The Correlation Analysis Of Serum Lactate Dehydrogenase And Clinical Features And Prognosis In Patients With Multiple Myeloma

ObjectiveAn retrospective analysis of serum lactate dehydrogenase?LDH?levels in 128newly diagnosed multiple myeloma?MM?patients at the First Affiliated Hospital of Jinan University was performed to investigate the relationship between serum lactate dehydrogenase?LDH?levels and clinical features and prognosis,and to investigate the specific threshold value of serum LDH associated with the prognosis of multiple myeloma.MethodsThe clinical data of 128 patients with newly diagnosed MM were collected and the clinical data of the serum LDH were calculated.The threshold value of serum LDH was set at 300 U/L and divided into two groups:low serum LDH<300U/L group and high serum LDH?300U/L group,The clinical features and prognosis of MM patients in different serum LDH groups were analyzed.ResultsThere were 24 cases?18.75%?of MM patients with high serum LDH?300U/L,and 104 cases?81.25%?of MM patients with low serum LDH<300U/L.There was no significant difference in gender?age?serum calcium and immunoglobulin typing between the low serum LDH group and the high serum LDH group?p values were>0.05?.The baselinelevels ofthetwo groups werestable and comparable.Compared with low serum LDH group,high serum LDH group had significantly shorter median overall survival?OS??14.1 vs.40.7 months,p=0.000?and median progress free survival?PFS??7.5vs.24.6months,p=0.001?,as well as2-yearOSrate?21.6%vs.74.7%,p=0.000?and2-yearPFSrate?14.2%vs.51.1%,p=0.001?and ORR?50.0%vs.70.1%,p=0.004?.Compared with serum LDH<300U/L group,Elevated serum LDH to?300 U/L group was associated with International Staging System?ISS?stage III?p=0.009?,Durie-Salmon?DS?stage III?p=0.006?,higher level of?₂-microglobulin?p=0.020?,higher creatinine?p=0.008?,higher Plasma cells in bone marrow?p=0.028?,lower blood platelet count?p=0.001?and lower albumin level?p=0.043?.High serum LDH group was associated with worse median OS with in D-S stage:15.8 vs.49.1 months for high and low serum LDH groups in DS-I/II?p=0.003?,11.2 vs.40.1months in DS-III?p=0.001?respectively.High serum LDH group was correlated with inferior median PFS with in D-S stage:7.8 vs.24.7 months for high and low serum LDH groups in DS-I/II?p=0.042?,5.7vs.24.6 months in DS-III?p=0.008?respectively.Increased LDH was also associated with worse median OS with in ISS stage:14.5 vs.41.8months for high and low LDH serum groups in ISS-I/II?p=0.017?,11.2 vs.34.6months in ISS-III?p=0.001?respectively.Increased LDH was correlated with inferior median PFS with in ISS stage:9.8vs.26.9 months for high and low serum LDH groups in ISS-I/II?p=0.037?,5.6vs.24.6 months in ISS-III?p=0.002?respectively.When MM patients are in disease progression,the levels of serum LDH was raised obviously,the difference was statistically significant?p<0.05?,The Univariate analysis showed that elevated LDH,sex and lower platelet counts had an independent prognostic value for OS?p<0.05for all parameters?,howover the serum LDH was risk factors adversely impacting of PFS;the Multivariate analysis showed that elevated LDH was the inferior factor impacting both OS?p=0.000?and PFS?p=0.003?.ConclusionSerum LDH levels could be used as an indicator of MM risk stratification and prognosis,Serum LDH?300 U/L indicated poor prognosis of MM.Although serum LDH was easily affected by other factors,it could be used as an important indicator to judge the disease progression and prognosis of MM patients because of its simple and rapid detection.In the above applications,serum LDH should be combined with other risk indicators of MM analysis.