Overall survival of cancer patients with serum lactate dehydrogenase greater than 1000 IU/L

Abstract

High level of serum lactate dehydrogenase (LDH) is a well-known poor prognostic factor in patients with malignancies. However, there was no data on overall survival (OS) in cancer patients with serum LDH level > 1000 IU/L, and the prognostic value of the changes in LDH over time for OS had not been reported. Clinical data of 311 cancer patients with metastatic disease with serum LDH >1000 IU/L (four times upper limit of normal) admitted consecutively to a single center were reviewed in this retrospective study. LDH level ranged from 1002 to 8235 U/L with a mean of 1689 U/L. The median OS was 1.7 months (95 % CI: 1.4–2.0). About half of patients (n = 163, 52 %) died within 2 months with the median OS of 0.5 months (95 % CI: 0.3–0.7). Only 173 patients were indicated for salvage treatment. Fifty-one patients’ serum LDH level decreased to normal at 2 months following chemotherapy; OS was significantly longer in these patients (22.6 months, 95 % CI: 10.9–34.3, p < 0.001) compared to those with persistently abnormal serum LDH at 2 months (4.0 months, 95 % CI: 3.4–4.6). The independent factors that increased the death risk were ECOG performance status 3–4 (HR: 2.05, 95 % CI: 1.42–2.97, p < 0.001), supportive care only (HR: 2.91, 95 % CI: 2.06–4.10, p < 0.001), and persistently abnormal serum LDH at 2 months (HR: 2.72, 95 % CI: 1.67–4.42, p < 0.001). In conclusion, serum LDH level > 1000 IU/L predicted a terminal stage in metastatic cancer patients. OS was significantly prolonged in patients indicated for effective palliative treatment and LDH level decreased to normal at 2 months.

Lactic Acid Downregulates Viral MicroRNA To Promote Epstein-Barr Virus-Immortalized B Lymphoblastic Cell Adhesion and Growth

“…Thus, miR-BHRF1-1 may contribute to cell adhesion, proliferation, and motility of EBV-infected B cells in response to LA. Consistent with previous observations in many cancers (9,24,25), LDH was elevated in B cells by EBV infection and in EBV-positive B-cell lymphoma cells. However, previous studies suggest that EBV encodes LMP1 to upregulate anaerobic glycolysis (20,21) and c-myc induces LDH-A expression (26), but whether EBV upregulates c-Myc to induce LDH-A expression or is directly induced by LMP1 is not clear.…”

“…LDH catalysis is a rapid and near-equilibrium reaction that relies heavily on local lactate gradients (8). Increased LDH and production of lactate are considered aspects of poor prognosis for several malignancies, including solid tumors (9,10), but whether and how oncogenic viruses exploit this metabolic program to induce cancer development and respond to an acidic microenvironment is not clear.…”

The Cytoreductive Effect of Radiotherapy for Small Cell Ovarian Carcinoma of the Pulmonary Type: A Case Report and Review of the Literature

“…Although LDH has five isoforms with different distributions, it was not necessary to detect these isoforms separately because no specific isoform was characteristically increased. This is useful, because total serum LDH assessment is convenient and inexpensive [27]. Serum LDH can be a useful tumor marker to evaluate the effectiveness of the treatment and to assess the prognosis.…”

Serum Hyaluronic Acid Levels Are Altered in Acute Leukemia Patients: Potential Prognostic Implications

“…It is a well-known poor prognostic factor in patients with malignancies [42]. The positive correlation between serum LDH and serum HA implies a relationship between HA metabolism and the activity of the malignant process, although it is difficult to determine the mechanism behind the elevated serum HA concentrations in patients with AML, B-ALL, and MCL.…”