Association of serum copper, zinc and copper to zinc ratio in patients with acute myeloid leukemia

Acute myeloid leukemia (AML) is a rare hematological disorder that has detrimental effects on human health and requires the exploration of biomarkers for diagnosis and prognostic evaluation. Essential trace elements like copper (Cu) and zinc (Zn) play diverse biological functions, however, limited data are available regarding their role in AML. The present study aimed to determine the serum levels of Cu and Zn, and assess the serum Cu/Zn ratio (SCZR) in newly diagnosed adult AML cases. This observational case-control study included 50 adult AML patients and 50 healthy controls. Blood samples were collected to analyze complete blood count (CBC), serum levels of Cu and Zn were determined by an atomic absorption spectrophotometer. The study showed significant hematological abnormalities in AML, including anemia (reduced hemoglobin/hematocrit levels), leukocytosis (elevated WBC counts), and thrombocytopenia (low platelet counts). Compared to controls, AML patients exhibited significantly higher (p = < 0.05) serum Cu levels (2.01 ± 0.87 mg/L), lower Zn levels (1.02 ± 0.54 mg/L), and an elevated SCZR (2.74 ± 2.31). Furthermore, higher blast counts (> 40%) were significantly associated (p = 0.005) with reduced Zn levels (0.82 ± 0.37 mg/L), and shorter survival episodes (9.51 ± 3.93 months; p = 0.001). A moderate-to-strong inverse correlation was observed between blast counts (> 40%) and survival duration (p = 0.001). The study demonstrated significant differences in serum Cu, Zn, and SCZR between AML patients and controls. Particularly, reduced serum Zn was linked to higher blast counts, whereas serum Cu and SCZR showed no association with blast burden. These findings highlight the prognostic relevance of blast burden and trace element dysregulation in AML.