Harnessing nature's arsenal: next steps for garlic-based therapies in acute myeloid leukemia.

This letter commends the recent study by Abdelkarim et al. on the pro-apoptotic effects of an Allium sativum (garlic) extract in acute myeloid leukemia (AML). While acknowledging the significance of their ex vivo findings on primary patient cells, we propose several key considerations to strengthen the translational potential of this research. Firstly, we emphasize the need for standardized phytochemical characterization of the complex extract to ensure reproducibility. Additionally, we suggest expanding the mechanistic investigation to include the extrinsic apoptosis pathway and direct measurement of reactive oxygen species. Furthermore, we discuss strategies to enhance the targeting of resistant leukemia stem cell populations, such as prolonged exposure or combination therapy with venetoclax. Finally, we advocate for in vivo validation using patient-derived xenograft models to evaluate efficacy within a physiologically relevant microenvironment. Addressing these points will be crucial for harnessing the full potential of Allium sativum as a complementary therapy in AML.