Evaluation Of Lactate Dehydrogenase On The Prognosis Of Multiple Myeloma

Objective A simple,repeatability,practical and inexpensive test indicators of multiple myeloma(MM)should be found and promoted in basic-level hospitals.According to the clinical database of the patients with MM,the study analyzed the correlation between LDH and other prognostic factors which were accepted widely,such as HB,PLT,ALB,ISS,CRP,and the relevency between the high level of LDH and the survival time of MM.Methods The database of petients with new diagnosis of MM who received 2 or more cycles of chemotherapy and had the evaluable effect of treatment,was collected from January 2002 to January 2016.All kinds of prognotic factors such as LDH,was recorded detailedly.Futhermore,basic characteristic,relevant index of molecular biology and follow-up results,such as death time,were included in the data.Survival curves were plotted according to the method of Kaplan–Meier and comparisons between groups were made with.Differences among different groups were compared with the Chi square test?Fisher exact probability.Survival was measured from the date of initiation of treatment until the date of patient's death or last follow-up examination.A level of P<0.05 was considered to be statistically significant for all comparisons.All P values are two-sided and confidence intervals refer to 95% boundaries.All analyses were performed using SPSS statistical software(version 19.0).The institutional upper limit of normal for LDH was 245 IU/L in my hospita;serum LDH levels were considered increased when they were ?300 IU/L to avoid false increases caused by hemolyzed samples.Results1.In the 101 patients,the male had 57 cases(56.4%),the female had 44 cases(43.6%),the ratio of gender was 1.29:1.the median age was 61 years(range 31 to 86)?Patients were divided into two groups based on LDH levels: group A included patients who presented with LDH?300 IU/L at diagnosis(11.9%,12patients),and group B included patients with LDH<300 IU/L(88.1%,89 patients).2.According to the level of PLT,all patients were devided into two groups,75 patients with PLT?100×109/L were assigned to group one,including 4 cases with LDH?300IU/L;26 patients with PLT<100×109/L group two,and 8 cases with LDH?300IU/L inside.Significant difference of the ratio was shown in two groups,P=0.002.3.According to the level of HB,all patients were devided into three groups,37 patients with HB>90g/L were assigned to group one,including 2 cases with LDH?300IU/L(2/12=16.7%);48 patients with 60<HB?90g/L group two,and 8 cases with LDH?300IU/L inside(8/12=66.6%);and 6 patients with 30<HB?60g/L group three,and 2 cases with LDH?300IU/L inside(2/12=16.7%)?P=0.045.4.According to the level of ?2-MG,all patients were devided into three groups,24 patients with ?2-MG<3.5 mg/L were assigned to group one,including 1 cases with LDH?300IU/L;39 patients with HB between 3.5mg/L and 5.5mg/L group two,and 3 cases with LDH?300IU/L inside.38 patients with HB?5.5mg/L group three,8 cases with LDH?300IU/L inside.P=0.001.5.All patients were devided into two groups based on the level of SCr,27 patients with SCr>100umol/L were assigned to group one,including 7 cases with LDH ?300IU/L;72 patients with SCr?100umol/L group two,and 5 cases with LDH?300IU/L inside.Significant difference of the ratio was shown in two groups,P=0.016.6.All patients were devided into two groups based on the level of ALB,48 patients with ALB?35g/L were assigned to group one,including 6 cases with LDH?300IU/L;53 patients with ALB<35g/L group two,and 6 cases with LDH?300IU/L inside.No significant difference of the ratio was shown in two groups,P=0.016.7.48 patients were devided into two groups based on the level of CRP,15 patients with CRP>8mg/L were assigned to group one,including 2 cases with LDH?300IU/L;33 patients with CRP?8mg/L group two,and 4 cases with LDH?300IU/L inside.No significant difference of the ratio was shown in two groups,P=1.8.According to ISS,17 cases in the ISS-1 which had no case in the group of LDH?300IU/L,41 cases in the ISS-2 which had 4 cases in the group of LDH?300IU/L,43 cases in the ISS-3 which has 8 cases in the group of LDH?300IU/L,P=0.047.9.According to the criteria of IMWG,12 cases achieved a CR(complete remission),including 1 case in the group of LDH?300IU/L(1/12=8.3%);26 cases achieved a VGPR(very good partial remission),including 2 cases in the group of LDH?300IU/L(2/12=16.7%);44 cases achieved a PR(partial remission),including 4 cases in the group of LDH?300IU/L(4/12=33.3%);5 cases achieved a SD(stable disease),including 1 cases in the group of LDH?300IU/L(1/12=8.3%);14 cases achieved a PD(progressive disease),including 4 cases in the group of LDH?300IU/L(4/12=33.3%),.P=0.394.10.The median OS of patients who had LDH?300IU/L levels was 12 months versus 47 months for patients with LDH<300 IU/L levels,P=0.000.Survival curves were plotted according to the method of Kaplan–Meier showed that patients with LDH?300IU/L had shorter OS.Conclusions1.Increased serum LDH levels was related with platelet?HB??2 microglobulin?ISS.Furthermore,LDH levels could be used to predict the severity of MM.2?Increased serum LDH levels was related with shorter OS.Combining with the ISS,chromosome,etc,LDH levels could be used as a prognostic marker.