Serum Metallomics Reveals Insights into the Associations of Elements with the Progression of Preleukemic Diseases Towards Acute Leukemia

Abstract Context Acute leukemia (AL) is a critical neoplasm of white blood cells with two main subtypes: acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Objective This study is focused on understanding the association of the preleukemic disease aplastic anemia (APA) with ALL and AML at metallomic level, using healthy subject as a control. Materials and methods In this study, a validated and efficient ICP-MS/MS-based workflow was employed to profile a total of 13 metallomic features. The study encompassed 41 patients with AML, 62 patients with ALL, 46 patients with APA, and 55 age-matched healthy controls. The metallomic features consisted of 8 essential elements (Ca, Co, Cu, Fe, Mg, Mn, Se, and Zn) and 5 non-essential/toxic elements (Ag, Cd, Cr, Ni, and Pb). Results Six out of the thirteen elements were found to be substantially different (p < 0.05) using absolute concentrations between serum samples of acute leukemia (ALL and AML) and preleukemia (APA) patients in comparison with healthy subjects. Elements including magnesium, calcium, iron, copper and zinc were up-regulated and only one element (chromium) was down-regulated in serum samples of disease when compared with healthy subjects. Discussion Through the utilization of both univariate tests and multivariate classification modeling, it was determined that chromium exhibited a progressive behavior among the studied elements. Specifically, chromium displayed a sequential up-regulation from healthy individuals to preleukemic disease (APA), and ultimately in patients diagnosed with ALL. Conclusion Overall, metallomic-based biomarkers may have utility to predict the association of APA with ALL.