Pre-and Post-Transplant Serum Lactate Dehydrogenase Levels as a Predictive Marker for Patient Survival and Engraftment in Allogeneic Hematopoietic Stem Cell Transplant Recipients

Abstract

Background:The discovery of biomarkers to predict the development of complications associated with hematopoietic stem cell transplantation (HSCT) offers a potential avenue for the early identification and treatment of these life-threatening consequences. Serum lactate dehydrogenase (sLDH) has been identified as a potential biomarker for determining the outcome of allogenic HSCT (allo-HSCT). Methods: A retrospective study was performed using data collected from 204 allo-HSCT recipient patients to examine the predictive value of sLDH levels pre-and post-allo-HSCT on patient survival, graft-versushost-disease (GVHD) incidence, and time to platelet/white blood cells (WBC) engraftment. Results: Our findings show that neither pre-(p= 0.61) nor post-transplantation (p= 0.55) sLDH levels were associated with GVHD incidence. However, elevated sLDH levels pre-and post-transplantation (≥ 386 and ≥ 409 IU/mL, respectively) were found to be adverse risk factors for patient survival (p= 0.16, p= 0.20, respectively). Furthermore, a median sLDH level≥ 400 IU/mL from day +5 to day +15 post-transplantation had a significant positive association with enhanced time to platelet and white blood cell (WBC) engraftment, compared to patients with sLDH levels < 400 IU/mL (p< 0.001). Conclusions: Our data suggests that high sLDH levels pre-and post-allo-HSCT could be considered a predictor of poor patient survival. Furthermore, high levels of sLDH days 5-15 post-allo-HSCT could be associated with improved time to platelet and WBC engraftment; however, this appears to come at the cost of increased mortality risk.

Lactylation: a Passing Fad or the Future of Posttranslational Modification

“…Lactate and histone lactylation significantly improve the survival, self-renewal, and reprogramming capacity of stem cells. High serum lactate dehydrogenase activating lactate to pyruvic acid, could be considered a predictor of poor patient survival in pre-and post-allogeneic hematopoietic stem cell transplantation [ 46 ]. Moreover, increasing evidence indicates that hypoxic preconditioning improves the survival of stem cells [ 47 , 48 ].…”