Anti-Leukemic Activity of Smilax china L. Root Extracts against Acute Myeloid Leukemia Cells and Inhibition of Xenograft Tumor Growth In-vivo

Abstract

Acute myeloid leukemia (AML) is a clinically challenging malignancy with limited effective therapies and significant toxicity. This study evaluated the anti-leukemic potential of ethanolic extract of Smilax china L. root in HL-60 cells and a xenograft mouse model. The extract markedly reduced HL-60 cell viability in a dose- and time-dependent manner (IC₅₀ = 65.2 µg/mL at 24 h). Mechanistic analyses showed strong induction of apoptosis, increased Bax expression, decreased Bcl-2 levels, and an elevated Bax/Bcl-2 ratio. Cell-cycle arrest at the G2/M phase further confirmed its antiproliferative activity. The extract also significantly inhibited HL-60 cell migration and invasion. In vivo treatment of HL-60 xenograft-bearing mice (5 and 10 mg/kg) resulted in substantial suppression of tumor growth with minimal systemic toxicity. Tumor tissues exhibited reduced TNF-α, IL-1β, and IL-6 levels, indicating an additional anti-inflammatory effect. These findings demonstrate that Smilax china L. root extract exerts multi-target anti-leukemic actions by inducing apoptosis, blocking cell-cycle progression, suppressing metastasis-related behavior, and down-regulating inflammatory cytokines. Smilax china shows therapeutic promise as a complementary strategy for AML and warrants further investigation of its active constituents.