Increased Serum Lactate Dehydrongenase Should Be Included Among the Variables That Define Very-High-Risk Multiple Myeloma
Increased Serum Lactate Dehydrongenase Should Be Included Among the Variables That Define Very-High-Risk Multiple Myeloma
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DOI：
10.1016/j.clml.2011.07.001
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发表时间：
2011-10-01
影响因子：
2.7
通讯作者：
Dimopoulos, Meletios A.
中科院分区：
文献类型：
--
作者：
Gkotzamanidou, Maria;Kastritis, Efstathios;Dimopoulos, Meletios A.
在203例连续接受新型药物前期治疗的症状性MM患者中，高水平的血清LDH与较差的生存率独立相关，并且可以识别出ISS-2和ISS-3中预后更差的患者亚组。评估血清乳酸脱氢酶（LDH）水平是一种简单、廉价且容易获得的方法，可以被认为是定义高危多发性骨髓瘤的变量之一。背景：在有症状的多发性骨髓瘤（MM）患者中，血清乳酸脱氢酶（LDH）水平高与疾病晚期特征相关，为国际分期系统（ISS）增加了预后价值，并预测了较差的生存期。然而，目前尚不清楚这种异常对采用新型药物治疗方案的患者的影响。患者和方法：为了解决这一问题，我们分析了203例连续未选择的有症状的MM患者，这些患者在单一中心接受了新型药物的前期治疗。结果：LDH正常患者的中位总生存期为54个月，而LDH升高患者的中位总生存期为21个月（P = 0.003），而血清LDH升高与早期死亡的高概率相关。多因素分析证实，LDH水平升高与生存率低独立相关。此外，升高的LDH水平可以识别ISS-2和ISS-3中预后更差的患者亚组。结论：我们的结论是，血清LDH是一种简单、廉价、容易获得的血液检测，可能包括在定义高危MM的变量中。
In 203 consecutive unselected patients with symptomatic MM who received upfront treatment with novel agents, high levels of serum LDH were independently associated with poor survival and could identify subgroups of patients within ISS-2 and ISS-3 with even worse outcome. Evaluating serum LDH levels is a simple, inexpensive, and readily available procedure that could be considered among the variables that define very-high-risk MM.Background: In patients who have symptomatic multiple myeloma (MM), a high serum lactate dehydrogenase (LDH) level is associated with features of advanced disease, adds prognostic value to the international staging system (ISS) and predicts for inferior survival. However, it has not been clearly defined what the impact of this abnormality is for patients treated upfront with novel agent-based regimens. Patients and Methods: To address this issue we analyzed 203 consecutive unselected patients with symptomatic MM who received upfront treatment with novel agents in a single center. Results: The median overall survival for patients with normal LDH was 54 months but in patients with increased LDH levels it was 21 months (P = .003), whereas increased serum LDH was associated with a higher probability of early death. Multivariate analysis confirmed that an increased LDH level is independently associated with poor survival. Furthermore, increased LDH levels could identify subgroups of patients within ISS-2 and ISS-3 with even worse outcome. Conclusion: We conclude that serum LDH is a simple, inexpensive, and readily available blood test that may be included among the variables that define very-high-risk MM.