OBJECTIVE: To evaluate serum lactate dehydrogenase (LDH) as a prognostic factor in previously untreated patients with multiple myeloma. DESIGN: Study of 391 consecutive patients with uniformly treated multiple myeloma, followed until death in 63% of patients. SETTING: Tertiary, referral cancer center. PATIENTS: A total of 391 consecutive, previously untreated, symptomatic patients with various stages of multiple myeloma. INTERVENTION: Various chemotherapy regimens that included doxorubicin or glucocorticoids, or both, with a consistent response rate (53%). MEASUREMENTS: Outcomes included clinical response based on a 75% reduction of calculated tumor load and survival time from treatment. Univariate and multivariate analyses were used. MAIN RESULTS: Eleven percent of patients showed a high serum LDH level of more than 5.0 mukat/L (300 U/L). An elevated LDH level was seen more frequently with a rise in the tumor load; an increased level was present in 26% of patients with high tumor mass. A high LDH level was associated with plasma cell leukemia or lymphoma-like clinical features (43%) and with plasma cell hypodiploidy (17%). Only 20% of patients with elevated LDH levels responded to chemotherapy compared with a response rate of 57% for patients with low levels of LDH. Using multivariate analysis, LDH was a significant independent predictor of response (P = 0.001), with an odds ratio of 0.25 (95% Cl, 0.11 to 0.57). A high LDH level was associated with a short median survival (9 months) and showed the highest relative risk (2.63; Cl, 1.75 to 3.95; P = 0.001). CONCLUSIONS: Elevation of the LDH level suggests the presence of occult extraosseous disease and high tumor mass. The LDH level is a predictor of a poor prognosis in selected patients who should be considered for early intensive treatment.
OBJECTIVE: To evaluate serum lactate dehydrogenase (LDH) as a prognostic factor in previously untreated patients with multiple myeloma. DESIGN: Study of 391 consecutive patients with uniformly treated multiple myeloma, followed until death in 63% of patients. SETTING: Tertiary, referral cancer center. PATIENTS: A total of 391 consecutive, previously untreated, symptomatic patients with various stages of multiple myeloma. INTERVENTION: Various chemotherapy regimens that included doxorubicin or glucocorticoids, or both, with a consistent response rate (53%). MEASUREMENTS: Outcomes included clinical response based on a 75% reduction of calculated tumor load and survival time from treatment. Univariate and multivariate analyses were used. MAIN RESULTS: Eleven percent of patients showed a high serum LDH level of more than 5.0 mukat/L (300 U/L). An elevated LDH level was seen more frequently with a rise in the tumor load; an increased level was present in 26% of patients with high tumor mass. A high LDH level was associated with plasma cell leukemia or lymphoma-like clinical features (43%) and with plasma cell hypodiploidy (17%). Only 20% of patients with elevated LDH levels responded to chemotherapy compared with a response rate of 57% for patients with low levels of LDH. Using multivariate analysis, LDH was a significant independent predictor of response (P = 0.001), with an odds ratio of 0.25 (95% Cl, 0.11 to 0.57). A high LDH level was associated with a short median survival (9 months) and showed the highest relative risk (2.63; Cl, 1.75 to 3.95; P = 0.001). CONCLUSIONS: Elevation of the LDH level suggests the presence of occult extraosseous disease and high tumor mass. The LDH level is a predictor of a poor prognosis in selected patients who should be considered for early intensive treatment.
Authors: Li-Pin Kao; Samy A F Morad; Traci S Davis; Matthew R MacDougall; Miki Kassai; Noha Abdelmageed; Todd E Fox; Mark Kester; Thomas P Loughran; Jose' L Abad; Gemma Fabrias; Su-Fern Tan; David J Feith; David F Claxton; Sarah Spiegel; Kelsey H Fisher-Wellman; Myles C Cabot Journal: J Lipid Res Date: 2019-07-30 Impact factor: 5.922
Authors: Emma C Scott; Parameswaran Hari; Sathish Kumar; Raphael Fraser; Omar Davila; Nina Shah; Robert Peter Gale; Miguel Angel Diaz; Vaibhav Agrawal; Robert F Cornell; Siddhartha Ganguly; Gorgun Akpek; Cesar Freytes; Shahrukh Hashmi; Ehsan Malek; Rammurti T Kamble; Hillard Lazarus; Melhem Solh; Saad Z Usmani; Abraham S Kanate; Ayman Saad; Saurabh Chhabra; Usama Gergis; Jan Cerny; Robert A Kyle; Cindy Lee; Tamila Kindwall-Keller; Amer Assal; Gerhard C Hildebrandt; Leona Holmberg; Richard T Maziarz; Taiga Nishihori; Sachiko Seo; Shaji Kumar; Tomer Mark; Anita D'Souza Journal: Biol Blood Marrow Transplant Date: 2018-08-22 Impact factor: 5.742
Authors: C Fernández de Larrea; R A Kyle; B G M Durie; H Ludwig; S Usmani; D H Vesole; R Hajek; J F San Miguel; O Sezer; P Sonneveld; S K Kumar; A Mahindra; R Comenzo; A Palumbo; A Mazumber; K C Anderson; P G Richardson; A Z Badros; J Caers; M Cavo; X LeLeu; M A Dimopoulos; C S Chim; R Schots; A Noeul; D Fantl; U-H Mellqvist; O Landgren; A Chanan-Khan; P Moreau; R Fonseca; G Merlini; J J Lahuerta; J Bladé; R Z Orlowski; J J Shah Journal: Leukemia Date: 2012-11-21 Impact factor: 11.528
Authors: Ying-Hua Wang; William J Israelsen; Dongjun Lee; Vionnie W C Yu; Nathaniel T Jeanson; Clary B Clish; Lewis C Cantley; Matthew G Vander Heiden; David T Scadden Journal: Cell Date: 2014-09-11 Impact factor: 41.582