Haematological cancer treatment with cannabinoids

DiseaseTreatmentPatientResultsRef.
Hodgkin lymphoma, stage IIB, with incomplete remission after radio-chemotherapyAt 26 weeks of pregnancy, the patient began on her own a treatment with “cannabis oil”, supposed to be THC-predominant (1 mL to 5 mL, 3 times per day, concomitant to opioids)5 years after the first intervention, the patient became pregnant at the age of 21 yearsBefore starting with cannabis, an MRI scan revealed the progression of the disease; with cannabis, pain, and general status improved, tumour tissue decreased. The patient delivered a boy by C-section at week 34 who presented in the first 24 h postpartum with withdrawal syndrome and intestinal invagination, requiring care in neonatal intensive care unit (NICU) and surgery with bowel resection[91]
Native leukaemia blasts (acute undifferentiated leukaemia) cultured ex vivoTHC 2.5 % oily solution, (2 times ~1.6 mg per day increased to 6 drops (twice ~5 mg daily); not aimed as antitumour therapyElderly patient, palliative supportive care for tumour cachexiaTHC showed a considerable plasma inhibitory/pro-apoptotic effect in an apoptosis assay ex vivo; expression of the cannabinoid receptors is a prerequisite to achieve a pro-apoptotic effect in native leukaemia blasts[87]
CLLNabiximols single dose, stepwise increased from one actuation (2.7 mg THC + 2.5 mg CBD) to a maximum of 7 actuations (18.9 mg THC + 17.5 mg CBD), 15 patients received the maximal dose23 patients (18–80 years) with leukemic indolent B-cell lymphoma, without treatment indicationOn the treatment day, there was a signif. decrease in lymphocyte counts; however, cell proliferation and apoptosis did not change; CBD + THC had no effect on the natural course of the disease (median follow-up was 2.8 years, range: 1.4–4.2 years)[88]
Acute lymphoblastic leukaemia, positive for Philadelphia chromosome mutationFive different THC-Es (“Rick Simpson oil”) over a period of 78 days, after unsuccessful bone marrow transplantation and chemotherapy14-year-old girlExtracts reduced blast cells but varied in their effects and side effects; with each new extract, the dose had to be adjusted again, starting with a lower dose; in parallel blast cells increased. The appropriate dose was identified by observation of side effects (euphoria, panic, appetite, nausea, fatigue) as guidance; the patient passed away due to a bowel perforation as a late effect of chemotherapy[10]

MRI: magnetic resonance imaging; signif.: significant; ~: about