Prognostic value of lactate dehydrogenase activity in myelodysplastic syndromes.
Several prognostic factors for patients with myelodysplastic syndromes (MDS) have been defined in the past. One of these factors appears to be the serum lactate dehydrogenase (LDH) activity. However, the precise predictive value of an elevated LDH level with regard to AML transformation remains uncertain. In this study, the prognostic value of the LDH activity was examined in a cohort of 180 patients with de novo MDS (median age 71 years [27-93]; f/m-ratio 1:1.2; RA: n=53; RARS: n=37; RAEB: n=50; RAEBT: n=19; CMML: n=21). Significant differences in LDH activities were found among FAB groups (P<0.05), and especially among IPSS groups (HIGH: 411+/-574; INT-2: 221+/-90; INT-1: 254+/-145; LOW: 192+/-47 U/l; P<0.05). An LDH level of >/=300 U/l was found to be associated with a significantly shorter median survival (10.3 months) when compared to <300 U/l (33.7 months; P<0.01). Moreover, an LDH activity of >/=300 U/l indicated a reduced AML-free survival in our MDS patients (P<0.01). As assessed by Cox regression, the inclusion of LDH as additional variable into the IPSS system resulted in an improved prediction concerning survival, but not with regard to AML evolution. Together, our data show that a serum LDH activity of >/=300 U/l in MDS is associated with a significantly shorter survival and higher risk to transform to AML. The LDH activity should be considered as an important prognostic factor in MDS.
Department of Internal Medicine I, Division of Hematology and Hemostaseology, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria
F
F
Wimazal
W R
WR
Sperr
M
M
Kundi
P
P
Meidlinger
C
C
Fonatsch
J H
JH
Jordan
R
R
Thalhammer-Scherrer
I
I
Schwarzinger
K
K
Geissler
K
K
Lechner
P
P
Valent
D000206:Actuarial Analysis; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002471:Cell Transformation, Neoplastic / Q000378:metabolism; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D007951:Leukemia, Myeloid / Q000175:diagnosis / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000145:classification / Q000175:diagnosis / Q000201:enzymology*; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate
D007770:L-Lactate Dehydrogenase