Assessment of Oxidative and Antioxidant Status in Relation to Selected Trace Elements Among Leukemia Patients in Thi Qar Governorate

Abstract

The present study aimed to assess selected antioxidant markers and trace elements in patients with hematological malignancies and to examine their variations among different disease groups. The study focused on serum glutathione peroxidase 1 (GPx1), vitamin D3, copper, zinc, and selenium in patients with chronic myeloid leukemia (CML), acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and multiple myeloma (MM). The study included 96 patients diagnosed with CML, AML, ALL, or MM, comprising 41 males and 55 females, with ages ranging from 20 to 85 years. Blood samples were collected from patients attending the Hematology Consultation Unit at Nasiriyah Teaching Hospital between November 2025 and April 2026. A control group of 26 apparently healthy individuals, matched for age and socioeconomic status, was also included. Serum GPx1 and vitamin D3 concentrations were determined using enzyme-linked immunosorbent assay (ELISA), while serum copper, zinc, and selenium concentrations were measured by atomic absorption spectrophotometry (AAS). Data were expressed as median and range, and differences among the studied groups were evaluated using the Kruskal–Wallis test. A p-value of less than 0.05 was considered statistically significant. Serum vitamin D3 levels were significantly higher in all patient groups compared with the control group, with the highest median values observed in MM and AML patients. GPx1 levels differed significantly among the studied groups, with the highest level found in MM patients and the lowest level in CML patients. Serum copper levels were significantly increased in AML and MM patients, whereas lower levels were observed in CML and ALL compared with the control group. Zinc levels showed no statistically significant differences among the studied groups. Selenium levels were significantly decreased in ALL patients and increased in MM patients compared with the control group. The findings indicate that hematological malignancies are associated with alterations in selected antioxidant-related markers and trace elements. The differences in GPx1, vitamin D3, copper, and selenium levels among CML, AML, ALL, and MM patients may reflect variations in oxidative and antioxidant status associated with the different disease types. In contrast, serum zinc did not show a significant difference among the studied groups. These findings support the importance of further investigation of antioxidant markers and trace elements in patients with hematological malignancies.