Introduction
Foods for Acute Myeloid 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.
Acute myeloid leukemia (AML) is a cancer that affects the blood and bone marrow. It is the most common leukemia in adult population and accounts for about 80% of all cases. It is characterized by an overproduction of immature white blood cells, called myeloblasts or leukemic blasts. These cells crowd the bone marrow and prevent it from making normal blood cells. Due to the overproduction, they spill out into the bloodstream and circulate around the body and due to being immature and abnormal, are unable to perform their normal function of fighting infection in the body. Reduced numbers of red blood cells and platelets made by the marrow cause anemia and easy bleeding and bruising. Acute myeloid leukemia is classified into different subtypes based on the appearance of the leukemic cells under the microscope and cytogenetics of the blasts. The 5-year survival rate for AML is 27% as per the American Cancer Society. AML treatment includes a more intensive induction chemotherapy regimen that is highly toxic to the bone marrow. About 60-80% of newly diagnosed AML will achieve a complete response with induction therapy. This is followed by consolidation therapy and a hematopoietic cell transplant. In addition, supportive care with the right nutrition (foods and natural supplements) can help improve the patients’ well-being.
For Acute Myeloid 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 Acute Myeloid 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 Acute Myeloid Leukemia?
For example does it matter if vegetable Cauliflower is consumed more compared to Welsh Onion? Does it make any difference if fruit Pummelo is preferred over Mango? Also if similar choices are made for nuts/seeds like Butternut over Chestnut and for pulses like Broad Bean over Pigeon Pea. And if what I eat matters – then how does one identify foods which are recommended for Acute Myeloid Leukemia and is it the same answer for everyone with the same diagnosis or genetic risk?
Yes! Foods you eat matters for Acute Myeloid 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 Curcumin, Lycopene, Isoliquiritigenin, Quercetin, Formononetin. And Mango contains active ingredients Curcumin, Isoliquiritigenin, Quercetin, Formononetin, Phloretin and possibly others.
A common mistake made when deciding and choosing foods to eat for Acute Myeloid 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 Acute Myeloid Leukemia.
YES – FOOD CHOICES MATTER FOR CANCER. NUTRITION DECISIONS MUST CONSIDER ALL ACTIVE INGREDIENTS OF FOODS.
Skills Needed for Nutrition Personalization for Acute Myeloid Leukemia?
Personalized nutrition for cancers like Acute Myeloid 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 Acute Myeloid 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.
Foods to Eat After Cancer Diagnosis!
No two cancers are the same. Go beyond the common nutrition guidelines for everyone and make personalized decisions about food and supplements with confidence.
Characteristics of cancers like Acute Myeloid Leukemia
All cancers like Acute Myeloid Leukemia can be characterized by a unique set of biochemical pathways – the signature pathways of Acute Myeloid Leukemia. Biochemical pathways like Angiogenesis, PI3K-AKT-MTOR Signaling, Oncogenic Cancer Epigenetics, MAPK Signaling are part of the signature definition of Acute Myeloid Leukemia. Each individual’s cancer genetics can be different and hence their specific cancer signature could be unique.
The treatments which are effective for Acute Myeloid 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 Acute Myeloid Leukemia when taking cancer treatment Idarubicin, 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.
NPM1, IDH2, CEBPA, WT1 and PTPN11 are the top ranked reported genes for Acute Myeloid Leukemia. NPM1 is reported in 13.0 % of the representative patients across all clinical trials. And IDH2 is reported in 5.1 %. The combined population patient data cover ages from 1 to 88. 53.5 % of the patient data are identified as men. The Acute Myeloid 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 Acute Myeloid 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 CAULIFLOWER or WELSH ONION?
Vegetable Cauliflower contains many active ingredients or bioactives such as Curcumin, Isoliquiritigenin, Formononetin, Phloretin, Lupeol. These active ingredients manipulate various biochemical pathways like MAPK Signaling, JAK-STAT Signaling, WNT Beta Catenin Signaling and Amino Acid Metabolism and others. Cauliflower is recommended for Acute Myeloid Leukemia when ongoing cancer treatment is Idarubicin. This is because Cauliflower modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Idarubicin.
Some of the active ingredients or bioactives in vegetable Welsh Onion are Curcumin, Lycopene, Isoliquiritigenin, Formononetin, Phloretin. These active ingredients manipulate various biochemical pathways like NFKB Signaling, WNT Beta Catenin Signaling and Amino Acid Metabolism and others. Welsh Onion is not recommended for Acute Myeloid Leukemia when ongoing cancer treatment is Idarubicin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.
VEGETABLE CAULIFLOWER IS RECOMMENDED OVER WELSH ONION FOR Acute Myeloid Leukemia AND TREATMENT Idarubicin.
Choose Fruit MANGO or PUMMELO?
Fruit Mango contains many active ingredients or bioactives such as Curcumin, Isoliquiritigenin, Quercetin, Formononetin, Phloretin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, Angiogenesis, Amino Acid Metabolism and Hypoxia and others. Mango is recommended for Acute Myeloid Leukemia when ongoing cancer treatment is Idarubicin. This is because Mango modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Idarubicin.
Some of the active ingredients or bioactives in fruit Pummelo are Curcumin, Lycopene, Isoliquiritigenin, Quercetin, Formononetin. These active ingredients manipulate various biochemical pathways like NFKB Signaling and WNT Beta Catenin Signaling and others. Pummelo is not recommended for Acute Myeloid Leukemia when ongoing cancer treatment is Idarubicin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.
FRUIT MANGO IS RECOMMENDED OVER PUMMELO FOR Acute Myeloid Leukemia AND TREATMENT Idarubicin.
Choose Nut BUTTERNUT or CHESTNUT?
Butternut contains many active ingredients or bioactives such as Curcumin, Lycopene, Isoliquiritigenin, Formononetin, Phloretin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, Angiogenesis, WNT Beta Catenin Signaling and Amino Acid Metabolism and others. Butternut is recommended for Acute Myeloid Leukemia when ongoing cancer treatment is Idarubicin. This is because Butternut modifies those biochemical pathways which have been scientifically reported to sensitize the effect of Idarubicin.
Some of the active ingredients or bioactives in Chestnut are Curcumin, Lycopene, Isoliquiritigenin, Formononetin, Phloretin. These active ingredients manipulate various biochemical pathways like WNT Beta Catenin Signaling and PI3K-AKT-MTOR Signaling and others. Chestnut is not recommended for Acute Myeloid Leukemia when ongoing cancer treatment is Idarubicin because it modifies those biochemical pathways which make the cancer treatment resistant or less responsive.
BUTTERNUT IS RECOMMENDED OVER CHESTNUT FOR Acute Myeloid Leukemia AND TREATMENT Idarubicin.
For Individuals with Genetic Risk of Cancer
The question asked by individuals who have genetic risk of Acute Myeloid 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 Acute Myeloid Leukemia pathway signature – the choices of food and supplements should be personalized.
Choose Vegetable GIANT BUTTERBUR or RED BELL PEPPER?
Vegetable Giant Butterbur contains many active ingredients or bioactives such as Apigenin, Myricetin, Isoliquiritigenin, Kaempferol, Curcumin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, Angiogenesis, JAK-STAT Signaling and Hypoxia and others. Giant Butterbur is recommended for risk of Acute Myeloid Leukemia when associated genetic risk is CEBPA. This is because Giant Butterbur increases those biochemical pathways which counteract the signature drivers of Acute Myeloid Leukemia.
Some of the active ingredients or bioactives in vegetable Red Bell Pepper are Quercetin, Isoliquiritigenin, Curcumin, Luteolin, Lycopene. These active ingredients manipulate various biochemical pathways like MAPK Signaling and Stem Cell Signaling and others. Red Bell Pepper is not recommended when risk of Acute Myeloid Leukemia when associated genetic risk is CEBPA because it increases the signature pathways of Acute Myeloid Leukemia.
VEGETABLE GIANT BUTTERBUR IS RECOMMENDED OVER RED BELL PEPPER FOR CEBPA GENETIC RISK OF CANCER.
Choose Fruit NANCE or MALABAR PLUM?
Fruit Nance contains many active ingredients or bioactives such as Apigenin, Myricetin, Isoliquiritigenin, Kaempferol, Curcumin. These active ingredients manipulate various biochemical pathways like MAPK Signaling, Angiogenesis and Hypoxia and others. Nance is recommended for risk of Acute Myeloid Leukemia when associated genetic risk is CEBPA. This is because Nance increases those biochemical pathways which counteract the signature drivers of Acute Myeloid Leukemia.
Some of the active ingredients or bioactives in fruit Malabar Plum are Apigenin, Myricetin, Isoliquiritigenin, Kaempferol, Curcumin. These active ingredients manipulate various biochemical pathways like Oncogenic Cancer Epigenetics and Stem Cell Signaling and others. Malabar Plum is not recommended when risk of Acute Myeloid Leukemia when associated genetic risk is CEBPA because it increases the signature pathways of Acute Myeloid Leukemia.
FRUIT NANCE IS RECOMMENDED OVER MALABAR PLUM FOR CEBPA GENETIC RISK OF CANCER.
Choose Nut COMMON WALNUT or EUROPEAN CHESTNUT?
Common Walnut contains many active ingredients or bioactives such as Quercetin, Ellagic Acid, Myricetin, Isoliquiritigenin, Kaempferol. These active ingredients manipulate various biochemical pathways like MAPK Signaling, Angiogenesis, RAS-RAF Signaling and Hypoxia and others. Common Walnut is recommended for risk of Acute Myeloid Leukemia when associated genetic risk is CEBPA. This is because Common Walnut increases those biochemical pathways which counteract the signature drivers of Acute Myeloid Leukemia.
Some of the active ingredients or bioactives in European Chestnut are Quercetin, Apigenin, Ellagic Acid, Myricetin, Isoliquiritigenin. These active ingredients manipulate various biochemical pathways like Stem Cell Signaling and others. European Chestnut is not recommended when risk of Acute Myeloid Leukemia when associated genetic risk is CEBPA because it increases the signature pathways of Acute Myeloid Leukemia.
COMMON WALNUT IS RECOMMENDED OVER EUROPEAN CHESTNUT FOR CEBPA GENETIC RISK OF CANCER.
In Conclusion
Foods and Supplements chosen are important decisions for cancers like Acute Myeloid Leukemia. Acute Myeloid 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 Acute Myeloid 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 Cauliflower 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 Acute Myeloid Leukemia?”. The addon multi-disciplinary team includes cancer physicians, clinical scientists, software engineers and data scientists.
Personalized Nutrition for Cancer!
Cancer changes with time. Customize and modify your nutrition based on cancer indication, treatments, lifestyle, food preferences, allergies and other factors.
References
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9) Perspective on Oncogenic Processes at the End of the Beginning of Cancer Genomics.
10) Landscape of Microsatellite Instability Across 39 Cancer Types.
11) Effects of isoliquiritigenin on ovarian cancer cells.