Foods for Chronic Myelomonocytic Leukemia!

Introduction

Foods for Chronic Myelomonocytic Leukemia should be personalized for each individual and also must adapt when cancer treatment or tumor genetic change. The personalization and adaptation must consider all the active ingredients or bioactives contained in different foods with respect to cancer tissue biology, genetics, treatments, lifestyle conditions and diet preferences. Hence while nutrition is one of the very important decisions for a cancer patient and individual at risk of cancer to make – how to choose foods to eat is not an easy task.

Chronic myelomonocytic leukemia (CMML) is a rare type of cancer that affects the bone marrow and blood cells. Symptoms of CMML can include fatigue, weakness, anemia, infections, and an enlarged spleen. Prompt diagnosis of CMML involves a combination of clinical evaluation, blood tests, and bone marrow examination. Understanding CMML entails recognizing it as a form of myelodysplastic/myeloproliferative neoplasm characterized by the abnormal production of monocytes and myeloid cells. Prognosis for CMML varies depending on the subtype, extent of the disease, and presence of certain genetic abnormalities. Accurate coding of CMML is achieved using the ICD-10 system. Pathology outlines play a critical role in the diagnosis and characterization of CMML. Survival rates and life expectancy for CMML are influenced by various factors, including age, overall health, and response to treatment. Treatment options for CMML aim to manage symptoms, minimize complications, and improve quality of life. Lab values such as monocyte count and complete blood count (CBC) are essential for monitoring CMML progression and treatment response. Researchers continue to investigate the underlying causes of CMML, including genetic mutations and environmental factors. A thorough diagnostic process ensures that CMML is differentiated from other similar blood disorders. Increasing awareness of CMML symptoms and diagnostic methods aids in early intervention and appropriate management. With ongoing advancements in treatment options and understanding of its pathophysiology, healthcare providers can offer more targeted care to individuals with CMML.

For Chronic Myelomonocytic Leukemia does it matter what vegetables, fruits, nuts, seeds one eats?

A very common nutrition question asked by cancer patients and individuals at-genetic risk of cancer is – for cancers like Chronic Myelomonocytic Leukemia does it matter what foods I eat and which I do not? Or if I follow a plant-based diet is that enough for cancer like Chronic Myelomonocytic Leukemia?

For example does it matter if vegetable Cluster Bean is consumed more compared to Cucurbita? Does it make any difference if fruit Pummelo is preferred over Pomegranate? Also if similar choices are made for nuts/seeds like Butternut over European Chestnut and for pulses like Alfalfa over Common Bean. And if what I eat matters – then how does one identify foods which are recommended for Chronic Myelomonocytic Leukemia and is it the same answer for everyone with the same diagnosis or genetic risk?

Yes! Foods you eat matters for Chronic Myelomonocytic Leukemia!

Food recommendations may not be the same for everyone and can be different even for the same diagnosis and genetic risk.

All foods (vegetables, fruits, nuts, seeds, pulses, oils etc.) and nutritional supplements are made up of more than one active molecular ingredient or bio-actives in different proportions and quantities. Each active ingredient has a unique mechanism of action – which can be activation or inhibition of different biochemical pathways. Simply stated foods and supplements which are recommended are those which do not cause an increase of molecular drivers of cancer but reduce them. Else those foods should not be recommended. Foods contain multiple active ingredients – hence when evaluating foods and supplements you need to consider the impact of all active ingredients cumulatively rather than individually.

For example Pummelo contains active ingredients Apigenin, Curcumin, Formononetin, Phloretin, Naringin. And Pomegranate contains active ingredients Apigenin, Curcumin, Formononetin, Phloretin, Naringin and possibly others.

A common mistake made when deciding and choosing foods to eat for Chronic Myelomonocytic Leukemia – is to evaluate only selected active ingredients contained in foods and ignore the rest. Because different active ingredients contained in foods may have opposing effects on cancer drivers – you cannot cherry pick active ingredients in foods and supplements for making a nutrition decision for Chronic Myelomonocytic Leukemia.

YES – FOOD CHOICES MATTER FOR CANCER. NUTRITION DECISIONS MUST CONSIDER ALL ACTIVE INGREDIENTS OF FOODS.

Skills Needed for Nutrition Personalization for Chronic Myelomonocytic Leukemia?

Personalized nutrition for cancers like Chronic Myelomonocytic Leukemia consists of recommended foods / supplements; not recommended foods / supplements with example recipes which prioritize use of recommended foods. An example of personalized nutrition can be seen at this link.

Deciding which foods are recommended or not is extremely complicated, requiring expertise in Chronic Myelomonocytic Leukemia biology, food science, genetics, biochemistry along with good understanding of how cancer treatments work and associated vulnerabilities by which the treatments could stop being effective.

MINIMUM KNOWLEDGE EXPERTISE NEEDED FOR NUTRITION PERSONALIZATION FOR CANCER ARE: CANCER BIOLOGY, FOOD SCIENCE, CANCER TREATMENTS AND GENETICS.

Characteristics of cancers like Chronic Myelomonocytic Leukemia

All cancers like Chronic Myelomonocytic Leukemia can be characterized by a unique set of biochemical pathways – the signature pathways of Chronic Myelomonocytic Leukemia. Biochemical pathways like Cytokine Signaling, JAK-STAT Signaling, Oncogenic Cancer Epigenetics, RAS-RAF Signaling are part of the signature definition of Chronic Myelomonocytic Leukemia. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.

The treatments which are effective for Chronic Myelomonocytic Leukemia need to be cognizant of the associated signature biochemical pathways for each cancer patient and individual at genetic risk. Therefore different treatments with different mechanisms of actions are effective for different patients. Similarly and for the same reasons foods and supplements need to be personalized for each individual. Hence some foods and supplements are recommended for Chronic Myelomonocytic Leukemia when taking cancer treatment Hydroxyurea, and some foods and supplements are not recommended.

Sources like cBioPortal and many others provide population representative patient anonymized data from clinical trials for all cancer indications. This data consists of clinical trial study details like sample size / number of patients, age groups, gender, ethnicity, treatments, tumor site and any genetic mutations.

RUNX1, CUX1, JAK2, KMT2D and EP300 are the top ranked reported genes for Chronic Myelomonocytic Leukemia. RUNX1 is reported in 11.9 % of the representative patients across all clinical trials. And CUX1 is reported in 9.5 %. The combined population patient data cover ages from 48 to 88. 62.5 % of the patient data are identified as men. The Chronic Myelomonocytic Leukemia biology along with reported genetics together define the population represented signature biochemical pathways for this cancer. If the individual cancer tumor genetics or genes contributing to the risk are also known then that should also be used for nutrition personalization.

NUTRITION CHOICES SHOULD MATCH WITH EACH INDIVIDUAL’S CANCER SIGNATURE.

Food and Supplements for Chronic Myelomonocytic Leukemia

For Cancer Patients

Cancer patients on treatment or on palliative care need to make decisions on food and supplements – for the needed dietary calories, for managing any treatment side effects and also for improved cancer management. All plant-based foods are not equal and choosing and prioritizing foods which are personalized and customized to ongoing cancer treatment is important and complicated. Here are some examples providing guidelines for making nutrition decisions.

Choose Vegetable CLUSTER BEAN or CUCURBITA?

Vegetable Cluster Bean contains many active ingredients or bioactives such as Stigmasterol, Beta-sitosterol, Linolenic Acid, Vitamin C, Linoleic Acid. These active ingredients manipulate various biochemical pathways like MYC Signaling, JAK-STAT Signaling, Cell Cycle Checkpoints and Cytokine Signaling and others. Cluster Bean is recommended for Chronic Myelomonocytic Leukemia when ongoing cancer treatment is Hydroxyurea. This is because Cluster Bean modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Hydroxyurea.

Some of the active ingredients or bioactives in vegetable Cucurbita are Curcumin, Formononetin, Phloretin, Bergapten, Lupeol. These active ingredients manipulate various biochemical pathways like DNA Repair and MYC Signaling and others. Cucurbita is not recommended for Chronic Myelomonocytic Leukemia when ongoing cancer treatment is Hydroxyurea because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

VEGETABLE CLUSTER BEAN IS RECOMMENDED OVER CUCURBITA FOR Chronic Myelomonocytic Leukemia AND TREATMENT Hydroxyurea.

Choose Fruit POMEGRANATE or PUMMELO?

Fruit Pomegranate contains many active ingredients or bioactives such as Apigenin, Curcumin, Formononetin, Phloretin, Naringin. These active ingredients manipulate various biochemical pathways like MYC Signaling, JAK-STAT Signaling, Cell Cycle Checkpoints and Cytokine Signaling and others. Pomegranate is recommended for Chronic Myelomonocytic Leukemia when ongoing cancer treatment is Hydroxyurea. This is because Pomegranate modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Hydroxyurea.

Some of the active ingredients or bioactives in fruit Pummelo are Apigenin, Curcumin, Formononetin, Phloretin, Naringin. These active ingredients manipulate various biochemical pathways like Cell Cycle Checkpoints and DNA Repair and others. Pummelo is not recommended for Chronic Myelomonocytic Leukemia when ongoing cancer treatment is Hydroxyurea because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

FRUIT POMEGRANATE IS RECOMMENDED OVER PUMMELO FOR Chronic Myelomonocytic Leukemia AND TREATMENT Hydroxyurea.

Choose Nut BUTTERNUT or EUROPEAN CHESTNUT?

Butternut contains many active ingredients or bioactives such as Apigenin, Curcumin, Formononetin, Phloretin, Stigmasterol. These active ingredients manipulate various biochemical pathways like JAK-STAT Signaling, Apoptosis, Cytokine Signaling and P53 Signaling and others. Butternut is recommended for Chronic Myelomonocytic Leukemia when ongoing cancer treatment is Hydroxyurea. This is because Butternut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Hydroxyurea.

Some of the active ingredients or bioactives in European Chestnut are Apigenin, Curcumin, Formononetin, Phloretin, Stigmasterol. These active ingredients manipulate various biochemical pathways like DNA Repair and MYC Signaling and others. European Chestnut is not recommended for Chronic Myelomonocytic Leukemia when ongoing cancer treatment is Hydroxyurea because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.

BUTTERNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR Chronic Myelomonocytic Leukemia AND TREATMENT Hydroxyurea.

For Individuals with Genetic Risk of Cancer

The question asked by individuals who have genetic risk of Chronic Myelomonocytic Leukemia or familial history is “What Should I Eat Differently from Before?” and how they should choose foods and supplements to manage risks of the disease. Since for cancer risk there is nothing actionable in terms of treatment – decisions of foods and supplements become important and one of the very few actionable things which can be done. All plant-based foods are not equal and based on identified genetics and pathway signature – the choices of food and supplements should be personalized.

Choose Vegetable BRUSSEL SPROUTS or BLACK CABBAGE?

Vegetable Brussel Sprouts contains many active ingredients or bioactives such as Curcumin, Formononetin, Phloretin, Lupeol, Salicylic Acid. These active ingredients manipulate various biochemical pathways like NFKB Signaling, JAK-STAT Signaling, Oncogenic Cancer Epigenetics and Apoptosis and others. Brussel Sprouts is recommended for risk of Chronic Myelomonocytic Leukemia when associated genetic risk is CUX1. This is because Brussel Sprouts increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in vegetable Black Cabbage are Curcumin, Apigenin, Formononetin, Phloretin, Lupeol. These active ingredients manipulate various biochemical pathways like TGFB Signaling and Oncogenic Cancer Epigenetics and others. Black Cabbage is not recommended when risk of Chronic Myelomonocytic Leukemia when associated genetic risk is CUX1 because it increases the signature pathways of it.

VEGETABLE BRUSSEL SPROUTS IS RECOMMENDED OVER BLACK CABBAGE FOR CUX1 GENETIC RISK OF CANCER.

Choose Fruit PAPAYA or MUSCADINE GRAPE?

Fruit Papaya contains many active ingredients or bioactives such as Curcumin, Formononetin, Phloretin, Lupeol, Salicylic Acid. These active ingredients manipulate various biochemical pathways like TGFB Signaling, NFKB Signaling, JAK-STAT Signaling and Apoptosis and others. Papaya is recommended for risk of Chronic Myelomonocytic Leukemia when associated genetic risk is CUX1. This is because Papaya increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in fruit Muscadine Grape are Curcumin, Apigenin, Formononetin, Phloretin, Lupeol. These active ingredients manipulate various biochemical pathways like WNT Beta Catenin Signaling and TGFB Signaling and others. Muscadine Grape is not recommended when risk of Chronic Myelomonocytic Leukemia when associated genetic risk is CUX1 because it increases the signature pathways of it.

FRUIT PAPAYA IS RECOMMENDED OVER MUSCADINE GRAPE FOR CUX1 GENETIC RISK OF CANCER.

Choose Nut COMMON WALNUT or CHESTNUT?

Common Walnut contains many active ingredients or bioactives such as Curcumin, Formononetin, Phloretin, Lupeol, Betulinic Acid. These active ingredients manipulate various biochemical pathways like NFKB Signaling, JAK-STAT Signaling, P53 Signaling and Cytokine Signaling and others. Common Walnut is recommended for risk of Chronic Myelomonocytic Leukemia when associated genetic risk is CUX1. This is because Common Walnut increases those biochemical pathways which counteract the signature drivers of it.

Some of the active ingredients or bioactives in Chestnut are Curcumin, Apigenin, Formononetin, Phloretin, Lupeol. These active ingredients manipulate various biochemical pathways like WNT Beta Catenin Signaling and TGFB Signaling and others. Chestnut is not recommended when risk of Chronic Myelomonocytic Leukemia when associated genetic risk is CUX1 because it increases the signature pathways of it.

COMMON WALNUT IS RECOMMENDED OVER CHESTNUT FOR CUX1 GENETIC RISK OF CANCER.

In Conclusion

Foods and Supplements chosen are important decisions for cancers like Chronic Myelomonocytic Leukemia. Chronic Myelomonocytic Leukemia patients and individuals with genetic-risk always have this question: “What foods and nutritional supplements are recommended for me and which are not?” There is a common belief which is a misconception that all plant-based foods could be beneficial or not but would not be harmful. Certain foods and supplements can interfere with cancer treatments or promote molecular pathway drivers of cancer.

There are different types of cancer indications like Chronic Myelomonocytic Leukemia, each with different tumor genetics with further genomic variations across each individual. Further every cancer treatment and chemotherapy has a unique mechanism of action. Each food like Cluster Bean contains various bioactives in different quantities, which have an impact on different and distinct sets of biochemical pathways. The definition of personalized nutrition is individualized food recommendations for the cancer indication, treatments, genetics, lifestyle and other factors. Nutrition personalization decisions for cancer require knowledge of cancer biology, food science and an understanding of different chemotherapy treatments. Finally when there are treatment changes or new genomics is identified – the nutrition personalization needs re-evaluation.

The addon nutrition personalization solution makes the decision making easy and removes all the guesswork in answering the question, “What foods should I choose or not choose for Chronic Myelomonocytic Leukemia?”. The addon multi-disciplinary team includes cancer physicians, clinical scientists, software engineers and data scientists.

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