title: Increased serum lactate dehydrongenase should be included among the variables that define very-high-risk multiple myeloma.
abstract: BACKGROUND
  In patients who have symptomatic multiple myeloma (MM), a high serum lactate dehydrogenase (LDH) level is associated with features of advanced disease, adds prognostic value to the international staging system (ISS) and predicts for inferior survival. However, it has not been clearly defined what the impact of this abnormality is for patients treated upfront with novel agent-based regimens.
  
  
  METHODS
  To address this issue we analyzed 203 consecutive unselected patients with symptomatic MM who received upfront treatment with novel agents in a single center.
  
  
  RESULTS
  The median overall survival for patients with normal LDH was 54 months but in patients with increased LDH levels it was 21 months (P = .003), whereas increased serum LDH was associated with a higher probability of early death. Multivariate analysis confirmed that an increased LDH level is independently associated with poor survival. Furthermore, increased LDH levels could identify subgroups of patients within ISS-2 and ISS-3 with even worse outcome.
  
  
  CONCLUSIONS
  We conclude that serum LDH is a simple, inexpensive, and readily available blood test that may be included among the variables that define very-high-risk MM.
authors: Department of Clinical and Therapeutics, Alexandra Hospital, School of Medicine, University of Athens, Greece.
authors: Maria
authors: M
authors: Gkotzamanidou
authors: Efstathios
authors: E
authors: Kastritis
authors: Maria Roussou Magdalini Migkou Maria
authors: MR
authors: Gavriatopoulou
authors: Nikitas
authors: N
authors: Nikitas
authors: Dimitra
authors: D
authors: Gika
authors: Despina
authors: D
authors: Mparmparousi
authors: Charis
authors: C
authors: Matsouka
authors: Evangelos
authors: E
authors: Terpos
authors: Meletios A
authors: MA
authors: Dimopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D007770:L-Lactate Dehydrogenase