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Published on: July 20, 2016
Serum copper is a simple but valuable prognostic marker in B-cell chronic lymphocytic leukemia
Hany A Labib1, Mona Hassanein, Rasha L Etewa
1Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Insights
High serum copper levels in B-cell chronic lymphocytic leukemia (B-CLL) patients correlate with adverse prognostic markers. This simple test indicates a poorer treatment response and shorter time to treatment initiation.
Area of Science:
- Hematology
- Clinical Chemistry
Background:
- B-cell chronic lymphocytic leukemia (B-CLL) is a heterogeneous lymphoid malignancy.
- Prognostic factors are crucial for guiding treatment decisions in CLL.
- Serum copper levels have not been extensively studied in relation to CLL prognosis.
Purpose of the Study:
- To investigate the association between serum copper levels and prognostic factors in B-CLL.
- To evaluate the relationship between serum copper and treatment response in CLL patients.
Main Methods:
- Serum copper, lactate dehydrogenase (LDH), and beta-2 microglobulin (β(2)M) were measured.
- Immunophenotyping (CD38, ZAP-70) and cytogenetic analysis (17p del) were performed.
- Data from 50 newly diagnosed CLL patients were analyzed.
Main Results:
- Elevated serum copper was linked to increased LDH, β(2)M, CD38, ZAP-70, and 17p deletion.
- High serum copper correlated with decreased hemoglobin, longer lymphocyte doubling time, and shorter time to treatment.
- Patients with high serum copper showed a lower treatment response rate.
Conclusions:
- Serum copper is a valuable, inexpensive biomarker in B-CLL.
- High serum copper levels are associated with adverse prognostic markers and poorer treatment outcomes.
- This finding supports the utility of serum copper testing in CLL management.
Abstract:
We investigated the relationship between serum copper and various prognostic factors, time to start treatment, and treatment response in patients with B-cell chronic lymphocytic leukemia (B-CLL) and related disorders. Fifty newly diagnosed CLL patients aged 36-70 years were included. Patients were studied for serum lactate dehydrogenase (LDH), serum copper, direct Coombs' test, serum β(2) microglobulin (β(2)M), immunophenotyping for diagnosis of B-CLL, evaluation of CD38 and zeta-associated protein (ZAP-70) expression, and fluorescence in situ hybridization technique for cytogenetic analysis. Fourteen of 50 patients had high serum copper level; they had a significant increase in LDH, serum β(2)M, incidence of positive Coombs' test, CD38 and ZAP-70, incidence of 17p del, and a decrease in hemoglobin concentration, lymphocyte doubling time and time to start treatment with a lower treatment response rate. No significant difference was found with regard to Rai staging for CLL. These results indicate that serum copper level, a cheap and simple laboratory test, is of great value in CLL patients as it showed a significant association with some important adverse prognostic markers such as increased expression of ZAP-70 and CD38, shorter time to start treatment and poor response to treatment.
