Serum trace elements (STE) were measured in 50 patients with chronic lymphocytic leukemia (CLL) and 100 normal subjects. Copper was higher in patients than in controls (1.50 k 0.06 versus 1.10 k 0.02 pg/ml, P < 0.001), increased steadily from Stage 0 to Stage 4 (P = 0.002), and correlated with the lymphocyte count and serum lactate dehydrogenase (P < 0.01) but not with acute phase reactants. Zinc was lower in patients than in controls (0.94 k 0.03 versus 1.10 +-0.02 pg/ml, P < 0.001). Zinc (NS), selenium (P = 0.039), and calcium (P = 0.033), were decreased in Stages 3-4 as compared to Stages 0-2. The copper-to-zinc ratio (CZR) increased continuously from Stage 0 to Stage 4 (P < 0.001). Discriminant analysis between two groups, Stage 0-2 and Stage 3-4, based on serum copper, zinc, calcium, and protein levels, allowed for a correct classification of 94% of the patients. Moreover, the clinical staging of the remaining 6% was modified retrospectively according to the results of discriminant analysis. It was concluded that (1) serum copper and CZR are useful indices of the extent of disease, (2) they are independent of a nonspecific acute phase reaction, (3) STE determination could be helpful in the staging of a limited number of CLL patients, and (4) zinc deficiency could contribute to immune dysfunction in CLL.
Cancer 60: 1842-1846, 1 987.
LASMA or serum trace element (STE) levels have P rarely been measured in patients with chronic lymphocytic leukemia (CLL). The total number of patients studied in the literature amounts to 84 to 100 patients in seven series for copper,'-7 37 patients in five series for zinc,4-6,8.9 17 to 26 patients in three series for selenium,"-'* and 0 patient for bromine. As compared with normal subjects, the level of Cu was elevated in patients in each of the reported series.'-7 The results were less reproducible for zinc and selenium. However, the significance of the findings was not investigated further, and the role of STE determination in CLL was not evaluated.
The current study was undertaken to (1) evaluate the trace element status and assess the potential need for supplementation of patients with CLL, and (2) examine