Prognostic significance of serum lactic dehydrogenase levels and fraction of S‐phase cells in non‐Hodgkin lymphomas

Lindh, Jack; Lenner, Per; Osterman, Birgitta; Roos, Göran

doi:10.1111/j.1600-0609.1993.tb00159.x

Cited by 11 publications

(5 citation statements)

References 18 publications

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“…A negative correlation was demonstrated between pretreatment serum LD and the probability of survival in these patients [46]. A negative correlation was demonstrated between pretreatment serum LD and the probability of survival in these patients [46].…”

Section: Oncologymentioning

confidence: 79%

8. Lactate dehydrogenase

Oladipo¹,

Dietzen²

2014

Diagnostic Enzymology

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A 66-year-old Caucasian female presented to the emergency room with a history of vomiting, diarrhea, worsening shortness of breath, and decreased oral intake. She was previously diagnosed with stage IV non-small cell lung carcinoma. She has a 20 pack-year history of cigarette smoking (1/2 a pack per day for 40 years) prior to diagnosis. On examination she had positive rhonchi bilaterally and decreased breath sounds in the right lower lobe. She had a right pleural effusion on chest X-ray. Her initial biochemical and hematology results are: serum chemistry -sodium 138 mmol/L, potassium 6.9 mmol/L, chloride 89 mmol/L, CO 2 15 mmol/L, glucose 8.1 mmol/L, blood urea nitrogen (BUN) 35.3 mmol/L, creatinine 301 μmol/L, phosphate 1.91 mmol/L, total calcium 2.2 mmol/L, albumin 26 g/L, alanine aminotransferase (ALT) 117 IU/L, alkaline phosphatase (ALP) 431 IU/L, lactate dehydrogenase (LD) 4,477 IU/L, total bilirubin 65 μmol/L, white blood cell (WBC) count 21.6 × 10 9 /L, hemoglobin 143 g/L, mean cell volume (MCV) 98.4 fL, platelets 169 × 10 9 /L, lymphocytes 5%, granulocytes 89.7%, monocytes 3.0%, basophils 1.9%, eosinophils 0.4%. DiscussionThis patient was found to have advanced carcinoma of the lungs and was admitted with a diagnosis of acute renal failure and metabolic acidosis secondary to vomiting and diarrhea. She also had pleural effusion for which she had a chest tube placed. Her liver enzymes showed that LD activity was increased to a greater degree compared with ALT and aspartate aminotransferase (AST) activities. The tumor cells were most likely the main source of LD. Some rapidly growing cancer cells depend on anaerobic glycolysis to generate ATP, even in the presence of adequate oxygen (the Warburg effect), thereby producing more lactate via LD [1]. Adenocarcinoma of the lung is strongly associated with cigarette smoking. A very high total LD, which can be as high as 20 times the upper reference limit, has been reported to be associated with poor outcome and a low survival rate [2]. Increased LD in lung carcinoma has been mainly attributed to LD 3 , LD 4 , and LD 5 isoenzymes [3,4]. In this case, LD isoenzymes were not measured. The renal function of this patient was compromised, as indicated by abnormal BUN and creatinine concentrations. In addition, leukocytosis suggests that this patient has an underlying infection. All these processes would result in tissue destruction and contribute to the circulating pool of LD. Patients who have

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Section: Oncologymentioning

confidence: 79%

8. Lactate dehydrogenase

Oladipo¹,

Dietzen²

2014

Diagnostic Enzymology

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“…The relevance of these B symptoms in patients with non-Hodgkin's lymphoma is less clear, but the symptoms tend to be related to more widespread or higher histological grade disease. Several previous large scale studies showed that hypoalbuminemia, elevation of serum β2 microglobulin (39,40) and an elevated LDH level were important prognostic factors for lymphoma with a FUO (41,42). Increased alkaline phosphatase activity can be an indirect indicator of progression and a poor prognosis of lymphoma (43).…”

Section: Discussionmentioning

confidence: 99%

Clinical Features of 66 Lymphoma Patients Presenting with a Fever of Unknown Origin

Zhang

Chen

et al. 2012

Intern. Med.

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Objective To investigate the clinical characteristics, diagnostic approaches, short-term efficacy of treatment and prognosis of lymphoma patients presenting with a fever of unknown origin (FUO). Methods We reviewed the records of 132 patients finally diagnosed with lymphoma in Huashan Hospital, half of whom initially presented with a FUO. The other 66 lymphoma patients without a history of FUO were diagnosed within a month when several patients in the FUO group were also diagnosed. Results The patients presenting with a FUO were predominantly young men (71.21%, p=0.35) characterized by a temperature ! 39 (55/66, 83.33%). Compared with the non-FUO group, patients in the FUO group more often had pancytopenia and hypohepatia, 61.54% with hypoalbuminemia (p<0.0001), 15.50% with significantly elevated lactate dehydrogenase (LDH) (p<0.0001), 92.45% with elevated serum β2 microglobulin (p=0.017), 93.48% with elevated urine β2 microglobulin (p=0.002) and 30.77% with elevated alkaline phosphatase (p=0.001). Ninety-four percent of the FUO patients had aggressive lymphomas (p=0.012), with a poor performance status (96.97%, p=0.003), stage III/IV disease (96.97%, p<0.0001), night sweats (21.21%, p=0.026), unexplained weight loss (46.97%, p=0.002) and more than one extranodal site involved (65.15%, p=0.002). The patients in the FUO group also showed poor prognoses, and most of them were in the high-intermediate or high risk classification of the disease (96.61%, p<0.0001), with a low complete remission (CR) rate (61.11% vs. 93.75%, p=0.043). Twenty-one (15.91%) of all the patients were diagnosed based on the finding of lesion sites by Positron Emission Tomography/Computed Tomography (PET/CT) scanning, which had not been detected by conventional scans. Conclusion Lymphoma presenting as FUO has a rapid progression and poor prognosis, and is difficult to diagnose. PET/CT scans can provide complementary information for an etiological diagnosis of a FUO and biopsy examinations are significant to establish an early diagnosis for patients presenting with a FUO.

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“…Neither treatment response nor the survival time was impacted by LDH levels [19]. Other studies showed that serum LDH in cases of NHL and paediatric HD is considered as an important prognostic factor [20,21]. According to [19], increased activities of LDH reflected poor treatment prognosis, and it is considered the single parameter that has an independent prognostic importance.…”

Section: Ldh and Lymphomamentioning

confidence: 99%