A heavy metal baseline score predicts outcome in acute myeloid leukemia

Abstract

Despite abundant epidemiological data linking metals to leukemia and other cancers, baseline values of toxic and essential metals in patients with leukemia and the clinical impact of these metals remain unknown. Thus, we sought to quantify metal values in untreated patients with acute myeloid leukemia (AML) and controls and determine the impact of metal values on AML patients' survival. Serum samples from patients with untreated AML and controls at Hospices Civils de Lyon were analyzed and compared for trace metals and copper isotopic abundance ratios with inductively coupled plasma mass spectrometry. Survival analysis was performed as a function of metal values, and a multi‐metal score was developed for patients with AML. Serum samples were collected from 67 patients with untreated AML and 94 controls. Most patients had intermediate‐risk cytogenetics (63.1%) without FLT3 internal tandem duplication mutations (75.6%) or NPM1 mutations (68.1%). Most metal values differed significantly between AML and control groups. Patients with lower magnesium and higher cadmium values had the worst survival rates, with only 36% surviving at 6 months (P = .001). The adverse prognostic effect of this combination was maintained on multivariate analysis. Based on this, we developed a novel metal score, which accounts for multiple relative abnormalities in the values of five toxic and five essential metals. Patients with a higher metal score had significantly worse survival, which was maintained on multivariate analysis (P = .03). This baseline metal scoring system was also prognostic when we applied it to a separate population of front‐line AML patients.

The trace that is valuable: serum copper and copper to zinc ratio for survival prediction in younger patients with newly diagnosed acute myeloid leukaemia

“…Accurate prognostic assessment of AML is imperative but not fixed. A recent study showed the impact of a multimetal score on AML patient survival, which indicated that these metals might indicate prognostic value when applied to a specific population of front-line AML patients [21]. In our study, in addition to cytogenetic stratification, serum Cu levels were associated with DFS and OS, and SCZR was only associated with OS in these younger de novo adult AML patients.…”

Gender Difference in the Associations among Heavy Metals with Red Blood Cell Hemogram

“…In the present study, we found a positive association between MCV and Cd exposure in the male participants. Since Cd affects both iron uptake and bone damage, macrocytic anemia could be explained by the carcinogenic properties of Cd outweighing its effects on iron uptake [ 45 ]. Hindrance of the effects of Cd by hypomethylating DNA on bone marrow differentiation can lead to macrocytic anemia.…”

Steady analyses of potassium stable isotopes using a Thermo Scientific Neoma MC-ICP-MS

“…Blood serum samples were collected from control participants ( n = 10) and patients ( n = 9) with newly diagnosed acute myeloid leukemia presented to Hospices Civils de Lyon, from January 2015 to April 2016. 19 The analysis of samples was approved by the Institutional Review Board of Hospices Civils de Lyon, Centre de Protection des Personnes du Centre Léon Bérard, ENS-Lyon, and the French Government Ministry of Health. Control samples, with the same age range as patients, were obtained from blood donors at Etablissement Français du Sang during the same time.…”