title: Serum selenium concentration at diagnosis and outcome in patients with haematological malignancies.
abstract: 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.
authors.affiliation: Centre for Haemato-Oncology, Barts Cancer Institute, Barts and the London School of Medicine, London, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Stevens
authors.forename: Rachel
authors.initials: R
authors.lastname: Waters
authors.forename: Christina
authors.initials: C
authors.lastname: Sieniawska
authors.forename: Shireen
authors.initials: S
authors.lastname: Kassam
authors.forename: Silvia
authors.initials: S
authors.lastname: Montoto
authors.forename: Jude
authors.initials: J
authors.lastname: Fitzgibbon
authors.forename: Ama
authors.initials: A
authors.lastname: Rohatiner
authors.forename: Andrew
authors.initials: A
authors.lastname: Lister
authors.forename: Simon
authors.initials: S
authors.lastname: Joel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D006689:Hodgkin Disease / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D008224:Lymphoma, Follicular / Q000097:blood / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012643:Selenium / Q000097:blood*; D012709:Serum Albumin / Q000378:metabolism; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D012709:Serum Albumin; D012643:Selenium