The Analysis Of84Clinical Cases Of Hematologic Malignancies Complicated With Hyperlactacidemia

Objective: To discuss the incidence, clinical characteristics, relatedfactors and treatment of malignant hematologic diseases complicated withhyperlactacidemia (HL). To study the correlations between lactate leveland mortality, pH value and mortality in patients with malignanthematologic diseases, respectively.Method: Collecting clinical data of2837patients diagnosed withmalignant hematologic diseases in the First Hospital of Jilin Universityfrom January2010to December2013.84cases complicated with HLwere analyzed for incidence, mortality, clinical characteristics and relatedfactors.Result:(1) The incidence of increased lactate was7.33%, with amortality of39.90%; the incidence of HL was2.96%, with a mortality of66.67%; the incidence of LA was1.27%, with a mortality of86.11%.(2)The incidences of HL in leukemia, lymphoma and multiple myelomawere3.68%,3.09%and0.75%, respectively. There were significantdifferences of incidences of HL among different primary diseases (P<0.01).(3) The incidence of HL was91.67%in non CR state, while in CRstate, the incidence was8.33%: there was significant difference betweenthe two states (P<0.01).(4) The incidence of associated pathological statebefore HL was96.43%, of which85.71%was infection,47.62%wasshock and44.05%was respiratory failure. The incidence of associatedpathological state before LA was94.44%, of which77.78%was infection,55.56%was shock,38.89%was failure.(5) For patients with increasedlactate, there was significant difference of mortality between different groups of lactic acid level and pH value(P<0.01); there was significantcorrelation between lactate levels and mortality, with a correlationcoefficient of0.250using Pearson test at ɑ<0.01．Conclusion:(1) Malignant hematologic disease complicated withHL and/or LA has high mortality and poor prognosis.(2) The HL and LAhave no typical symptoms and are difficult to diagnose at early stages,thus the clinicians should be alert when the HL and LA are occurred withinfection, shock or respiratory failure.(3) The incidence of malignanthematologic disease complicated with HL is associated with the type ofprimary disease and the degree of disease remission.(4) The mortality ofmalignant hematologic disease complicated with HL is correlated withlactate level and pH, which means early detection and timely treatmentare the most effective ways to reduce the mortality.