The Impact of High-dose Sodium Selenite Therapy on Bcl-2 Expression in Adult Non-Hodgkin’s Lymphoma Patients: Correlation with Response and Survival

Abstract

The present study was undertaken to explore the effect of administration of high doses of sodium selenite on the expression of Bcl-2 in patients with non-Hodgkin's lymphoma (NHL). Fifty patients with newly diagnosed NHL were randomly divided into two groups. Group A-I received standard chemotherapy whereas group A-II received adjuvant sodium selenite 0.2 mg kg-1 day-1 for 30 days in addition to chemotherapy. Enzyme-linked immunosorbent assay was used to assess Bcl-2 at the time of diagnosis and after therapy in the two groups. Sodium selenite administration resulted in significant decline of Bcl-2 level after therapy in group A-II (8.6 +/- 6.9 ng/ml vs 3 6.9 +/- 7.9 ng/ml, P < 0.05). Also, complete response reached 60% in group A-II compared to 40% in group A-I. Significant increase in CD4/CD8 ratio was noticed in group A-II compared to group A-I after therapy (1.45 +/- 0.36 vs 1.10 +/- 0.28 p 0.04). Overall survival time in months was significantly longer in complete remission patients in group A-II (21.87 +/- 1.41) compared to group A-I (19.70 +/- 1.95) (p = 0.01). It is concluded that sodium selenite administration at the dosage and duration chosen acts as a down regulator of Bcl-2 and improves clinical outcome.

Serum Selenium Deficiency in Patients with Hematological Malignancies: Is a Supplementation Study Mandatory?

“…A small clinical randomized study in patients with non-Hodgkin's lymphoma showed that Se supplementation during chemotherapy increases the percentage of cases with a reduction of lymphadenopathy, and decreases splenic size and bone marrow infiltration [15]. Further prospective clinical trials showed that Se can reduce toxicities of chemotherapy in patients with solid tumors and hematological malignancies [15,16,17,18,19,20]. …”

Selenium and Glutathione Peroxidase Status in Adult Egyptian Patients with Acute Myeloid Leukemia

“…Other studies showed that Se enhances apoptosis via caspase-dependent mode [25]. Recently, Asfour and coworkers demonstrated that adjuvant Se therapy in non-Hodgkin lymphoma patients improves response to therapy, supports the immune system, and has a positive influence on patients' survival [16,26,27].…”

“…Recently, Asfour et al [16] concluded that Na 2 SeO 3 administration acts as a cytoprotective agent, alleviating the immunosuppressive effects of cytotoxic chemotherapy.…”

Optimising Selenium for Modulation of Cancer Treatments

“…In the same trial, slowing of PSA velocity was also observed, and one patient had >50% reduction in serum PSA. Another clinical trial adding SS 200 μg/kg/day (equivalent to 14,000 μg/day in a 70-kg adult) to chemotherapy in lymphoma patients reported less toxicity with combination therapy than with chemotherapy alone, including infections and reduction in cardiac function (27).…”

“…Asfour et al reported a trial randomising 50 patients with non-Hodgkin lymphoma to either very high doses of SS (200 μg/kg/day) with cyclophosphamide, vincristine, doxorubicin and prednisone chemotherapy or chemotherapy alone (27). A significantly greater tumour response rate was observed in the Se group than controls (60% vs. 40% respectively), with correspondingly lower levels of the oncogene B-cell lymphoma 2 (BCL2) in bone marrow aspirates in Se-treated patients compared to controls.…”