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Leukemia is cancer of bone marrow blood cells. Studies have shown marijuana stimulates leukemia cell death, assists in the management of symptoms associated with cancer and traditional cancer treatments, and lowers the risk of complications following bone marrow transplants.
Overview of Leukemia
Leukemia is cancer of the body’s blood cells that form within the bone marrow and the lymphatic system. As cancerous blood cells form, they eventually crowd out healthy blood cells. According to the National Cancer Institute, while leukemia primarily affects adults over the age of 55, it is also the most common cancer in children under 15.
There are many types of leukemia. The most common form of leukemia involves white blood cells, which are essential for the body to effectively fight off infections. In leukemia, the bone marrow produces abnormal white blood cells that don’t function properly, which in turn weakens the immune system. Although not as common, red blood cells, which are responsible for carrying oxygen throughout the body, and platelets, which are cells that clot the blood, can also become cancer.
The cause of leukemia remains unknown, but it develops when blood cells acquire mutations or abnormalities in their DNA. These abnormalities cause them to grow and divide more rapidly.
Leukemia is classified in two ways; chronic or acute and lymphocytic or myelogenous. Chronic leukemia grows slowly, progressing gradually over time, and involves mature blood cells. Acute leukemia grows fast, progressing very quickly, and involves immature blood cells. Lymphocytic leukemia affects lymphoid cells, while myelogenous leukemia affects myeloid cells.
Symptoms associated with leukemia can vary depending on type, but they commonly include fatigue and weakness, frequent infections, weight loss, fever or chills, easy bleeding or bruising, swollen lymph nodes, regular nosebleeds, tiny red spots on the skin, excessive sweating, and bone pain or tenderness.
Treatment of leukemia typically involves chemotherapy. Biological therapy, targeted therapy and radiation therapy are also used to combat leukemia. A stem cell transplant, which replaces diseased bone marrow with healthy bone marrow, may also be required.
Findings: Effects of Cannabis on Leukemia
Evidence suggests that cannabis shows potential as a viable treatment option for leukemia. One of the major cannabinoids found in cannabis, tetrahydrocannabinol (THC), has been shown to induce apoptosis, or death, of leukemia cells (Powles, et al., 2005) (Murison, et al., 1987) (Scott, Shah, Dalgleish & Liu, 2013). Another major cannabinoid, cannabidiol (CBD), has also been shown to significantly decrease tumor burden and increase the death of cancerous leukemia cells (Gallily, et al., 2003) (McKallip, et al., 2006) (Scott, Shah, Dalgleish & Liu, 2013). Evidence has shown that a greater dose of cannabis is associated with a greater apoptosis response (Gallily, et al., 2003). One study found that combining THC treatment with additional established cytotoxic agents could further enhance leukemia cancer cell death (Liu, et al., 2008). These findings have caused researchers to conclude that cannabis “may be a novel and highly selective treatment for leukemia” (McKallip, et al., 2006).
One case study following a 14-year-old patient with an aggressive form of acute lymphoblastic leukemia observed improvements with oral cannabis treatment. The patient had previously undergone a bone marrow transplant and aggressive chemotherapy and radiation therapies, all of which has proven ineffective and had caused her to become ill and severely underweight. While she struggled with nausea, oral cannabis showed to provide anticancer effects, causing a drop in leukemic blast cell count, and the patient appeared to be gradually improving before she developed peritonitis and passed away due to her weakened immune system. Researchers had observed prior to her passing, however, that the greater the daily dosage of cannabis, the greater the response (Singh & Bali, 2013).
Cannabis has also been found to help cancer patients manage the nausea, vomiting and pain associated with traditional cancer treatments and to stimulate appetite (Guzman, 2003).
In addition, CBD has been shown to help prevent complications that can occur after a leukemia patient receives a stem cell or bone marrow transplant. Researchers discovered that leukemia patients that had undergone a transplant while being treated with CBD had a significantly lower risk of acquiring graft-versus-host disease (GVHD), a complication after a transplant where the transplanted cells attack the recipient’s body (Yeshurun, et al., 2015).
States That Have Approved Medical Marijuana for Leukemia
Nearly all states with comprehensive medical marijuana programs have approved medical marijuana for the treatment of cancer, including leukemia. These states include: Alaska, Arkansas, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and West Virginia.
In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.
While the state of Maryland hasn’t approved medical marijuana specifically for leukemia, it may allow patients whose condition is causing “chronic pain” to use cannabis.
Recent Studies on Cannabis’ Effect on Leukemia
Gallily, R., Even-Chena, T., Katzavian, G., Lehmann, D., Dagan, A., and Mechoulam, R. (2003, October). γ-Irradiation Enhances Apoptosis Induced by Cannabidiol, a Non-psychotropic Cannabinoid, in Cultured HL-60 Myeloblastic Leukemia Cells. Leukemia & Lymphoma, 44(10), 1767-73. Retrieved from http://www.tandfonline.com/doi/pdf/10.1080/1042819031000103917?needAccess=true.
Guzman, M. (2003, October). Cannabinoids: potential anticancer agents. Nature Reviews, 3(10), 745-55. Retrieved from http://www.nature.com/nrc/journal/v3/n10/full/nrc1188.html.
Jia, W., Hedge, V.L., Singh, N.P., Sisco, D., Grant, S., Nagarkatti, M., and Nagarkatti, P.S. (2006, August). D9-Tetrahydrocannabinol-Induced Apoptosis in Jurkat Leukemia T Cells Is Regulated by Translocation of Bad to Mitochondria. Molecular Cancer Research, 4(8), 549-62. Retrieved from http://mcr.aacrjournals.org/content/4/8/549.long.
Kampa-Schittenhelm, K.M., Salitzky, O., Akmut, F., Illing, B., Kanz, L., Salih, H.R., and Schittenhelm, M.M. (2016). Dronabinol has preferential antileukemic activity in acute lymphoblastic and myeloid leukemia with lymphoid differentiation patterns. BMC Cancer, 16, 25. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4715874/.
Leukemia. (2015, March 26). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/leukemia/basics/definition/con-20024914.
Leukemia-for patients. (n.d.). National Cancer Institute. Retrieved from http://www.cancer.gov/types/leukemia.
Liu, W.M., Scott, K.A., Shamash, J., Joel, S., and Powles, T.B. (2008, September). Enhancing the in vitro cytotoxic activity of Delta9-tetrahydrocannabinol in leukemic cells through a combinatorial approach. Leukemia & Lymphoma, 49(9), 1800-9. Retrieved from http://www.tandfonline.com/doi/full/10.1080/10428190802239188?needAccess=true.
McKallip, R.J., Jia, W., Schlomer, J., Warren, J.W., Nagarkatti, P.s., and Nagarkatti, M. (2006, September). Cannabidiol-induced apoptosis in human leukemia cells: A novel role of cannabidiol in the regulation of p22phox and Nox4 expression. Molecular Pharmacology, 70(3), 897-908. Retrieved from http://molpharm.aspetjournals.org/content/70/3/897.long.
Murison, G., Chubb, C.B., Maeda, S., Gemmell, M.A., and Huberman, E. (1987, August). Cannabinoids induce incomplete maturation of cultured human leukemia cells. Proceedings of the National Academy of Sciences of the United States of America, 84(15), 5414-8. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC298868/.
Powles, T., te Poele, R., Shamash, J., Chaplin, T., Propper, D., Joel, S., Oliver, T., and Liu, W.M. (2005, February 1). Cannabis-induced cytotoxicity in leukemia cell lines: the role of the cannabinoid receptors and the MAPK pathway. Blood, 105(3), 1214-21. Retrieved from http://www.bloodjournal.org/content/105/3/1214.long?sso-checked=true.
Scott, K.A., Shah, S., Dalgleish, A.G., and Liu, W.M. (2013, October). Enhancing the activity of cannabidiol and other cannabinoids in vitro through modifications to drug combinations and treatment schedules. Anticancer Research, 33(10), 4373-80. Retrieved from http://ar.iiarjournals.org/content/33/10/4373.long.
Singh, Y., and Bali, C. (2013, November 28). Cannabis extract treatment for terminal acute lymphoblastic leukemia with a Philadelphia chromosome mutation. Case Reports in Oncology, 6(3), 585-92. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901602/.
Yeshurun, M., Shpilberg, O., Herscovici, C., Shargian, L., Dreyer, J., Peck, A., Israeli, M., Levy-Assaraf, M., Gruenewald, T., Mechoulam, R., Raanani, P., and Ram, R. (2015, October). Cannabidiol for the Prevention of Graft-versus-Host-Disease after Allogeneic Hematopoietic Cell Transplantation: Results of a Phase II Study. Biology of Blood and Marrow Transplantation, 21(10), 1770-5. Retrieved from http://www.bbmt.org/article/S1083-8791(15)00375-4/fulltext.
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