Predictors of outcome of trace element levels in acute myeloid leukaemia patients: a prospective study for one year

Abstract

Abstract Background Trace elements are essential for mammalian metabolism. To date, no data have been presented predicting the relapse-free survival of acute myeloid leukemia (AML) patients based on the level of trace elements in the serum. This prospective cohort study had the following objectives: (i) to quantify essential trace elements in the serum of AML patients.(ii) to examine the predictive values of the trace element levels in newly diagnosed de novo AML patients. Methods 50 patients AML were studied. The control group consisted of 50 patients. Serum levels of the trace elements copper, zinc, copper to zinc ratio and selenium, were measured by spectrophotometry. The associations of trace element with the relapse-free survival of these AML patients were assessed by Kaplan–Meier survival curves. Results AML patients, a control group, and AML subgroups with and without hematological relapse were evaluated for trace element concentrations. AML patients showed higher copper and lower zinc levels than controls. AML patients had increased Cu/Zn ratios. AML patients had reduced selenium levels. Relapsed AML patients had increased copper and Cu to Zn ratios, but decreased zinc and selenium. Copper, zinc, Cu to Zn ratio, and selenium cut-off values for AML relapse and nonrelapse were identified via ROC curve analysis. Kaplan-Meier curves showed that patients with higher copper, lower zinc, higher Cu to Zn ratio, or lower selenium had a shorter estimated mean relapse-free survival time. Conclusions Trace element levels are correlated with long-term relapse-free survival in newly diagnosed AML patients and may serve as predictive biomarkers.