Copper Levels in Patients with Hematological Malignancies

INTRODUCTION: Copper is an essential trace element that plays an important role in human biochemistry. Its metabolic pathways involve cellular respiration, peptide biogenesis, connective tissue biosynthesis and antioxidant defense. It is known as an acute phase reactant increasing in response to infection, injure and in chronic inflammatory conditions.

AIM: The aim of this study is to observe the alterations of serum copper levels in patients with various hematological malignancies and also to examine the relation of its levels with the extent of the disease and assess the role of copper determination in staging these patients.

MATERIALS AND METHODS: 77 patients (32 male, 45 female) with various hematological diseases were studied. 50 normal, healthy subjects were studied along. Age ranged from 18–75 years (mean age: 63 years). There were 15 patients suffering from chronic lymphocytic leukaemia (CLL), 17 from non-Hodgkin lymphoma (NHL), 7 from Hodgkin’s disease, 13 from acute myeloid leukaemia (AML), 8 from multiple myeloma and 17 from remainder hematologic malignancies. Copper was measured by flame atomic absorption spectrometry (normal range 0,8–1,3 mg/l). Statistical analysis was conducted by SPSS 12.0. Student’s t-test was used.

RESULTS: Copper levels of the healthy control group were within normal range. When all patients were studied, 51 patients with relapsing disease had elevated copper levels (mean value 1,8 mg/l), whereas 26 patients with remission of their disease had normal copper levels (mean value 1,03 mg/l). Student’s t-test (Sig. two-tailed = p value was 0,000<0,001). When separate disease groups were studied, the results were in accordance with the aforementioned assumption made on all patients: 17 NHL patients (11 relapse − mean copper value = 1,87, 6 remission − mean copper value = 1,12, p<0,001), 15 CLL patients (8 relapse − copper = 1,57, 7 remission − copper = 0,86, p<0,001), 13 AML patients (9 relapse − copper = 1,9, 4 remission − copper = 1,09, p<0,001).

CONCLUSIONS: Our study indicates that elevated copper levels are associated with relapsing hematological malignancies, whereas normal copper levels are associated with remission of the underlying disease. Copper determination might prove to be beneficial in staging such patients, which will lead to proper therapeutic decisions.