Unlocking nature's potential: Soursop in the battle against resistant acute myeloid leukemia

Acute Myeloid Leukemia (AML) represents the predominant form of blood cancer in adults and ranks as the second most prevalent in pediatric populations. The disease is heterogeneous, characterized by proliferation and self-renewal, originating in the bone marrow and potentially metastasizing to various body regions. AML arises from a hematopoietic abnormality characterized by the accumulation of myeloblasts, which are immature myeloid cells. Genetic disorders, a medical history of bone marrow disorders, and chemoradiation can lead to genetic mutations that impact hematopoiesis. Leukemic stem cells (LSC) exhibit biological similarities to normal hematopoietic stem cells (HSC), yet they lose the capacity to differentiate progenitor blast cells into mature cells. As a result, progenitor blast cells remain inactive in the G₀ phase of the cell cycle where they proliferate into myeloblasts that are ineffective at differentiation. Standard treatment for AML involves chemotherapy, primarily utilizing cytarabine and daunorubicin. This approach demonstrates initially high remission rates; however, it frequently leads to relapses that are resistant to the drugs. Relapse and resistance are attributed to the survival of stem-cell-like progenitor cells within protective bone marrow niches. This leads to a long-term survival rate of 10-15 % for patients aged sixty and older, and a survival rate of less than 35-45 % for patients under sixty. Natural agents demonstrate potential as therapeutic agents for AML, characterized by low toxicity to normal cells and high toxicity to cancer cells. The plant soursop (Annona muricata) is of particular interest due to its potential application as an anticancer agent. Studies indicate that soursop exhibits cytotoxic effects on leukemic cancer cells through the induction of apoptosis and the inhibition of proliferation. Future research will investigate the mechanism of action and effectiveness of soursop in eliminating AML cells.