evidence that Stem Cell (Bone Marrow) Transplants work better if you have a healthy microbiome. A large study looked at the use of fecal transplants comparing them to people merely being left to their own devices for a year (19).
There is evidence that AFTER a Stem Cell Transplant, you would be extremely wise to immediately rebuild your microbiome. Where people simply went home, one year later they still only had 27% of their ideal microbiome - Yes, just two drugs for four rounds plus antibiotics for only 2 weeks cuts your microbiome by three quarters. How many Medical professionals realise this. Even Proton Pump inhibitors such as omeprazole, greatly damage the microbiome. The American Gastrointestinal Society Doctors say they should never be used for more than 3 days and only at low doses. Has a PPI caused your leukaemia?
NATURAL COMPOUNDS WITH RESEARCH SUPPORTING ANTI-LEUKAEMIA EFFECTS
Here are a few suggestions from research studies - we’ve done the hard work for you - and left the links in place for ease of reference:
i) Brazilian lapacho tree bark -
Ortho-quinones, called β-lapachone found in, for example, Pau D'arco, are known for their potential to control the abnormal increase in the number of cells and are good candidates for the treatment of AML leukemia. Pau D'arco is an anti-yeast and anti-viral from a tress bark in South America - https://scitechdaily.com/a-natural-compound-that-can-help-cure-leukemia/
ii) Fucoidan -
From brown seaweed, it has several studies showing effect against AML and T-cell Leukaemia. A summary of anticancer research is - https://cancerci.biomedcentral.com/articles/10.1186/s12935-020-01233-8
And Fucoidan causes apoptosis in Leukaemia cells - https://pubmed.ncbi.nlm.nih.gov/23880928/
iii) Honokiol -
Again, there are a number of studies showing effects with leukaemia.
With AML cells - https://pubmed.ncbi.nlm.nih.gov/35645831/
Honokiol kills AML cells - https://www.frontiersin.org/articles/10.3389/fphar.2022.897791/full
Honokiol with B-cell CLL - https://www.sciencedirect.com/science/article/pii/S0006497120532965
iv) Dandelion Root -
It seems to have active properties against leukaemia. See - https://ashpublications.org/blood/article/122/21/5216/12219/Dandelion-Root-and-Chronic-Myelomonocytic-Leukemia
Dandelion and Leukaemia - https://www.sciencedirect.com/science/article/abs/pii/S0378874110006434
v) Feverfew -
the active ingredient Parthenolide has been shown to have effects on CLL and ALL - https://www.canceractive.com/article/the-truth%20about%20feverfew%20and%20cancer.
CLL - https://oncdata.com/news/parthenolide-a-flowering-plant-compound-could-fight-cll
The FDA promised to fast-track the compound but never did.
vi) Grape Seed Extract -
There's limited research, but it appears to block an important pathway driving leukaemia - https://www.medicalnewstoday.com/articles/134311#2
vii) Berberine -
There are numerous studies with different types of leukemia - a Review: https://pubmed.ncbi.nlm.nih.gov/35331097/. It is especially powerful when combined with drugs.
Berberine induces cell death in ALL - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229801/
Berberine and Lymphoblastic Leukaemia - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536443/
Berberine and diffuse large B cell lymphoma - https://pubmed.ncbi.nlm.nih.gov/33930347/
Berberine and B-cell Lymphocytic leukaemia - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7536443/
viii) Turmeric -
Apart from its immune boosting, angiogenesis preventing and chemotherapy and radiotherapy enhancing benefits, turmeric has a good number of studies against leukaemia. It is active against all types of Leukaemia, and can work synergistically with EGCG from Green tea - https://www.turmericforhealth.com/turmeric-benefits/turmeric-and-leukemia
ix) Green tea
EGCG keeps CLL in check in majority of patients - https://newsnetwork.mayoclinic.org/discussion/green-tea-extract-appears-to-keep-cancer-in-check-in-majority-of-cll-patients/
x) Turmeric and Green Tea -
A recipe for CLL?: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646173/
xi) Resveratrol -
Another cancer stem cell killer, it has research since 2002 showing effects against leukaemia. For example see - https://pubmed.ncbi.nlm.nih.gov/30954463/
Resveratrol in Leukaemia and lymphoma - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152792/
xii) Ursolic Acid -
From Tulsi (Holy Basil) or Pistacchio nuts - another stem cell killer; kills leukaemia cells in vitro and in vivo - https://pubmed.ncbi.nlm.nih.gov/21950524/
xiii) Genistein -
Yet another stem cell killers also attacks leukaemia in vitro and in vivo -https://pubmed.ncbi.nlm.nih.gov/30618158/
Genistein and Leukaemia - https://pubmed.ncbi.nlm.nih.gov/34669117/
Genistein and haematological cancer - https://www.sciencedirect.com/science/article/abs/pii/S0304383510002557
xiv) Selenium -
This mineral has been shown to suppress various types of Leukaemia including CLL - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323677/
xv) Zinc -
Another important mineral for the immune system, Zinc is often at low levels in ALL patients. It seems capable of limiting progression in leukaemia - https://pubmed.ncbi.nlm.nih.gov/29492645/
xvi) Magnesium -
Important mineral for the immune system, the liver and some 300 reactions in metabolism, lowered levels are found in patients with leukaemia - https://www.researchgate.net/publication/321777142_Serum_Magnesium_Concentration_in_Patients_with_Leukemia_and_Lymphoma
xvii) Melatonin -
There is a growing level of research on the benefits of melatonin with leukaemia. Go to bed at a regular time; spend at least two hours out of doors even on the darkest day. And, possibly supplement, up to 20 mg a night. See - https://pubmed.ncbi.nlm.nih.gov/34355548/
Blood and lymph cancers, chemotherapy aid - https://www.eurekalert.org/news-releases/844487
A promising agent targeting leukaemia - https://pubmed.ncbi.nlm.nih.gov/31713261/
Melatonin inhibits cell proliferation and induces caspase activation and apoptosis - https://pubmed.ncbi.nlm.nih.gov/22582944/
xviii) Quercetin -
Multitarget effects of Quercetin with Leukaemia - https://pubmed.ncbi.nlm.nih.gov/25293876/
The potential anti-cancer effects of quercetin on blood, prostate and lung cancers: An update -https://www.frontiersin.org/articles/10.3389/fimmu.2023.1077531/full#:~:text=Also%2C%20in%20combination%20with%20the,an%20aggressive%20B%20cell%20lymphoma.
xix) Thiamine (vitamin B1)
Thiamine deficiency in CLL - https://pubmed.ncbi.nlm.nih.gov/11524517/
B-cell lymphoma, thiamine deficiency, and lactic acidosis - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5242120/
xx) Vitamin D
Vitamin D arms the immune cells. Vitamin D and leukemia - https://www.medicalnewstoday.com/articles/304797
Low Vitamin D and poor outcomes in CLL - https://www.nature.com/articles/bcj20179
xxi) Cannabis, leukaemia and lymphoma
Little or no decent research for its use with Leukaemia. Sorry!
Cannabinoid Receptor 1 has been identified as a predominant feature of Hodgkin's lymphoma cells and could be a potential target. See - https://pubmed.ncbi.nlm.nih.gov/24349109/
xxii) Carotenoids and lymphoma
Carotenoid slows down CLL growth - https://www.sciencedirect.com/science/article/pii/S2590262820300101
There is a significant inverse dose-response relationship between alpha-carotene intake and NHL risk (13% lower risk per 1000 μg/day increment of intake). A meta-analysis found that higher intakes of alpha-carotene, and beta-carotene foods such as lycopene and carrots, and lutein/zeaxanthin might well protect against B-cell NHL development. See - https://pubmed.ncbi.nlm.nih.gov/28011986/
xxiii) Apigenin - a major plant flavone, in high levels in herbs such as oregano, possessing antioxidant, anti-inflammatory, and anticancer properties with multi-targets:. It was researched with various leukaemia lines - https://pubmed.ncbi.nlm.nih.gov/35614109/
And - https://pubmed.ncbi.nlm.nih.gov/21364669/
And - https://www.nature.com/articles/cddis201041
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I sincerely hope this article gives you ideas for increasing your personal odds of survival if you have leukaemia - from sugar and cholesterol control, to fixing your gut and taking natural compounds.
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References
1. EBV active in 5% of CLL patients - https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(22)00404-7/fulltext
2. Diabetes and Leukemia - https://www.sciencedaily.com/releases/2012/06/120605121658.htm
3. Diabetes and CLL - https://ashpublications.org/blood/article/126/23/2095/105264/The-Impact-of-Diabetes-on-Clinical-Outcomes-in
4. Poor sugar control and ALL - https://link.springer.com/article/10.1007/s13410-021-01021-8
5. Fasting Blocks ALL development - https://pubmed.ncbi.nlm.nih.gov/27941793/
6. Fasting can restrict cancer - https://keck.usc.edu/fasting-like-diet-turns-the-immune-system-against-cancer/.
7. Cholesterol and Leukaemia - https://aacrjournals.org/mcr/article/9/2/215/90801/Cholesterol-Regulates-VEGFR-1-FLT-1-Expression-and
8. Stem cells and lymphoma - https://pubmed.ncbi.nlm.nih.gov/35565219/
9. Breg cells and ALL - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6496973/
10. Bone Marrow fats - https://pubmed.ncbi.nlm.nih.gov/31668874/
11. CLL, Metformin and bone marrow fat - https://www.sciencedaily.com/releases/2017/10/171016122159.htm
12. Health of bone Marrow fat affects health of Lymphocytes - https://www.sciencedirect.com/science/article/pii/S1040842821000779
13. The Microbiome and bone marrow - https://www.jci.org/articles/view/128521
14. Damage to microbiome and leukaemia risk:- https://www.sciencedirect.com/science/article/pii/S1040842821000779
15. Pathogens causing leukaemia - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047521/
16. Heal your gut - https://chriswoollamshealthwatch.com/featured/heal-your-gut-now-hug-it/
17. Children, microbiome and leukaemia - https://pubmed.ncbi.nlm.nih.gov/32911536/
18. Chemotherapy, immunosupressants and leukaemia - https://www.sciencedirect.com/science/article/pii/S1040842821000779
19. Microbiome after Stem Cell Transplants - https://www.cancer.gov/news-events/cancer-currents-blog/2020/microbiome-health-survival-stem-cell-transplant
20. Metformin, an Anti-diabetic Drug to Target Leukemia - https://pubmed.ncbi.nlm.nih.gov/30147674/ and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673187/
21. The Role of Cholesterol in Chronic Lymphocytic Leukemia Development and Pathogenesis - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10385576/
22. Cholesterol starvation kills lymphoma cells - https://news.northwestern.edu/stories/2021/01/cholesterol-starvation-kills-lymphoma-cells/
23. Bacterial Infections in patients with CLL - https://ashpublications.org/blood/article/130/Supplement%201/3461/114617/Bacterial-Infections-in-Patients-with-Chronic
24 .Cells, cytokines, chemokines, and cancer stress: A biobehavioral study of patients with chronic lymphocytic leukemia -https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.31538
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