Effects of Metformin on Leukemia: Biological Mechanisms, Targets, and Treatment Possibilities

Metformin: A medication for leukemia and diabetesChanges in lipid and adiponectin mechanisms, as well as the overactivation of inflammatory cytokines and signaling pathways, occur similarly in both diabetes and cancer (1-3).Obesity, body mass index (BMI), insulin resistance, and hyperglycemia in individuals with diabetes are directly associated with a higher risk of leukemia (4, 5).Additionally, individuals with underlying metabolic syndrome have a higher risk of developing leukemia compared to those without it (6,7).One indirect mechanism of metformin is its ability to inhibit the mitotic division of cancer cells, which is influenced by lipogenesis and hyperinsulinemia.In cancer patients, somatomedin C promotes the division of cancer cells (8)(9)(10)(11).Metformin helps prevent the survival of cancer cells through an indirect mechanism by activating the insulin receptor and reducing glucose levels.Since cancer cells depend