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Predictive Value of Pretransplant Serum Lactate Dehydrogenase (LDH) Levels for Survival in Patients who have undergone Allogeneic Hematopoietic Stem Cell Transplantation (alloHSCT)

Serdar Sivgin, Tahsin Ozenmis, Leylagul Kaynar, Fatih Kurnaz, Hulya Sivgin, Suleyman Baldane, Gokmen Zarars?z, Bulent Eser, Ali Unal and Mustafa Cetin

Objectives and aim: Our objective was to investigate the association of pre-transplant Lactate Dehydrogenase (LDH) levels with complications and survival following allogeneic Hematopoietic Stem Cell transplantation (alloHSCT).
Materials and methods: We retrospectively analyzed data of 156 patients who had undergone alloHSCT from 2004 to 2010 in Dedeman Stem Cell Transplantation Hospital, Kayseri, Turkey. Pretransplant serum lactate dehydrogenase (LDH), alkaline phosphatase (ALP), creatinin and fibrinogen levels drawn within 7 days prior to transplantation were analyzed with data of transplant procedures.
Results: 63 (40.3%) of the patients were female, while 93 (59.7%) were male. The median age was 26 years (min-max:13-57). The median pretransplant serum levels of; LDH was 202U/L (min-max: 71-1202), alkaline phosphatase 83.0 U/L (min-max: 21-379), creatinin 0.70mg/dL (min-max: 0.30-2.40), and fibrinogen 293mg/dL (minmax: 7.0-566.0); respectively. Univariate and multivariate analysis showed that high pre-transplant LDH levels (≥ 246ng /mL) were significantly correlated with decreased disease-free survival (DFS) rates (p=0.037). A higher risk of death was observed in high LDH group both in univariate and multivariate analysis (hazard ratio=2.27, CI: 1.06-3.57 and hazard ratio=1.94, CI: 1.06-3.57; respectively). In univariate analysis; although there was a correlation between high serum LDH levels and decreased rates of OS, this was not statistically significant (hazard ratio=1.31, CI: 0.80- 2.13, p=0.286). There was no statistically significant difference among groups for the parameters ALP, creatinin, CD 34+ cell count, age, gender and diagnosis (p > 0.05).
Conclusion: Pre-transplant increased serum LDH levels may be associated with poor survival in patients who have undergone allogeneic hematopoietic stem cell transplantation.

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