Role of essential and trace elements in chronic myeloid leukemia: associations with serum trace element profiles and hematological parameters.

Abstract

Background: Chronic myeloid leukemia is a myeloproliferative malignancy characterized by the Philadelphia chromosome with uncontrolled expansion of myeloid cells. Trace elements are essential for cellular metabolism, DNA repair, antioxidant defence, and immune regulation, and their imbalance may influence leukemogenesis and contribute to oxidative stress, immune dysregulation, and hematological alterations. Profiling trace elements may improve understanding of CML-associated trace element alterations and identify candidate biomarkers for future validation.

Material and methods: A cross-sectional study at Banaras Hindu University, India, included 93 CML patients and 93 age and sex-matched healthy controls from an eastern Indian population. Serum chromium (Cr), copper (Cu), manganese (Mn), lead (Pb), cadmium (Cd), arsenic (As), iron (Fe), selenium (Se), and zinc (Zn) concentrations were measured by atomic absorption spectroscopy. Complete blood counts were performed, and data analysed using descriptive statistics, Mann-Whitney U test, Chi-square/Fisher's exact tests, and Spearman correlation analysis.

Results: CML patients exhibited significantly elevated serum concentrations of Cu, Mn, Pb, Cd, and As compared with healthy controls, whereas Cr, Fe, Se, and Zn concentrations were significantly higher in healthy controls. Several trace elements showed statistically significant associations with hematological parameters, suggesting complex interactions between elemental imbalance and CML biology.

Conclusion: This study strongly shows dysregulation of essential and toxic trace elements in CML. Imbalance of selenium (Se), zinc (Zn), iron (Fe), manganese (Mn), and copper (Cu) may contribute to oxidative stress, immune dysfunction, and leukemogenesis, and toxic metals may enhance genomic instability. Trace-element profiling, especially selenium-related biomarkers, may serve as candidate biomarkers associated with CML and warrant validation in larger prospective studies.