BACKGROUND: Early recognition of disease progression in low-risk myelodysplastic syndromes (MDS) is an important decision point concerning intensive therapies. In a screen program searching for dynamic prognostic determinants, we have identified lactate dehydrogenase (LDH) as a most suitable follow-up parameter. PATIENTS AND METHODS: LDH levels were serially determined in 221 patients with de novo MDS (median age 70 years, range 24-94). The increase in LDH was correlated with survival and acute myeloid leukemia (AML) evolution. RESULTS: Confirming previous data, an elevated LDH at diagnosis was found to be associated with an increased probability of AML evolution and decreased probability of survival (P < 0.05). In the follow-up, we found that in patients who progressed (to higher IPSS category or AML), LDH levels were significantly higher in the two 3-month period preceding progression compared with the initial two 3-month period (P < 0.005). In a subgroup of patients, the increase in LDH was accompanied or followed by other signs of disease progression, such as occurrence of thrombocytopenia or appearance of circulating blasts. In multivariate analyses, the LDH increase was found to be an independent prognostic variable. CONCLUSIONS: LDH is an interesting follow-up parameter in MDS, which may assist in early recognition of disease progression and thus help in risk stratification and patient selection for interventional therapies.
BACKGROUND: Early recognition of disease progression in low-risk myelodysplastic syndromes (MDS) is an important decision point concerning intensive therapies. In a screen program searching for dynamic prognostic determinants, we have identified lactate dehydrogenase (LDH) as a most suitable follow-up parameter. PATIENTS AND METHODS: LDH levels were serially determined in 221 patients with de novo MDS (median age 70 years, range 24-94). The increase in LDH was correlated with survival and acute myeloid leukemia (AML) evolution. RESULTS: Confirming previous data, an elevated LDH at diagnosis was found to be associated with an increased probability of AML evolution and decreased probability of survival (P < 0.05). In the follow-up, we found that in patients who progressed (to higher IPSS category or AML), LDH levels were significantly higher in the two 3-month period preceding progression compared with the initial two 3-month period (P < 0.005). In a subgroup of patients, the increase in LDH was accompanied or followed by other signs of disease progression, such as occurrence of thrombocytopenia or appearance of circulating blasts. In multivariate analyses, the LDH increase was found to be an independent prognostic variable. CONCLUSIONS: LDH is an interesting follow-up parameter in MDS, which may assist in early recognition of disease progression and thus help in risk stratification and patient selection for interventional therapies.
Authors: Asmita Mishra; Dana E Rollison; Thomas H Brandon; Najla H Al Ali; Maria Corrales-Yepez; Eric Padron; Pearlie K Epling-Burnette; Jeffrey E Lancet; Alan F List; Rami S Komrokji Journal: Leuk Res Date: 2015-04-07 Impact factor: 3.156
Authors: Peter L Greenberg; Heinz Tuechler; Julie Schanz; Guillermo Sanz; Guillermo Garcia-Manero; Francesc Solé; John M Bennett; David Bowen; Pierre Fenaux; Francois Dreyfus; Hagop Kantarjian; Andrea Kuendgen; Alessandro Levis; Luca Malcovati; Mario Cazzola; Jaroslav Cermak; Christa Fonatsch; Michelle M Le Beau; Marilyn L Slovak; Otto Krieger; Michael Luebbert; Jaroslaw Maciejewski; Silvia M M Magalhaes; Yasushi Miyazaki; Michael Pfeilstöcker; Mikkael Sekeres; Wolfgang R Sperr; Reinhard Stauder; Sudhir Tauro; Peter Valent; Teresa Vallespi; Arjan A van de Loosdrecht; Ulrich Germing; Detlef Haase Journal: Blood Date: 2012-06-27 Impact factor: 22.113
Authors: Tarif H Sallam; Manal A Shams Eldin El Telbany; Hanan M Mahmoud; Mutea A Iskander Journal: Turk J Haematol Date: 2013-09-05 Impact factor: 1.831