Lemanne Dawn, Block Keith I, Kressel Bruce R, Sukhatme Vikas P, White Jeffrey D
Oncology, Oregon Integrative Oncology.
Block Center for Integrative Cancer Treatment, Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, University of Illinois at Chicago.
Cureus. 2015 Dec 29;7(12):e441. doi: 10.7759/cureus.441.
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.
我们报告了一例48岁男性患者的病例,该患者在被诊断为慢性淋巴细胞白血病20年后,使用绿茶提取物表没食子儿茶素-3-没食子酸酯实现了完全分子缓解。该患者28岁时出现淋巴细胞增多、轻度贫血、轻度血小板减少和巨脾,为此进行了脾切除术。此后对其进行了观察。在接下来的二十年里,他经历了两次与慢性淋巴细胞白血病相关的症状性事件。第一次发生在诊断后十二年(40岁时),患者出现发热、盗汗和中度贫血。他被诊断为继发于慢性淋巴细胞白血病的自身免疫性溶血性贫血。患者拒绝传统治疗,选择饮食、运动和补充剂方案,尽管潜在的慢性淋巴细胞白血病仍然明显,但他从自身免疫性溶血性贫血中康复。这是第一例发表的成人继发性自身免疫性溶血性贫血“自发”康复的病例报告。在慢性淋巴细胞白血病诊断后的第二个十年里,系列骨髓活检显示淋巴细胞增多加剧,外周淋巴细胞增多最少。然而,诊断后二十年,外周淋巴细胞增多加速,白细胞计数升至55,000/µL。由于患者继续拒绝传统治疗,他转而接受了一种补充剂方案治疗,该方案包括高剂量的绿茶提取物表没食子儿茶素-3-没食子酸酯。外周淋巴细胞增多得到缓解。更值得注意的是,包括流式细胞术在内的骨髓检查未发现恶性克隆的证据。两年后(51岁时),外周血和骨髓没有慢性淋巴细胞白血病或任何恶性肿瘤的分子证据。该患者52岁时仍然健康。