Title : Methylating Agents as Rescue Adjunct Therapy to Chemotherapeutic Alkylating Medications for Improved Outcomes in Chronic Lymphocytic Leukemia: A Case Study and Protocol with National Implications
Abstract:
Although the non-enzymatic methylation of cytidine (C) by S-adenosylmethionine (SAM) and methylcobalamin to 5-methylcytidine and its subsequent spontaneous deamination to thymidine (T) in DNA at physiologic pH and temperature has been implicated in some C to T point mutagenic cancers, cancers in general display a global hypomethylation of their DNA; SAM, therefore, sold as the over-the-counter (OTC) supplement SAM-e, as well as the OTC methylcobalamin precursor cyanocobalamin may still possibly play a role as potential rescue adjunct therapies in certain cancers, particularly those treated with alkylating chemotherapeutic agents used in chronic lymphocytic leukemia (CLL), much in the same way that folic acid is used as a rescue adjunct therapy when using antifolate chemotherapeutic agents. Clinical trials in support of this proposal were set to begin just prior to the COVID-19 pandemic but have been indefinitely postponed; however, an ongoing case study employing this methylation protocol is currently underway and has, since its inception, also been implemented nationally, with its highly successful results presented here along with current updates.
