A Case of Complete and Durable Molecular Remission of Chronic Lymphocytic Leukemia Following Treatment with Epigallocatechin-3-gallate, an Extract of Green Tea

Abstract

We report the case of a 48-year-old man who achieved a complete molecular remission 20 years after a diagnosis of chronic lymphocytic leukemia while using epigallicatechin-3-gallate, an extract of green tea. The patient presented at age 28 with lymphocytosis, mild anemia, mild thrombocytopenia, and massive splenomegaly, for which a splenectomy was performed. He was then followed expectantly. Over the next two decades, he suffered two symptomatic chronic lymphocytic leukemia-related events. The first occurred twelve years after diagnosis (at age 40) when the patient developed fevers, night sweats, and moderate anemia. He was diagnosed with autoimmune hemolytic anemia secondary to chronic lymphocytic leukemia. The patient declined conventional therapy in favor of a diet, exercise, and supplement regimen, and recovered from the autoimmune hemolytic anemia though the underlying chronic lymphocytic leukemia remained evident. This is the first published case report of "spontaneous" recovery from secondary autoimmune hemolytic anemia in an adult. Over the second decade following chronic lymphocytic leukemia diagnosis, serial bone marrow biopsies demonstrated increasing lymphocytosis, with minimal peripheral lymphocytosis. However, twenty years after diagnosis, peripheral lymphocytosis accelerated, with white blood cell counts rising to 55,000/µL. Because the patient continued to refuse conventional therapy, he was treated instead with a supplement regimen that included high doses of epigallocatechin-3-gallate, a green tea extract. Peripheral lymphocytosis resolved. More remarkably, a bone marrow examination, including flow cytometry, showed no evidence of a malignant clone. Two years later (at age 51), the peripheral blood and bone marrow were without molecular evidence of chronic lymphocytic leukemia or any malignancy. The patient remains well at age 52.

The Effects of Green Tea Catechins in Hematological Malignancies

“…Lemanne et al (2015) reported a case of a 48-year-old man with CLL who presented a complete clinical and molecular regression, 20 years after a diagnosis, without conventional therapy and using EGCG [ 128 ]. These studies suggest that green tea catechin extracts are safe/tolerated (in the tested doses) in healthy individuals [ 129 , 130 ] and leukemia patients [ 123 , 125 , 126 , 128 ], as well as inexpensive and effective.…”

“…D'Arena et al ( 2013) additionally reported that green tea extract, orally for 6 months, reduced the absolute number of B-lymphocytes and circulating Treg cells accompanied by a decline of IL-10 and TGF-beta serum levels in a cohort of patients with low-risk CLL (Rai stage 0, n = 12/10 per group (n = 32 and 42 patients respectively) [127]. Lemanne et al (2015) reported a case of a 48-year-old man with CLL who presented a complete clinical and molecular regression, 20 years after a diagnosis, without conventional therapy and using EGCG [128]. These studies suggest that green tea catechin extracts are safe/tolerated (in the tested doses) in healthy individuals [129,130] and leukemia patients [123,125,126,128], as well as inexpensive and effective.…”

Cancer Metabolism as a Therapeutic Target and Review of Interventions

“…A meta-analysis showed an inverse association between tea catechin intake and various cancers [370], and another meta-analysis demonstrated that GTCs reduced the risk of gastrointestinal, breast, gynecological, leukemia, lung, and thyroid cancers [379]. Case reports and clinical studies also observed positive outcomes in patients with B cell malignancies and chronic lymphocytic leukemia (CLL) treated with GTCs [380,381]. In a randomized trial, GTCs significantly reduced the risk of prostate cancer [382,383].…”

Integrative Hematology: State of the Art

“…Beyond the preclinical data, it is interesting to underline the presence in the literature of a case report in which complete remission, both hematological and molecular (persistent after 3 years), was obtained, with the use of curcumin and EGCG only [ 66 ] for their synergistic action. The evidence of the synergy led to the publication of an editorial with a captivating title: “Turmeric and green tea: a recipe for B-CLL”, which shows how the two substances partly share mechanisms of action, but each one also has its own specific mechanisms, which increases the advantage of using both.…”