Association between chronic agricultural pesticide exposure, oxidative stress biomarkers, and acute leukemia risk: a case-control study in southeastern Iran

Exposure to agricultural pesticides has been suggested as a potential environmental risk factor for hematological malignancies. However, evidence regarding the relationship between pesticide exposure, oxidative stress, and acute leukemia remains limited in high-exposure agricultural regions. This study aimed to investigate the association between organochlorine pesticide exposure and oxidative stress biomarkers in patients with acute leukemia in Kerman Province, Iran. In this case-control study, 72 patients diagnosed with acute leukemia and 72 healthy controls were enrolled. Serum concentrations of organochlorine pesticides were measured using gas chromatography. Oxidative stress biomarkers, including malondialdehyde (MDA) and total antioxidant capacity (TAC), as well as pesticide toxicity/exposure biomarkers, including acetylcholinesterase (AChE), and paraoxonase-1 (PON1), were evaluated. Statistical analyses were performed using independent t-tests, correlation analysis, logistic regression, and survival models. Patients with acute leukemia showed significantly higher serum levels of organochlorine pesticides compared with controls (p < 0.001). Oxidative stress markers were significantly altered in the patient group, with increased MDA levels and reduced TAC levels. In addition, AChE and PON1 activities were significantly lower among patients than controls (p < 0.001). Positive correlations were observed between pesticide exposure and oxidative stress indices. Multivariate logistic regression analysis identified pesticide exposure as an independent factor associated with hematological malignancies (OR = 3.5, 95% CI: 2.2–5.4). The findings suggest that chronic exposure to agricultural pesticides may contribute to oxidative stress imbalance and impaired detoxification capacity in patients with acute leukemia. These results highlight the importance of environmental exposure monitoring and preventive strategies in agricultural communities with high pesticide use.