ASCO Abstract Number: 6522
An extract of green tea appears to have clinical activity with low toxicity in chronic lymphocytic leukemia (CLL) patients who used it in a phase II clinical trial, say researchers at Mayo Clinic.
The findings, to be presented Monday, June 7, during the annual meeting of the American Society of Clinical Oncology (ASCO), are the latest in a series of Mayo studies to show promise for use of the chemical epigallocatechin gallate (EGCG) — the major component of green tea — in reducing the number of leukemia cells in patients with CLL. Mayo first tested EGCG in a variety of laboratory assays about eight years ago, and it was found to reduce the survival of CLL leukemic cells. This laboratory finding was followed by a successful phase I clinical trial — the first time green tea extract had been studied in CLL patients.
“Although only a comparative phase III trial can determine whether EGCG can delay progression of CLL, the benefits we have seen in most CLL patients who use the chemical suggest that it has modest clinical activity and may be useful for stabilizing this form of leukemia, potentially slowing it down,” says Tait Shanafelt, M.D., a Mayo Clinic hematologist and lead author of the study.
“These studies advance the notion that a nutraceutical like EGCG can and should be studied as cancer preventives,” says Neil Kay, M.D., a hematology researcher whose laboratory first tested the green tea extract in leukemic blood cells from CLL patients. “Using nontoxic chemicals to push back cancer growth to delay the need for toxic therapies is a worthy goal in oncology research — particularly for forms of cancer initially managed by observation such as CLL.”
Drs. Shanafelt and Kay caution that EGCG is not a substitute for chemotherapy. All of the patients Mayo tested with EGCG were early stage, asymptomatic CLL patients who would not otherwise be treated until their disease progressed. The extract was supplied by the National Cancer Institute (NCI) and Polyphenon E International for these initial clinical trials.
CLL is a blood cancer that is a hybrid between leukemia and lymphoma. Progression of the disease is measured by the quantity of leukemia cells in the blood and bone marrow as well as enlargement of lymph nodes due to infiltration by the leukemia cells. In the phase I study, published in May 2009 in the Journal of Clinical Oncology, researchers found that the blood lymphocyte (leukemia cell) count was reduced in one-third of participants, and that the majority of patients who entered the study with enlarged lymph nodes due to involvement by CLL saw a 50 percent or greater reduction in their lymph node size.
Using the highest dose tested in the phase I study, the researchers launched their phase II clinical trial in an additional 36 patients. The results presented at the ASCO meeting evaluate the effects in these 36 patients as well as the six patients from the phase I trial treated at the same dose (total 42 patients). Results from 41 patients who have completed the study show that 31 percent of patients had a 20 percent or greater sustained reduction in blood leukemia count, and 69 percent of patients with enlarged lymph nodes saw a reduction of node size of 50 percent or greater.
In all, 69 percent of CLL patients had a biological response to EGCG as evidenced by a 20 percent or greater sustained reduction in blood lymphocyte count and/or a 50 percent or greater reduction in lymph node size, the researchers say.
Because EGCG was being studied in patients who did not otherwise need treatment, the researchers took a rigorous approach toward studying side effects. Most clinical trials of therapeutic agents only report grade 3 and higher side effects, but the researchers looked at and reported grade 1 and grade 2 as well. While a number of patients had transient grade 1 or 2 side effects, only three of 42 experienced a grade 3 side effect during their six months of treatment. “All in all, the treatment was well tolerated with very mild side effects in most patients,” Dr. Shanafelt says.
The researchers say that the prior publications on the effects of EGCG on CLL leukemia cells in the laboratory and the data from the published phase I study have been widely disseminated via the Internet by patient advocacy groups. Based on information from patients and colleagues throughout the country, the Mayo researchers have become aware that many CLL patients nationwide have started to use EGCG supplements, which are readily available over the counter.
“Without a phase III clinical trial, we cannot make a recommendation that EGCG be used by CLL patients, but those who want to take supplements should consult with their oncologists and need to receive appropriate monitoring using laboratory tests,” Dr. Kay says.
The study was funded by grants from the NCI, the Mayo Comprehensive Cancer Center, and from donors and patient advocacy foundations. The authors declare no conflicts of interest.
Does anyone have information about the dosage of EGCG and good sources for high quality supplements of EGCG at a good price?
Your question has been referred for an answer.
Did you get good information on a proper source of EGCG? I have been taken Natures Bounty brand gotten at the supermarket and I have gotten no improvement of my CLL.
I have CLL and I am taking 1000mg of EGCG every morning, is that enough?
What should be the dosage?
Your question has been referred for an anser.
Today I have been diagnosed with very, very early stage of CLL. With no symptoms, I was advised to go home and forget about it and come back in six months for a checkup. Then I went on line to Mayo Clinic and saw the testing you have done with Green Tea Extract. Is this something that I can take now? I am a 77 year old Jewish woman of East European heritage and I have been a 27 year caretaker of my husband who had a major stroke 27 years ago. He is now in a nursing home, having suffered another stroke. I am now free to enjoy life and heard this today. I am not ready to be sick, as I have years to make up. Can you help me?
i too would like to know how much green tea should be taken to make a difference? is the liquid extract the best way to obtain this?
I did not know there was a liquid extract. Where do you get that?
I would also greatly appreciate information about dosage and a good source of high quality EGCG. It makes so much sense to try to slow progression of early CLL rather than wait and worry!
Can you also tell me when the Phase 3 trial will be?Thank you.
Dee, did you get a reference of source of Green Tea Extract? I have been using Natures Bounty for months and have not gotten any reduction in my node size. So far as I can see, it is doing me no good. I take six 325 mg capsules per day. I do not know how much active ingredient that is.
I have been taking green tea extract for months, but my nodes have not gone down and white blood cell count keeps going up. I take 6 325 mg capsules per day, which I buy that the grocery store; the brand is Nature’s Bounty. I am early stage CLL. Lots of big nodes in my neck; WBC were 9,000 three years ago and now 32,000, platelets vary from 145 to as low as 90.
Thank you for your message.
Unfortunately, we cannot diagnose conditions, provide second opinions or make specific treatment recommendations through this correspondence. However, I have attached a couple of links to pages on our website that you may find helpful: (insert links) If you would like to seek help from Mayo Clinic, please call one of our appointment offices in Arizona at 480-301-1735; Florida, 904-953-0323; or Minnesota, 507-284-2511.
Thanks, but the links were not successfully inserted into your email.
Bishop Dansby
Mr. Dansby, I apologize the links didn’t get attached to the original message. You may visit this site for more information on CLL (http://www.mayoclinic.com/health/chronic-lymphocytic-leukemia/DS00565/DSECTION=treatments-and-drugs). Thanks. Stacy
I need to know if it makes a difference whether you get your green tea extract from the supermarket, and I need to know what part of the, say, 325 mg green tea capsule is the active ingredient EGCG in a given product.
Dear Mayo Clinic Staff,
Thank you for your progressive clinical research with EGCG in reducing leukemia cells in some patients with CLL.
I am diagnosed with CLL. I am interested in knowing whehter I may participate in the Phase III clinical trial. Also, would you report to me the level of EGCG administered to participants in the Phase I clinical trail with lead uathor Dr. Dait Shanafelt.
Thank you again for helping so many of us with CLL.
Sincerely,
Dan Dinan
I’ve referred your question on and someone should be in contact with you within a few days.
Dear Mayo Clinic Staff,
I am a pre-treatment (asymptomatic) CLL patient and would like information about participating in the Phase III clinical trial.
Thank you.
Thank you for your message. I have attached a couple of links to pages on our website that you may find helpful: http://www.mayoclinic.com/health/chronic-lymphocytic-leukemia/DS00565, http://www.mayoclinic.com/health/clinical-trials/DI00033. You can also send an email directly to clinicaltrials@mayo.edu for additional information. If you would like to seek help from Mayo Clinic, please call one of our appointment offices in Arizona at 480-301-1735; Florida, 904-953-0323; or Minnesota, 507-284-2511.
To whomsoever it may concern in MAYO CLINIC,
Dear Sirs,
I am an INDIAN,residing in INDIA.My wife Mrs.K.VIJAYA MURTY(Age 58yrs)is suffering from CLL.since last 6yrs.She has Lymph nodes only on the neck below the jawas those too, little enlarged.
Her recent CBC report indicates;
Hb: 7.4 GM/dl.,RBC: 2.5 Million/ul,WBC:35000/ul,PLT:130000/ul,
DIFF.WBC Count;
LYMPH:85%,NEUT:12% MIXD.03%,Absolute Lymph Count-29750/ul.
Trusting the results claimed by you,she is being given EGCG capsules(2 cps twice a day since about a fortnight)from The Vitamin Shoppe, US containing (i)Green tea a Exrtact(Camellia sinensis (leaf)std.to75% polyphnols 187.5 mg,30% Epigallocatechin Gallate 75mg–250mg/serving.
(ii)Green Tea(Camellia sinensis)—220mg/serving.
Kindly advice if the intake dosage(2 caps twice a day) is adequate?
Thanks and regards.
K.K.Murty,
JABALPUR,INDIA,
mob:+91 9425154250
We have received your comment and forwarded it for answering.
my husband was recently diagnosed with CLL. Stage 0 or 1 according to his oncologist. no treatment now. come back in 4 months. FISH test showed most benign marker. however, he is only 61 years old and would like to last a while longer than the median 12 years. we are interested in the tea trial. can you give us more information about the trial itself and, if not possible for us (live in maine) then what dosages of the extract might be worth trying? thank you. heidi
Your question has been referred to for a reply.
I have searched all of the Mayo info on CLL research that included EGCG, and all of the comments and replys on this site asking for the doseage used in the phase II trial, and have as yet not learned the answer. Does anyone have it? Will Mayo provide the answer? HELP please anyone.
I have actual copies of the 2 Mayo trials.
The dosage is 2 grams 2000 mg) per day. I have early stage CLL and have had promising results using the tea extract which I have been using for 4 months. Be sure to let your doctor know prior to using to ensure that lab results are ordered to check for possible side effects.
If you send me your email, I can forward info on the trials. You are also welcome to call me on my cell phone 619-212-0027, to discuss further.
Happy to help,
Bernie
Hi Bernie, could you please send me the copies of Mayo trials? My mom has been diagnosed with CLL 12 years ago, and managed to stay symptom-free so far. Unfortunately recently her wcb has started to climb up, so I have started to look into ECGC/curcumin supplementation.
Thanks in advance,
Ana
I was diagnosed with CLL about 6 months ago. I am 52 years old, female and otherwise in really good health. Since it is very early in the diagnosis with no symptoms (other than some slightly enlarged lymph nodes), I have been in the watch and wait phase. My internist (who discovered the CLL through a routine blood test) prescribed a series of supplements included EGCG. I have been taking AOR Active Green tea (700mg/455 catechins) twice a day. Along with the EGCG I have also been taking Tumeric, Reservatrol, Vitamin D and Omega-3 Fish oil twice a day. I just went back for my check several weeks ago and the news was great! My WBC went down to 6800 from 11,500 and my LYMPH went down 51% from 61% and NEUT up to 36% from 31%! Yay! Of course, we can’t be 100% sure that is all the supplements at work, but I will take the good news nonetheless and continue with my course as is. I have also read “Anti-Cancer – A New Way of Life” by David Servan-Schrieber. Though at times it can be a bit technical, the diet/mind/body portion of it is wonderfully written and I would highly recommend it to read
can you please give me the name and contact information of your internist doctor
thanks
jnv100@gmail.com
Dear Mayo Clinic Staff,
I was diagnosed in December of 2011 with asymptomatic CLL. I would like to be considered for the Green Tea, ECGC Trial 111 Study if and when it happens.
Thank you,
Cindy
The article that was published about this study is available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727287/?tool=pubmed. The sentence defining the dosage states, “Polyphenon E with a standardized dose of epigallocatechin-3-gallate (EGCG) was administered using the standard phase I design with three to six patients per dose level (range, 400 to 2,000 mg by mouth twice a day).” The article later suggests that people tolerated the maximum dose well and that some people who received the higher doses seemed to do better in some respects, which is probably why they used the highest dosage in the next study. Still, as someone with no expertise in this area, I wouldn’t try to dose myself based on this information, and I can see why the Mayo people don’t want to specify a dosage in the context of patients asking what they should take. I went to an integrative medicine specialist at a major cancer center, who recommended 1,000 mg. twice a day. I’m not sure whether a regular oncologist would necessarily know about this; some of them tend to be dismissive of anything other than meds as such.
Dear sir / madam,
I come from the Netherlands and my wife has CLL stage 0.
We follow this discussion about the influence of green tea extract on CLL here on your blog. For one year my wife visited a orthomolecular doctor and he suggested EGCG-50+ Green tea extract (90% polyfenol, 50% EGCG, <1% cafeïne) 200 milligram jjper capsule, 3 capsules per day. So far no results. As far as I can follow the discussion I presume that this dosage is to low.
Dear friends from the Mayo Clinic, can you please advise me about a proper dosage and if you have any other suggestions please let me know. All the best for all those followers on this blog.
Sincerly.
Anton
Your question has been referred for reply and will be answered directly via email.
Hello Mayo Clinic,
I have just been diagnosed with CLL and am hunting down information to help me understand what is happening and what I might do that could impact my situation in a positive way. Many posters asked for information about the dosage that was used in the trials, as well as the brand and strength of the extract used, and it seems that you replied to questions individually – and I am looking forward to hearing from you! Here are my questions:
1) what is the optimal dosage, and how is this described – ie “active” ingredient, capsules, ml, mg…
2) are all extracts equal?
3) are there preferred brands?
Many thanks!
Gail
We have forwarded your questions for reply.
I am impressed with your phase I and II results. I was diagnosed yesterday with non-symptomatic CLL. I would like to know the dose for EGCG used in your phase I clinical trials. Additionally, I am very interested in being a participant in your phase III trial.
Aubrey Rogers
We have forwarded your note to the research area.
Hi there-
I am seeking a lot the same info as others who have posted. I am a 33 year old female recently diagnosed with CLL (early stages, assymptomatic). As I understand it is pretty rare for somebody my age to have this type of cancer…which makes me pretty nervous! Here are my questions…any info will be greatly appreciated!
*Where can I get the highest quality EGCG?
*What is the dosage that is most optimal?
*How long should it be taken for?
*What’s the best way to take EGCG in combonation with curcumin?
**Do you have any info in regards to CLL and being
so young (33 yrs)?
**Are there any studies/clinical trials dealing with CLL and
very young adults?
Thanks so much!
Sherry
Your questions have been referred to the research area.
Well, you are not alone. I am a 42 year old female diagnosed 2 weeks ago. Still waiting for some test results but appear to be “watch and wait”. I have the same questions. Thanks for your post.
I have just been diagnosed with Stage 0 CLL. I will be meeting with my oncologist next week to see the results of my FISH test and would like to talk about participating in the Phase III trial, but if for some reason that is not happening, to determine what dosages were used so we can give this a try on our own. The mg dosage of the tablets is not always the same as the mg dosage of the EGCG within the tablet, and I can’t tell if the 2,000 mg twice daily references the tablet itself or the EGCG within it. I am also wondering where to get it and what is best taken with the EGCG. (Folate? Turmeric?) And in what doses.
I have been diagnosed with CLL a year ago. Currently no other symptoms other than extremely fatigued. I have had 3 blood tests first with white cell count 34,000 – then 3 months later 27,000 and the last one 37,000. I would like information on green tea and the trials if you are still doing them. I would like to know how much green tea and what form, brand etc.
I am 55 year old male otherwise very healthy
Please reply
I was diagnosed with Stage 0 CLL six months ago and began the Green Tea Extract, usually three 725 mg caps a day. I also take Vitamin D-3 5000, Omega 3 Fish Oil 1,000 and Acai Berry 500. Sometimes I take Turmeric. My hemotologist/oncologist recommended turmeric 500 2x a week.
My WBC went from 21,500 to 16,900 over a six month period. All numbers overall improved. I use Life Extension brand of Green Tea Extract. Hope this helps, I am 58 and in good health – no symptoms
I have been on self-administered EGCG for untreated indolent small cell lymphoma since diagnosis 4 years ago. I have recently added medium risk prostate cancer to my cancer “list”.
Since EGCG has also been indicated to have potential benefits for prostate cancer, I would also like to know if you can direct me a supplement source for high-quality EGCG. (I assume the EGCG from Polyphenon Pharma is not available to the general public.)
Thanks for any assistance you provide – and keep up the excellent clinical work. There are lots of us out here who welcome your efforts and applaud your results.
Joe, have you had similar results to Mayo in your self-administered trial? What dosage do you take and do you have side effects?
Marlene,
I was diagnosed with indolent lymphoma four years ago. As with most people diagnosed with any form of cancer, a certain degree of panic sets in. As anyone familiar with cancer will tell you (we have lots of cancer history in my family), everyone’s cancer is theirs alone, i.e., mine is unique to me as yours is unique to you. That said, I can offer from my own experience that I believe there is a natural tendency for most people to initially be scared of a worse case scenario. In order to deal with my own uncertainties I spent the first year learning enough about the disease to feel competent in asking good questions of my oncologist and in evaluating information such as that which has brought you to this posting site. (Very generously provided by the Mayo Clinic, I might add.)
When I heard about and read up on the Mayo Clinic’s Green Tea/EGCG in-vitro research and later clinical trial, I jumped at the opportunity to do something that might help slow down my disease progression. So I began with Green Tea/EGCG supplements almost immediately. As the Mayo trial has progressed, I have adjusted my dosage accordingly.
At 63, I am considerably younger than you, but for each of us the challenges are similar – Adopt any and all lifestyle/dietary changes that will improve our “chances” to outlive our cancers. (lymphoma for me, CLL for you.)
Since I have had no apparent symptoms and feel exactly like I did before diagnosis, I encourage you to carry on with your life as you would have before being diagnosed – being mindful, of course, of the things you can do the “improve your odds” against a rarely cured but often treated disease. Who knows, you may well “outlive” your CLL. (In addition to my lymphoma, I have recently been diagnosed with prostate cancer and the decision to treat or not treat often is made based on the chances that the patient will outlive the disease progression.)
So do as I did, switch from coffee to green tea and add some EGCG supplements and keep on living your life on your terms. Its a much better pathway the one filled with fear of the unknown/unknowable.
Live Long & Stay Healthy,
Captain Joe
Hi ‘Captain’ Joe,
I loved your post and your words were highly motivating! I think in addition to all the medicines, something that we who are battling with this ‘emperor of maladies’, cancer, need are strong, profound motivating words to keep going with this ‘emperor’ in the background.
Thanks for the last line!