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Serum selenium concentration at diagnosis and outcome in patients with haematological malignancies
Author(s) -
Stevens Jane,
Waters Rachel,
Sieniawska Christina,
Kassam Shireen,
Montoto Silvia,
Fitzgibbon Jude,
Rohatiner Ama,
Lister Andrew,
Joel Simon
Publication year - 2011
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2011.08744.x
Subject(s) - medicine , gastroenterology , hazard ratio , selenium , univariate analysis , proportional hazards model , confidence interval , follicular lymphoma , multivariate analysis , lymphoma , albumin , materials science , metallurgy
Summary We have previously reported presentation serum selenium level to be predictive of outcome in diffuse large B–cell lymphoma. This has now been studied in a further 430 patients, 163 with acute myeloid leukaemia (AML), 156 with Hodgkin Lymphoma (HL), and 111 with Follicular Lymphoma (FL). Serum selenium was below the UK normal reference range in 45% of patients, and correlated with serum albumin ( r = 0·24–0·46, P < 0·001–0·003) in all tumour types. Independent predictors of presentation selenium were; French‐American‐British subtype and albumin ( P < 0·001 for both) in AML, haemoglobin ( P = 0·002) and B‐symptoms ( P = 0·01) in HL, and albumin ( P < 0·001) in FL. In AML and HL, response to first line therapy was lower in patients with low serum selenium, but selenium was no longer predictive of response when other variables were entered into a multivariate model. Low selenium was also associated with a worse overall survival in FL [Hazard Ratio (HR) 2·3, 95% confidence interval (CI) 1·4, 4·0] and a trend to a worse overall survival in AML (HR 1·43, 95% CI 0·96, 2·13) by univariate Cox regression analysis, but not by multivariate analysis. In conclusion, low serum selenium is associated with a worse outcome in patients with haematological malignancies, but is not independently predictive, suggesting that it reflects other factors.