The Effect of Elevated Serum Lactate Dehydrogenase Level on Survival of Newly Diagnosed Acute Myeloid Leukemia (AML) Patients

Abstract

Background: Acute myeloid leukemia (AML) is a complex clonal malignancy that is impacted by both environmental variables and  chromosomal anomalies. High tumour load and a poor prognosis are pathologically indicated by elevated white blood cell (WBC) count and lactate dehydrogenase (LDH) values.

Objective: This study aimed to assess the clinical significance and prognostic value of serum LDH levels in AML patients.

Patients and methods: At the Hematology Unit, Oncology Center, Mansoura University, we performed a retrospective analysis with 40  AML patients (19 males and 21 females) with a mean age of 44.3 ± 15.1 years. Hemoglobin was 8.5 g/dL, platelet count was 32.2 x 10⁹ /L,  and median WBC was 31.5 x 10⁹ /L. Median serum LDH was 731.5 IU/L. The eligible patients had intermediate dose Cytarabine  consolidation after receiving standard-intensity induction chemotherapy.

Results: AML patients exhibited significantly higher LDH levels  compared to healthy controls (215 IU/L; range 107- 330) (P<0.001). Higher LDH levels correlated positively with WBC count and were  notably associated with age over 60 and WBC > 50×10⁹ /L (P < 0.05). Patients whose LDH was higher than the median had an OS of two  months, which was significantly shorter (range 1-6 months) versus 6 months (range 1-9 months) for those below the median (P=0.035). Univariable and multivariable analyses confirmed elevated LDH as a poor prognostic indicator for OS (P=0.036; HR=1.007, 95% CI,  1.005-1.011).

Conclusion: High serum LDH level at diagnosis is an inexpensive, predictive marker of poor survival outcomes in patients  with recently diagnosed AML, underscoring its importance in prognostic assessments.