Serum LDH value as a predictor of clinical outcome in acute myelogenous leukaemia of the elderly

Abstract

72 patients aged over 60 suffering from acute myelogenous leukaemia (AML) and treated with aggressive chemotherapy were analysed with the aim of finding factors of prognostic relevance. With regard to complete remission achievement, the only variable of statistical significance found was the karyotype at diagnosis. As far as overall survival, in multivariate analysis performed by Cox hazard regression model unfavourable karyotype and serum lactic dehydrogenase (LDH) >400 IU/I were significantly related to an adverse clinical outcome. Finally, serum LDH was the only parameter to significantly influence disease-free survival. We conclude that serum LDH is a main prognostic factor in AML of the elderly and a potentially useful tool for identifying subsets of patients who may obtain a substantial advantage from aggressive chemotherapy.

Early blast clearance by remission induction therapy is a major independent prognostic factor for both achievement of complete remission and long-term outcome in acute myeloid leukemia: data from the German AML Cooperative Group (AMLCG) 1992 Trial

“…[40][41][42][43][44] These associations have been confirmed in some multivariate analyses. [45][46][47][48] In contrast, there are only a few studies addressing issues similar to those in the present analysis. The rapidity of achievement of CR has been identified to influence the patients' outcome in 2 studies.…”

Treatment, long-term outcome and prognostic variables in 214 unselected AML patients in Sweden

“…Among routinely measured laboratory variables, leucocyte count (Dutcher et al, 1987;Fenaux et al, 1989), LDH (Büchner and Heinecke, 1996;Ferrara and Mirto, 1996) and kidney function tests (Estey et al, 1989;Johnson et al, 1993Johnson et al, , 1995 have repeatedly been assigned prognostic value. Of such variables, LDH and creatinine appeared somewhat stronger than the leucocyte count in the Treatment and outcome of unselected AML 1391 present study, reaching independent significance for survival.…”

Acute Myeloid Leukemia, Version 3.2017, NCCN Clinical Practice Guidelines in Oncology

“…In the CALGB 10603/RATIFY Alliance trial, patients aged 18 to 60 years (n=717) with newly diagnosed FLT3-positive AML (internal tandem duplication [ITD] or tyrosine kinase domain [TKD]) were randomized to receive standard cytarabine therapy (200 mg/m 2 daily for 7 days via continuous infusion) and daunorubicin (60 mg/m 2 on days 1-3) with placebo or midostaurin (50 mg, twice daily on days [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. 28 If residual disease in the bone marrow was observed on day 21, patients were treated with a second blinded course.…”

“…Laboratory evaluations include blood chemistry and a CBC including platelets and a differential of white blood cells (WBCs); serum uric acid and lactate dehydrogenase have prognostic relevance and should be evaluated. 12,13 Bone marrow analysis with cytogenetics (karyotype ± fluorescence in situ hybridization) is necessary for risk stratification and to guide therapy of AML. A comprehensive evaluation of several molecular markers (eg, FLT3, NPM1, CEBPA, KIT, and other mutations) is important for risk assessment and prognostication in a subset of patients (category 2A), and may guide treatment decisions (category 2B).…”