Serum Lactate Dehydrogenase in Non-Hodgkin’s Lymphoma: A Prognostic Indicator

Abstract

Non-Hodgkin's lymphoma constitutes a group of disorders originating from the malignant transformation of lymphocytes and involving either the lymph nodes or extranodal sites. NHL commonly presents in the sixth to seventh decade of life with a male preponderance (50-75 %). Recent studies have shown importance of serum LDH in prognosis of NHL. Authors report a case of a 63 year old male presenting with complaints of fever and backache for past 4 months. General and systemic examination revealed bilateral axillary lymphadenopathy and splenomegaly respectively. Serum LDH level was highly elevated (3441 U/l). Excisional axillary and bone marrow biopsy were done before oncology referral. Complete workup revealed diffuse Non-Hodgkin's lymphoma with bone marrow infiltration. Patient died because of acute renal failure due to NHL and DM 2 (Type 2 diabetes mellitus).

Cancer Antigen 125 Serum Level in Head and Neck Diffuse Large B-Cell Lymphoma

“…In patients with LNH, LDH serum levels have prognostic importance and thus can be used to monitor treatment response and recurrence. 11 The results of our study show that the IPI score 0-1 is the highest with 81% in the study subjects with normal CA-125 serum level, having a low risk with a 5-year life expectancy of 73%. These results show that based on the calculation of the IPI component score of 81% of the DLBCL study subjects are found more at the age of ≤60 years, stage 1 and 2, normal LDH levels, no extranodal locations, and ECOG-PS 0.…”

“…Lactate dehydrogenase serum activity is increased in many cancer patients and thus may serve as a prognostic marker. 11 The LDH serum is also found to be involved in tumor metabolism. The hallmark of most cancer cells is a metabolic change in which cancer cells depend on anaerobic respiration as the main energy source.…”

Non-Hodgkin Lymphoma Metabolism

“…After glucose uptake, cancer cells favor the conversion of glucosederived pyruvate to lactate. Recent reports showed that NHL patients had elevated plasma lactate and lactate dehydrogenase (LDH) levels, which were linked to poor survival rates [17][18][19]. Furthermore, inhibition of LDHA, the enzyme that catalyzes the conversion of pyruvate to lactate, has yielded positive results in tumor reduction in a MYC-transformed Burkitt lymphoma model in vivo [20,21].…”

Single Nucleotide Polymorphisms in MIR143 Contribute to Protection Against Non-Hodgkin Lymphoma (NHL) in Caucasian Populations

“…Currently, in Australia, lymphoma is the sixth most commonly diagnosed cancer (most common is breast cancer, followed by prostate, colorectal, melanoma, and lung cancer) [4]. NHL is comprised of a large group of diverse lymphoid malignancies involving either the lymph nodes or extranodal sites and it is more prevalent in males living in more developed countries over the age of 60 years [5]. The two most common NHL subtypes are diffuse large B-cell lymphoma (DLBCL), which is highly aggressive with a poor prognosis [6] and follicular lymphoma (FL), which is more indolent, but it can undergo a high-grade transformation into DLBCL [7].…”

“…Serum lactate dehydrogenase A (LDH-A), which is an enzyme converting pyruvate to lactate, is commonly elevated in aggressive NHL cases, such as DLBCL and Burkitt’s lymphoma, and it has been used as a prognostic indicator for overall survival [5]. Cancer cells are able to produce lactate in a high oxygen environment (aerobic glycolysis), causing a phenomenon of cancer metabolism, known as the Warburg effect.…”