The extract from grape seeds which contain dimer, trimer, and tetramer proanthocyanidins, also showed antineoplastic activity in human acute myeloid leukemia (AML) HL-60/adriamycin (HL-60/ADR) cell line, and the grape seed extract, can inhibit the growth of HL-60/ADR cells by increasing the expression of Bax, reduce the expression of B-cell lymphoma-2 (Bcl-2) and increase the activity of caspase-3 and caspase-9 [130]. Here, CASP9 is linked to acute myeloid leukemia.