Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul 18;8(29):48350-48361.
doi: 10.18632/oncotarget.16237.

High serum lactate dehydrogenase predicts an unfavorable outcome in Chinese elderly patients with multiple myeloma

Yan Gu  1   2 , Ya-Hui Yuan  1 , Ji Xu  1 , Qing-Lin Shi  1 , Xiao-Yan Qu  1 , Rui Guo  1 , Hua Bai  1 , Jia-Dai Xu  1 , Jian-Yong Li  1 , Li-Juan Chen  1
Affiliations

High serum lactate dehydrogenase predicts an unfavorable outcome in Chinese elderly patients with multiple myeloma

Yan Gu et al. Oncotarget. .

Abstract

There is significant heterogeneity among multiple myeloma (MM) patients with the survival duration varying greatly from a few months to several years. This study retrospectively analyzed serum lactate dehydrogenase (LDH) in 105 cases of newly diagnosed elderly MM patients to investigate its value for outcome prediction. Serum LDH concentrations were evaluated prior to induction therapy. Prognostic analyses were carried out based on LDH levels and patients' other clinical data. We also applied the recently proposed Revised International Staging System (R-ISS) to 70 patients with the available data. Of all the patients, elevated serum LDH levels (≥271U/L) were observed in 13.3% (14 out of 105) patients at diagnosis. Compared with normal LDH group, high LDH group had significantly shorter overall survival (OS) (15.5 vs. 52.5 months, p = 0.002) and median progression free survival (PFS) (12.0 vs. 24 months, p = 0.030), as well as 2-year OS rate (20% vs. 81%, p < 0.001) and PFS rate (22% vs. 44%, p = 0.005). A multivariate analysis identified high LDH as a unique independent adverse prognostic parameter for both OS and PFS. In addition, there were significant differences between R-ISS II and R-ISS III patients in both median OS (52.5 vs. 15.5 months, p < 0.001) and PFS (23 vs. 7.5 months, p = 0.004). Furthermore, high LDH was a unique independent adverse indicator for overall response rate (ORR) and early death in elderly MM patients. These results identified LDH as an unfavorable prediction for the outcome of Chinese elderly patients with MM. R-ISS based on LDH is superior to ISS in prognostic assessment.

Keywords: LDH; R-ISS; multiple myeloma; outcome.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. A. OS and B. PFS analyses were performed according to serum LDH levels at diagnosis in the whole cohort
Figure 2
Figure 2. A. OS and B. PFS analyses between patients at ISS II and III
Figure 3
Figure 3. A. OS and B. PFS analyses between patients at R-ISS II and III
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Palumbo A, Anderson K. Multiple myeloma. The New England journal of medicine. 2011;364:1046–1060. - PubMed
    1. Gkotzamanidou M, Kastritis E, Gavriatopoulou MRMMM, Nikitas N, Gika D, Mparmparousi D, Matsouka C, Terpos E, Dimopoulos MA. Increased serum lactate dehydrongenase should be included among the variables that define very-high-risk multiple myeloma. Clinical lymphoma myeloma and leukemia. 2011;11:409–413. - PubMed
    1. Dawson SI. Long-term risk of malignant neoplasm associated with gestational glucose intolerance. Cancer. 2004;100:149–155. - PubMed
    1. Fujiwara S, Kawano Y, Yuki H, Okuno Y, Nosaka K, Mitsuya H, Hata H. PDK1 inhibition is a novel therapeutic target in multiple myeloma. British journal of cancer. 2013;108:170–178. - PMC - PubMed
    1. Terpos E, Katodritou E, Roussou M, Pouli A, Michalis E, Delimpasi S, Parharidou A, Kartasis Z, Zomas A, Symeonidis A, Viniou NA, Anagnostopoulos N, Economopoulos T, et al. High serum lactate dehydrogenase adds prognostic value to the international myeloma staging system even in the era of novel agents. European journal of haematology. 2010;85:114–119. - PubMed