Serum selenium (Se) levels were measured before, during and after high-dose induction chemotherapy in 70 patients with acute non-lymphocytic leukemia (ANLL). Pre-treatment serum Se levels were lower in patients than in controls (0.082 +/- 0.033 micrograms/ml versus 0.097 +/- 0.035 micrograms/ml, P less than 0.01). Pretreatment serum Se correlated inversely with the absolute peripheral blast cell count (R = -0.62, P less than 0.001) and other measurements of the tumor burden. Seven days after the initiation of chemotherapy, serum Se increased significantly in proportion to the initial tumor burden (P less than 0.01). Thereafter, serum Se levels remained essentially normal in patients entering a complete remission while decreasing gradually in failures. In conclusion, these data do not lend support to the hypothesis that a low selenium status enhances the risk of developing ANLL, but indicate that serum Se levels in patients with acute leukemia are mostly dependent on tumor activity.