Follicular Lymphoma
Conditions
Keywords
Low grade lymphoma, Diet, Antioxidants, Non Hodgkin Lymphoma - Follicular Lymphoma grade 1&2 stage III/IV
Brief summary
A dietary intervention study in patients with Follicular Lymphoma (FL) Stage III/IV to assess the ability of several dietary factors to induce apoptosis, inhibit cell proliferation and modulate tumor cell infiltrate in vivo.
Detailed description
Dietary factors plays an important role in the prevention of several diseases. The cardiovascular disease mortality have dropped dramatically the last 20 years, but the relative death rates from cancer remains fairly stable. There is reason to believe that factors in the tumors microenvironment is of great importance for the outcome of many malignant diseases, including FL. Factors predicting a poor outcome are associated with inflammation, oxidative stress which both impair the hosts immune response and produces growth stimulatory signals. In this open study with 45 patients to be included we seek to perform a dietary intervention with comparison of apoptosis rate, proliferation rate and immune cell infiltrate before and after the intervention period.
Interventions
DRUGGarlic extract (Allicin)
6 garlic pearls daily
DRUGPomegranate juice (ellagic acid)
Pomegranate juice 100%, 660ml /495 ml every second day.
DRUGOmega 3 fatty acids (EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid))
1000mgx5 daily
DRUGSelenium (L-Selenomethionine),
100mcgx2 daily
DRUGGrape juice (resveratrol, quercetin)
Merlot grape juice 100%, 660ml /495 ml every second day
DRUGGreen Tea (Epigallocathechin gallate)
Green Tea. 2 cups daily
Sponsors
University of Oslo
Oslo University Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 years or more. * Permanent address in Norway, located in health region south or east. People living outside these areas in other health regions in Norway may be able to participate but after individual evaluation. * Histologically verified follicular lymphoma grade I or II without clinical signs of transformation to aggressive lymphoma. * Stage III/IV. * Previously untreated or at least 1 year since rituximab treatment or 6 months since cytotoxic chemotherapy. * Not scheduled for disease specific treatment for the next 3 months. * At least one pathological superficial lymph node available for ultrasound guided biopsy. * Cytologically and/or immunocytologically compatible with follicular lymphoma. * Women with childbearing potential, only with use of safe contraceptives
Exclusion criteria
* Gross abnormalities in blood samples. (Hematologic values Hgb\< 10, leukocytes\< 2,5, trombocytes \<100, liver enzymes (ALAT,ASAT,GT,ALP) \> 2,5 x upper normal values,bilirubin \>35 creatinine \>130) * Other serious medical illness (unstable cardiovascular disease, unstable pulmonary disease, uncontrolled diabetes, autoimmunity, chronic infection or other active cancer). * Use of NSAID, ASA the last two weeks prior to enrollment. * Use of systemic corticosteroids the last two months prior to enrollment. * Regular use of anticoagulants as LMW Heparin or warfarin. * Use of carbamazepin, nifedipin and other drugs metabolized with CYP 3A4 where interaction might cause hazardous side effects which cannot be controlled with serum measurements or organ function monitoring. * Inclusion in another clinical trial which involves medication or nutritional supplements. * Use of complementary medicine/alternative medicine which includes high dose\* vitamins or antioxidants/nutritional supplements 2 weeks prior to sampling procedures . * Regularly use of omega 3 fatty acids more than 1g / day * History of serious or unstable medical or psychiatric disorder. * History of heavy alcohol consumption \> 3 units / day. * Pregnancy * Individuals judged by the clinical investigator to be unable to follow instructions and procedures of the study. (\*high dose is defined as vitamins or antioxidant supplements exceeding what is present in regular multi-vitamin supplements covering regular RDAs)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Apoptosis an proliferation rate in tumor cells, | At the end of intervention (week 16) |
Secondary
| Measure | Time frame |
|---|---|
| Levels of: proinflammatory cytokines,tumor immune cell infiltrate | Week 16 |
Countries
Norway
Contacts
Primary ContactKjell Magne Russnes, MD
Backup ContactHarald Jr. Holte, MD, PhD
Outcome results
None listed