Trace elements (selenium, copper and zinc) in de novo acute leukemia: serum levels and their relation with some clinical and laboratory parameters

BACKGROUND: Trace elements normally appear in low concentrations in the human body and play an important role in the enzyme systems in many metabolic processes. Trace elements, mostly selenium (Se) and zinc (Zn), were involved in the defense against oxidative stress in cells. Oxidation could lead to the generation of free radicals that have been involved in the pathogenesis of many diseases, including leukemia. While Cu at the physiological level provides cellular health and at higher than the physiological level causes angiogenesis and a higher incidence of cancers. Objectives: The aim of this study was to measure the essential trace elements (selenium, zinc, and copper) in the serum of adult patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) and their relation to some clinical and laboratory parameters. Materials and Methods: This case–control study comprised 39 adult patients with de novo acute leukemia (AL) (28 patients with AML and 11 patients with ALL) conducted from January to June 2022. The patients were collected from Iraqi Center for Hematology in Baghdad Teaching Hospital in Medical City. A total of 40 apparently healthy adults were included in this study as a control group. Peripheral blood and bone marrow smears were examined at the presentation for establishing the diagnosis. The serum level of selenium, zinc, and copper was measured by a microplate reader for both patients and the control group, before starting chemotherapy. Immunophenotyping and renal function tests (RFTs) were taken from the patient's files. RESULTS: There was a statistically lower median level of selenium among the patients group in comparison to the control group (P < 0.001), while both zinc and copper did not show statistical difference between both groups (P > 0.05). Only hemoglobin (Hb) showed a significant negative correlation between patients with AL and the level of selenium. There was a significantly lower zinc level among the abnormal RFT group in comparison to the normal group. CONCLUSIONS: There was a significantly lower serum selenium level in AL patients than in the control group. Selenium level showed a negative correlation with Hb among AL patients only, in which an increase in selenium level was associated with a decrease in Hb level among AL patients. There was no significant difference in the serum level of zinc and copper between AL patients and the control group. There was a significantly lower zinc level among the abnormal RFT group in comparison to the normal group.