Therapeutic Potential of Ginger Rhizomes ( <i>Zingiber officinale</i> ) on Leukemia

Leukemia continues to provide a significant therapeutic challenge due to relapse, medication resistance, and treatment-associated toxicity, which frequently hinder sustained disease management. Rhizomes of ginger (Zingiber officinale) possess bioactive phenolics, notably 6-gingerol and 6-shogaol derivatives, which have demonstrated antileukemia efficacy in preclinical models. This study rigorously assesses the evidence regarding ginger-derived preparations and isolated compounds in both acute and chronic leukemia models, focusing on recurring mechanisms and translational viability. In leukemia cell line investigations and sparse resistant-model data, ginger-related interventions are consistently linked to diminished viability and the induction of mitochondrial apoptosis, typically indicated by alterations in Bax/Bcl-2 ratios, PARP breakage, and caspase-related measurements. Numerous studies indicate redox modulation, often characterized by elevated intracellular reactive oxygen species in leukemic cells, coupled with diminished pro-survival signaling, such as PI3K/Akt, as indicated by decreased pAkt and survivin levels. The suggested immunomodulatory and anti-inflammatory effects, encompassing alterations in NK-cell activity and cytokines like TNF-α and IL-6, are inadequately substantiated within leukemia-specific immunological contexts. Interpretation is limited by the variability in extract composition and chemical characterisation, inconsistent dose and exposure circumstances, dependence on endpoint markers without causative manipulation, and a lack of leukemia-specific clinical data. Ginger-derived compounds exhibit multi-target biological activity that necessitates further exploration through standardized and chemically defined preparations, pharmacokinetic and pharmacodynamic characterization, clinically relevant exposure benchmarks, and meticulously designed leukemia-focused translational and early-phase clinical studies to elucidate safety, efficacy, and compatibility with current therapies.