This article organizes the evidence and information from 10 lymphoma related cancer studies that use high dose vitamin C to improve cancer cell kill rate and reduce toxicity from chemotherapy. Particularly, B Cell Lymphoma and Chronic Lymphocytic Leukemia (CLL). Each section includes the evidence summary above the research fact table.

Clinical trial shows IVC is safe for chronic Lymphoma patients

Researchers at the Tokai University School of Medicine in Tokyo recognize that additional therapeutic strategies are required for Lymphoma cancer patients that suffer relapses, and that ascorbic acid (vitamin C) has been shown to “exert remarkable anti-cancer effects” and “recent clinical studies have also demonstrated that intravenous high ascorbic acid has an antitumor effect in patients with a number of different cancers”. The small trial represents another study that shows high doses of ascorbic acid administered intravenously is safely tolerated by cancer patients. They plan to proceed to a Phase II trial.  

Mayo Clinic use vitamin C for Lymphoma patients

The Mayo Clinic teamed up with the National Cancer Institute to complete a large Phase II trial to document how high-dose intravenous vitamin C (IVC) can be used in combination with chemotherapy to treat patients with lymphoma that has come back or does not respond to standard therapy. The chemotherapeutics they are combining with vitamin C are numerous: Carboplatin, Cisplatin,  Cytarabine, Dexamethasone, Etoposide, Gemcitabine Hydrochloride, Ifosfamide, Oxaliplatin.

Other studies have shown that ascorbic acid can damage cancer cell DNA through its ability to maintain high steady states of  (hydrogen peroxide); this anti-cancer mechanism can make cancer cells more susceptible to chemotherapy. The Mayo Clinc aims to document in a large group that the combination of IVC and chemotherapy kills more cancer cells. Estimated completion date is March 2024.

The second ongoing clinical trial is in Phase I studying the efficacy of IVC in combination with chemotherapy (melphalan) for relapsed refractory multiple myeloma patients. It is carried out by the University of Iowa and is expected to be completed in August of 2023.

Vitamin C improves chemo, targeted, and immunotherapy against lymphoma

A study using mouse models shows that high-dose ascorbic acid (Vitamin C) has a synergistic affect with checkpoint inhibitors, specifically anti-PD1/PD-L1; meaning it improved the capability of this novel immunotherapy. Vitamin C helped overcome the resistance mechanisms of the cancer cells: enhanced the immune system ability to recognize the tumor cells, increased activity of cytotoxic T cells (immune cell that kills cancer cells), and activation of NK cells and APCs (immune cells dendritic and macrophages). In summary, the linked study in the table below explains how Vitamin C improved the immunotherapies ability to prompt the bodies immune system cells to find the cancer cells, and penetrate the tumor leading to cell death. 

In an in vitro study conducted by The Ohio State University, vitamin C was shown to enhance arsenic trioxide (ATO) cytotoxicity in CLL B cells.

The University of Picardie Jules Verne (Amiens, France) showed ascorbic acid selectively induced cell death in leukemic CLL B-cells by acting as a pro-oxidant, which resulted in the generation of H2O2 in the extracellular (outside cell) environment. Furthermore, Vitamin C showed a synergistic interaction with targeted therapy drugs Ibrutinib, Idelalisib and Venetoclax.

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