Determination Relation of the Zinc Serum Level in Acute Leukemia Adult Patients with Mucositis and Neutropenic Prevalence before and after Treatment in Isfahan' Seyed-Al-Shohada Hospital, 2012–2013

Document Type : Original Article

Authors
Valiollah Mehrzad 1
Mehdi Mahmood-Zadeh 1
Awat Feizi 2
Arash Raisi 1
1 Department of Hematology and Oncology, Medical School, Isfahan, Iran
2 Department of Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Neutropenic fever and mucositis with 70% outbreak average is one of the major reasons of death in the acute leukemia adult patients. The aim of this study was to determine the relationship of serum zinc level with neutropenic fever and mucositis prevalence in acute leukemia adult patients and comparison of the effects of therapeutic intervention with the serum zinc correct level in the group of patients with zinc deficiency. Materials and Methods: From May 2012 to May 2013 in a double-blind, randomized, placebo-controlled study, on the basis of zinc serum level, 40 acute leukemia adult patients were divided into two groups of normal and deficiency zinc, and neutropenic fever and mucositis prevalence were taken into consideration in each and every group. The deficiency zinc patients were randomly allocated to zinc or control group in a blocked randomization schedule. The data analysis was performed by SPSS software 20 and with the aid of variance analysis statistical method, logistic regression, and X2statistical test. Results: Serum zinc level was higher in acute leukemia adult patients without mucositis and neutropenic fever than others but was not statistically significant. There is a positive relation between receiving zinc with recovery; although the relationship has not become statistically significant. Conclusion: These data, although preliminary, suggest that zinc therapy could be a valid therapeutic adjuvant to improve the quality-of-life of acute leukemia adult patients.

Keywords

1.
Seftel MD. Controversies in the management of fever in the neutropenic cancer patient. Transfus Apher Sci 2010;42:151-6.  Back to cited text no. 1
[PUBMED]    
2.
Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 2014;120:1453-61.  Back to cited text no. 2
[PUBMED]    
3.
Jones JA, Avritscher EB, Cooksley CD, Michelet M, Bekele BN, Elting LS. Epidemiology of treatment-associated mucosal injury after treatment with newer regimens for lymphoma, breast, lung, or colorectal cancer. Support Care Cancer 2006;14:505-15.  Back to cited text no. 3
[PUBMED]    
4.
Chow V, Dorcy KS, Sandhu R, Gardner K, Becker P, Pagel J, et al. Evaluation of early discharge after hospital treatment of neutropenic fever in acute myeloid leukemia (AML). Leuk Res Rep 2013;2:26-8.  Back to cited text no. 4
[PUBMED]    
5.
Duncan GG, Epstein JB, Tu D, El Sayed S, Bezjak A, Ottaway J, et al. Quality of life, mucositis, and xerostomia from radiotherapy for head and neck cancers: A report from the NCIC CTG HN2 randomized trial of an antimicrobial lozenge to prevent mucositis. Head Neck 2005;27:421-8.  Back to cited text no. 5
[PUBMED]    
6.
Stokman MA, Spijkervet FK, Boezen HM, Schouten JP, Roodenburg JL, de Vries EG. Preventive intervention possibilities in radiotherapy-and chemotherapy-induced oral mucositis: Results of meta-analyses. J Dent Res 2006;85:690-700.  Back to cited text no. 6
[PUBMED]    
7.
Rodríguez-Caballero A, Torres-Lagares D, Robles-García M, Pachón-Ibáñez J, González-Padilla D, Gutiérrez-Pérez JL. Cancer treatment-induced oral mucositis: A critical review. Int J Oral Maxillofac Surg 2012;41:225-38.  Back to cited text no. 7
    
8.
Berdanier DC, Dwyer JT, Feldman EB. Handbook of Nutrition and Food. Boca Raton: CRC Press; 2007. p. 240.  Back to cited text no. 8
    
9.
Kadrmas JL, Beckerle MC. The LIM domain: From the cytoskeleton to the nucleus. Nat Rev Mol Cell Biol 2004;5:920-31.  Back to cited text no. 9
    
10.
Al-Ebraheem A, Farquharson MJ, Ryan E. The evaluation of biologically important trace metals in liver, kidney and breast tissue. Appl Radiat Isot 2009;67:470-4.  Back to cited text no. 10
[PUBMED]    
11.
Costello LC, Franklin RB. Cytotoxic/tumor suppressor role of zinc for the treatment of cancer: An enigma and an opportunity. Expert Rev Anticancer Ther 2012;12:121-8.  Back to cited text no. 11
[PUBMED]    
12.
John E, Laskow TC, Buchser WJ, Pitt BR, Basse PH, Butterfield LH, et al. Zinc in innate and adaptive tumor immunity. J Transl Med 2010;8:118.  Back to cited text no. 12
[PUBMED]    
13.
Prasad AS. Zinc: Role in immunity, oxidative stress and chronic inflammation. Curr Opin Clin Nutr Metab Care 2009;12:646-52.  Back to cited text no. 13
[PUBMED]    
14.
Agarwal A, Khanna P, Baidya DK, Arora MK. Trace elements in critical illness. J Endocrinol Metab 2011;1:57-63.  Back to cited text no. 14
    
15.
Beguin Y, Brasseur F, Weber G, Bury J, Delbrouck JM, Roelandts I, et al. Observations of serum trace elements in chronic lymphocytic leukemia. Cancer 1987;60:1842-6.  Back to cited text no. 15
[PUBMED]    
16.
Inaba H, Greaves M, Mullighan CG. Acute lymphoblastic leukaemia. Lancet 2013;381:1943-55.  Back to cited text no. 16
[PUBMED]    
17.
Villela L, Bolaños-Meade J. Acute myeloid leukaemia: Optimal management and recent developments. Drugs 2011;71:1537-50.  Back to cited text no. 17
    
18.
Franklin RB, Milon B, Feng P, Costello LC. Zinc and zinc transporters in normal prostate and the pathogenesis of prostate cancer. Front Biosci 2005;10:2230-9.  Back to cited text no. 18
[PUBMED]    
19.
Costello LC, Franklin RB, Feng P, Tan M, Bagasra O. Zinc and prostate cancer: A critical scientific, medical, and public interest issue (United States). Cancer Causes Control 2005;16:901-15.  Back to cited text no. 19
[PUBMED]    
20.
Schlag P, Seeling W, Merkle P, Betzler M. Changes of serum-zinc in breast cancer (author's transl). Langenbecks Arch Chir 1978;346:129-33.  Back to cited text no. 20
[PUBMED]    
21.
Lightman A, Brandes JM, Binur N, Drugan A, Zinder O. Use of the serum copper/zinc ratio in the differential diagnosis of ovarian malignancy. Clin Chem 1986;32:101-3.  Back to cited text no. 21
[PUBMED]    
22.
Ebara M, Fukuda H, Hatano R, Saisho H, Nagato Y, Suzuki K, et al. Relationship between copper, zinc and metallothionein in hepatocellular carcinoma and its surrounding liver parenchyma. J Hepatol 2000;33:415-22.  Back to cited text no. 22
[PUBMED]    
23.
Gurusamy K. Trace element concentration in primary liver cancers – A systematic review. Biol Trace Elem Res 2007;118:191-206.  Back to cited text no. 23
[PUBMED]    
24.
Issell BF, MacFadyen BV, Gum ET, Valdivieso M, Dudrick SJ, Bodey GP. Serum zinc levels in lung cancer patients. Cancer 1981;47:1845-8.  Back to cited text no. 24
[PUBMED]    
25.
Gupta SK, Singh SP, Shukla VK. Copper, zinc, and Cu/Zn ratio in carcinoma of the gallbladder. J Surg Oncol 2005;91:204-8.  Back to cited text no. 25
[PUBMED]    
26.
Gac AC, Parienti JJ, Chantepie S, Fradin S, Le Coutour X, Leclercq R, et al. Dynamics of procalcitonin and bacteremia in neutropenic adults with acute myeloid leukemia. Leuk Res 2011;35:1294-6.  Back to cited text no. 26
[PUBMED]    
27.
King JC. Zinc: An essential but elusive nutrient. Am J Clin Nutr 2011;94:679S-84.  Back to cited text no. 27
[PUBMED]  
Advanced Biomedical Research
Volume 2018, February
February 2018
Pages 1-5