Reviving Rakta: Deep Molecular Remission in Chronic Myeloid Leukaemia

Abstract

Chronic Myeloid Leukaemia (CML) is a myeloproliferative neoplasm driven by constitutively active BCR-ABL tyrosine kinase arising from the Philadelphia chromosome t (9;22). From an Ayurvedic standpoint, it correlates with Vatarakta-sadrusha avastha, involving Vata–Rakta avarana resulting in Rakta dhatu dushti and impaired haematopoietic regulation. This case study describes a 29-year-old male with chronic-phase CML (baseline: Hb: 7.3 g/dl, WBC: 19,220/µL, Platelets: 3.6 lakh/µL) who was managed exclusively with Ayurvedic intervention following patient-informed withdrawal from imatinib. The treatment protocol comprised Hingwashtak Churna with ghee, Navayas Loha, Ashwattha Kwath (decoction of Ficus religiosa) with honey, and Vayasthapan Mahakashaya over six months. Ashwattha, with Kashaya rasa and Sheeta virya, promotes Rakta-prasadana and Dhatu-sthirata; its phytoconstituents (flavonoids, phenolics) exert antioxidant and immunomodulatory effects potentially influencing abnormal myeloid proliferation. Vayasthapan Mahakashaya, a classical Rasayana formulation, supports Ojas, Dhatu-poshana, and systemic homeostasis. Post-intervention, the patient achieved haematological remission (WBC: 8,700/µL, platelets normalised) and a substantial molecular response (BCR-ABL IS: 0.101%, approaching major molecular response threshold), alongside 8kg weight gain and complete resolution of constitutional symptoms, with no adverse events documented. This report suggests potential standalone value of Ayurvedic intervention in CML management and warrants further controlled investigation.