Table 3.

Natural compounds that exert anti-ALL effects through pro-oxidation.

Natural Compound	Cell Type	Action	Possible Anti-Leukemia Mechanism	Refs
Ardisiacrispin B	CCRF-CEM human T-cell ALL cell line	Induces apoptosis	Activates caspases 8 and 9 and caspase 3/7 and increases ROS production	[160]
Artesunate	Jurkat, CEM, and Molt-4 human T-cell ALL cell lines	Induces apoptosis	ROS-dependent mitochondria-mediated pathway	[161]
Baicalin	Jurkat human T-cell ALL cell line, human peripheral blood mononuclear cells (PBMCs) isolated from blood of healthy volunteers	Induces apoptosis in Jurkat cells while having little cytotoxicity on PBMCs	ROS-dependent mitochondria-mediated apoptotic pathway	[162]
Camalexin	Jurkat human T-cell ALL cell line, human lymphoblasts, and primary fibroblasts	In the micromolar range, camalexin exhibits time- and concentration-dependent cytotoxicity to Jurkat cells but has little cytotoxicity to normal cells.	ROS-dependent mitochondria-mediated apoptotic pathway	[163]
Curcumin	697, REH, RS4;11, and SupB15 human B-cell precursor ALL cell lines	Induces apoptosis	ROS-dependent mitochondria-mediated intrinsic pathway	[164]
Cyanidin-3-rutinoside	HL-60 human promyelocytic leukemia cell line, CCRF-CEM and Molt-4 human T-cell ALL cell lines, human PBMCs isolated from healthy donors	Induces apoptosis in leukemia cell lines while having little cytotoxicity to normal PBMCs	ROS-dependent activation of p38 MAPK and JNK	[165]
Matrine	Human ALL B-lymphocytes	Promotes apoptosis in ALL cells	Promotes ROS generation, upregulates Bax, and downregulates Bcl-2	[166]
Parthenolide	SEM and RS4;11 pre-B ALL cell lines, human T-cell ALL cells	Induces rapid apoptotic cell death	Promotes ROS generation	[158,167]
Piperlongumine	GC-resistant B-ALL cell lines and GC-sensitive B-ALL cell lines, human PBMCs B cells	Regardless of GC-resistance, piperlongumine inhibits the proliferation of all B-ALL cell lines but not normal B cells and induces apoptosis	Promotes ROS generation	[159]
Resveratrol	Jurkat human T-cell ALL cell line, normal lymphocytes	Resveratrol synergizes with barasertib or everolimus to enhance the cytotoxic effect on ALL cells without affecting normal lymphocytes	Promotes ROS generation	[157]
Sanguinarine	697, REH, RS4;11, and SupB15 human B-cell precursor ALL cell lines	Promotes ALL cell apoptosis	Promotes ROS generation, upregulates Bax, and downregulates Bcl-2	[168]
Triptolide	ALL cell line (NALM-6/R) with cross-resistance to cytarabine (araC) and doxorubicin (ADM)	Reversal of the drug resistance of ALL cells inhibits cell proliferation, induces apoptosis in vitro, and inhibits tumor growth in a mouse xenograft model	Impairs mitochondrial membrane potential and increases ROS production	[169]