Simple Summary
Acute lymphoblastic leukemia (ALL) is the most common cancer in children, where immature white blood cells grow uncontrollably. While chemotherapy can treat it, side effects and resistance are common. Curcumin, a natural substance found in turmeric, has shown promising anticancer effects. This systematic review scientifically summarises the anti-leukemic effects of curcumin from cell lines, animal and human. Curcumin works through multiple ways, including damaging cancer cell DNA, causing stress inside the cells, blocking growth signals, and some additional mechanisms in causing suicidal cell death in ALL cells. However, studies in animals are very limited, and there is no solid evidence from human trials yet. One major challenge is that curcumin is not easily absorbed in the body, which makes it harder to use as a medicine. More research is needed to improve how curcumin is delivered in the body and to test its safety and effectiveness in people with ALL.
Abstract
Background: Acute lymphoblastic leukemia (ALL) is a hematological malignancy characterised by uncontrolled proliferation of lymphoid cells. Despite improved outcomes with modern chemotherapy, treatment resistance and adverse effects remain major clinical challenges. Curcumin, a natural compound from Curcuma longa, has shown anticancer potential in multiple malignancies, including leukemia. This systematic review aims to summarise preclinical and clinical evidence on the anti-leukemic effects and mechanisms of action of curcumin in ALL. Methods: A literature search was conducted in August 2025 across PubMed, Scopus, Ovid MEDLINE, and Web of Science according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Primary research involving in vitro, in vivo, and human studies examining curcumin’s anti-leukemic effects on ALL were included. Of the 2034 records screened, 26 articles met the inclusion and exclusion criteria. Results: Curcumin inhibited proliferation and induced cytotoxicity and apoptosis in ALL cells via reactive oxygen species generation, DNA damage, mitochondrial dysfunction, and caspase activation. It also inhibited the Janus kinase/signal transducer and activator of transcription (JAK/STAT) and phosphoinositol-3 kinase/protein kinase B (PI3K/AKT) signalling, downregulated breakpoint cluster region-Abelson (BCR-ABL), Wilms tumor 1 (WT1), and Multidrug resistance 1 (MDR1) mRNAs, and induced ceramide accumulation and autophagy. In vivo evidence was limited, and no human studies were identified. Conclusions: Curcumin exerts multi-targeted anti-leukemic effects in ALL. Clinical translation is constrained by its poor bioavailability and limited clinical data. Future research should focus on improving the bioavailability of curcumin via chemical or pharmaceutical modification, as well as conducting well-designed clinical trials.