**13. Concluding remarks**

Unfortunately, in spite of all the above characteristics, Vitamin C has never been easily or favorably accepted as an anticancer drug, by the western Medicine. This also explains why, although the data on its anticancer efficacy are outstanding and straightforward, many scientists still prefer to consider "controversial" the role of Vitamin C in the treatment of cancer. As we have seen, the idea that the oral administration of Vitamin C, in high doses, is not effective against cancer is a conceptual artefact, originating from questionable interpretations of pharmacokinetics data, after oral and/or intravenous administration. On the other hand, the idea that Vitamin C, administered in high doses by intravenous infusion, behaves as a pro-drug

beyond being experimentally questionable, has not led to clinically significant results

/

or outcomes [124–128]. More importantly, encouraging results have emerged from unbiased interpretation of the available data [129]. In particular, as it has been shown up to 110 g/m<sup>2</sup>

day are very well tolerated by the majority of patients, and even in the absence of any significant clinical remission, intravenous Vitamin C is almost invariably associated with a clear-cut

As a result, History repeat itself! … and just as Vitamin C was dismissed as ineffective, against cancer, more than 30 years ago, on the ground of questionable clinical trials [130, 131], nowadays, it runs again the risk of being definitively discarded, in spite of the large amount of

It is clear that much remains to be understood about the cytotoxic effects of Vitamin C against cancer, and much more can (and must!) be done, to both improve the intravenous therapy and

**a.** The type of pharmaceutical preparation, the sodium salt of the ascorbic acid to be pre-

**c.** The level of tissue oxygenation (cell cultures are better oxygenated than tumor tissues, and this may explain the differences in the outcomes between in vitro and in vivo treatment of cancer) [135]. In clinical settings, an improved tumor tissue oxygenation could be obtained

**d.** The level of blood glucose (glucose may interfere with the uptake of ascorbate by cancer cells) [136, 137], and the possibility of associating an adequate dietetic regimen to the treat-

A recent study provided clear-cut evidence that Vitamin C is a main regulator of hematopoietic stem cell (HSC) function and leukemogenesis. In fact, Agathocleous and co-workers, using a peculiar strategy for isolation of HSCs and hematopoietic progenitor cells (HPCs) from murine bone marrow, showed that HSCs have unusually high levels of Vitamin C,

scientific evidence, demonstrating its extraordinary efficacy in fighting cancer!

further investigate the oral administration route of the high doses of the nutrient.

ferred, when administered by the intravenous route [132];

ment with high doses of oral or intravenous Vitamin C.

**12. Latest evidence of the role of Vitamin C in leukemia**

with either ozone or hyperbaric oxygen;

Improving the intravenous treatment can (and should!) be achieved, by considering:

**b.** The time and schedule of administration (slow infusion to be preferred) [133, 134];

of H<sup>2</sup> O2

168 Myeloid Leukemia

improvement in patient's quality of life.

The rationale behind the use of high doses of Vitamin C in the treatment of acute leukemia is strong and very well grounded. In summary:


**d.** Although administered by intravenous infusion, in the majority of clinical trials performed so far, Vitamin C appears to be effective, in fighting cancer, even when administered by mouth;

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Do we really need more information or evidence, to start clinical trials on Vitamin C, in the treatment of acute and chronic myeloid leukemia?
