Clinical significance on the dynamic monitoring of serum lactate dehydrogenase levels in acute leukemia

doi:10.3969/j.issn.1673-8640.2014.06.011

Abstract

Abstract: Objective To monitor dynamically serum lactate dehydrogenase (LDH) levels in acute leukemia (AL) patients,and to investigate the clinical significance on the monitoring of pathogenetic condition and prognosis evaluation. Methods The LDH levels of 2 170 times from 1 184 de novo AL patients were analyzed retrospectively. The relationship of LDH levels with disease progression and AL prognosis was evaluated.The relationships between LDH levels and blood cell counts,the proportion of bone marrow leukemia cells,cytogenetic abnormality, flow cytometry immunophenotyping and the other related diagnostic markers were analyzed. Results LDH levels of AL patients in different stages of the disease were different. The LDH levels of incipient and relapse stages in AL patients were significantly higher than those of remission stage in AL patients and those in healthy controls (P<0.05). The LDH levels of remission stage in AL patients reduced, but were still significantly higher than those in healthy controls (P<0.05). The LDH levels of acute lymphoblastic leukemia (ALL) patients were significantly higher than those of acute myeloid leukemia (AML) patients (P<0.05). Compared with the other diagnostic and prognostic indicators of AL, LDH levels had correlation with the proportion of bone marrow leukemia cells,cytogenetic abnormality and flow cytometry immunophenotyping (P<0.05). Conclusions The serum LDH levels of AL patients in different stages and different subtypes are different significantly. The LDH levels can be used as a supplementary indicator of AL diagnosis, disease progression and therapeutic effect evaluation.

Key words: Lactate dehydrogenase, Acute leukemia, Diagnosis, Disease progression, Therapeutic effect evaluation

CLC Number:

Q554

LIU Hua, ZHENG Qin, ZENG Tingting, YE Yuanxin, LI Guixing, SU Jun. Clinical significance on the dynamic monitoring of serum lactate dehydrogenase levels in acute leukemia[J]. , 2014, 29(6): 622-626.

References

[1] Estey E,Dhner H. Acute myeloid leukaemia[J] . Lancet,2006,368(9550): 1894-1907.
[2] Chen CY,Cheng A,Huang SY,et al. Clinical and microbiological characteristics of perianal infections in adult patients with acute leukemia[J] . PLoS One,2013,8(4):e60624.
[3] Shima T,Miyamoto T,Kikushige Y,et al. Quantitation of hematogones at the time of engraftment is a useful prognostic indicator in allogeneic hematopoietic stem cell transplantation[J] . Blood,2013,121(5):840-848.
[4] Teng CL,Young JH,Hsu SL,et al. Lactate dehydrogenase, not vascular endothelial growth factor or basic fibroblast growth factor,positively correlates to bone marrow vascularity in acute myeloid leukemia[J] . J Clin Med Assoc,2006,69(11):534-537.
[5] Wimazal F, Sperr WR, Kundi M, et al. Prognostic value of lactate dehydrogenase activity in myelodysplastic syndromes[J] . Leuk Res, 2001,25(4):287-294.
[6] Satoh Y,Matsumura I,Tanaka H,et al. C-terminal mutation of RUNX1 attenuates the DNA-damage repair response in hematopoietic stem cells[J] . Leukemia,2012,26(2):303-311.
[7] Chou FS,Griesinger A,Wunderlich M,et al. The thrombopoietin/MPL/Bcl-xL pathway is essential for survival and self-renewal in human preleukemia induced by AML1-ETO[J] . Blood,2012,120(4):709-719.
[8] Renneville A,Boissel N,Nibourel O,et al. Prognostic significance of DNA methyltransferase 3A mutations in cytogenetically normal acute myeloid leukemia: a study by the Acute Leukemia French Association[J] . Leukemia,2012,26(6):1247-1254.
[9] Urayama KY,Chokkalingam AP,Manabe A,et al. Current evidence for an inherited genetic basis of childhood acute lymphoblastic leukemia[J] . Int J Hematol,2013,97(1):3-19.
[10] McBride A,Westervelt P. Recognizing and managing the expanded risk of tumor lysis syndrome in hematologic and solid malignancies[J] . J Hematol Oncol,2012,5:75.
[11] Yi JH,Kim JH,Baek KK,et al. Elevated LDH and paranasal sinus involvement are risk factors for central nervous system involvement in patients with peripheral T-cell lymphoma[J] . Ann Oncol,2011, 22(7):1636-1643.
[12] Martínez-Laperche C,Gómez-García AM,Lassaletta , et al. Detection of occult cerebrospinal fluid involvement during maintenance therapy identifies a group of children with acute lymphoblastic leukemia at high risk for relapse[J] . Am J Hematol, 2013,88(5):359-364.
[13] Portell CA,Sweetenham JW. Adult lymphoblastic lymphoma[J] . Cancer J,2012,18(5):432-438.
[14] Alves GV,Fernandes AL,Freire JM,et al. Flow cytometry immunophenotyping evaluation in acute lymphoblastic leukemia: correlation to factors affecting clinic outcome[J] . J Clin Lab Anal,2012,26(6):431-440.
[15] Chen SW,Li CF,Chuang SS,et al. Aberrant co-expression of CD19 and CD56 as surrogate markers of acute myeloid leukemias with t(8;21) in Taiwan[J] . Int J Lab Hematol,2008,30(2):133-138.
[16] Abdelhaleem M. Frequent but nonrandom expression of lymphoid markers on de novo childhood acute myeloid leukemia[J] . Exp Mol Pathol,2007,83(2):259-263.
[17] Estey EH. Acute myeloid leukemia: 2013 update on risk-stratification and management[J] . Am J Hematol,2013,88(4):318-327.
[18] 包书萌,李永哲. 急性白血病预后不良相关基因研究进展[J] . 国际检验医学志,2008,29(9):819-820.
[19] Gmidène A,Sennana H,Wahchi I,et al. Cytogenetic profile of a large cohort of Tunisian de novo acute myeloid leukemia[J] . Hematology,2012,17(1):9-14.
[20] Yan J,Wang K,Dong L,et al. PML/RARalpha fusion protein transactivates the tissue factor promoter through a GAGC-containing element without direct DNA association[J] . Proc Natl Acad Sci USA,2010,107(8):3716-3721.
[21] Martinelli G,Rondoni M,Buonamici S,et al. Molecular monitoring to identify a threshold of CBFbeta/MYH11 transcript below which continuous complete remission of acute myeloid leukemia inv16 is likely[J] . Haematologica,2004,89(4):495-497.
[22] De Braekeleer E,Douet-Guilbert N,Rowe D,et al. ABL1 fusion genes in hematological malignancies: a review[J] . Eur J Haematol,2011,86(5):361-371.
[23] Holmlund T,Lindberg MJ,Grander D,et al. GCN5 acetylates and regulates the stability of the oncoprotein E2A-PBX1 in acute lymphoblastic leukemia[J] . Leukemia,2013,27(3):578-585.
[24] Tamai H,Miyake K,Yamaguchi H,et al. Resistance of MLL-AFF1-positive acute lymphoblastic leukemia to tumor necrosis factor-alpha is mediated by S100A6 upregulation[J] . Blood Cancer J,2011,1(11):e38.
[25] 张延清,戴海滨,王京华,等. 连续动态观察乳酸脱氢酶对MDS预后判定的意义[J] .中国实验血液学杂志,2011,19( 1):85-89.
[26] 高绍华. 血清LDH、HBDH水平与急性白血病患者临床转归的关系[J] .武警医学院学报,2009,15(4):341-342.