title: Rising serum lactate dehydrogenase often caused by granulocyte-or Granulocyte-macrophage colony stimulating factor and not tumor progression in patients with lymphoma or myeloma.
abstract: Since rising serum lactate dehydrogenase (LDH) heralds progression in patients with lymphoma or myeloma we investigated the significance of its elevations during chemotherapy supported by granulocyte (G-) or Granulocyte-Macrophage (GM-) colony stimulating factors (CSF). To Exclude effects of resistant disease we analyzed 52 courses of therapy in 36 responding patients. During hematologic recovery LDH increased above normal in 53% and 85% of patients with leukocyte counts of 10,000/microL and 15,000/microL, respectively. After CSF discontinuation LDH fell to or towards normal during 20 courses with adequate follow-up. Therefore rising serum LDH in patients with lymphoma or myeloma may be caused the CSF administration during chemotherapy and not by progressive disease. Proper identification of this effect can prevent unnecessary tests or treatment delays.
authors.affiliation: Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: A H
authors.initials: AH
authors.lastname: Sarris
authors.forename: A
authors.initials: A
authors.lastname: Majlis
authors.forename: M A
authors.initials: MA
authors.lastname: Dimopoulos
authors.forename: A
authors.initials: A
authors.lastname: Younes
authors.forename: F
authors.initials: F
authors.lastname: Swann
authors.forename: M A
authors.initials: MA
authors.lastname: Rodriguez
authors.forename: P
authors.initials: P
authors.lastname: McLaughlin
authors.forename: F
authors.initials: F
authors.lastname: Cabanillas
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000494:pharmacology*; D006689:Hodgkin Disease / Q000188:drug therapy / Q000201:enzymology*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D007958:Leukocyte Count; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000201:enzymology*; D012074:Remission Induction; D013997:Time Factors
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D007770:L-Lactate Dehydrogenase