Pre-and Post-Transplant Serum Lactate Dehydrogenase Levels as a Predictive Marker for Patient Survival and Engraftment in Allogeneic Hematopoietic Stem Cell Transplant Recipients

Background: The discovery of biomarkers to predict the development of complications associated with hematopoietic stem cell transplantation (HSCT) offers a potential avenue for the early identification and treatment of these life-threatening consequences. Serum lactate dehydrogenase (sLDH) has been identified as a potential biomarker for determining the outcome of allogenic HSCT (allo-HSCT). Methods: A retrospective study was performed using data collected from ۲۰۴ allo-HSCT recipient patients to examine the predictive value of sLDH levels pre- and post-allo-HSCT on patient survival, graft-versus-host-disease (GVHD) incidence, and time to platelet/white blood cells (WBC) engraftment. Results: Our findings show that neither pre- (p= ۰.۶۱) nor post-transplantation (p= ۰.۵۵) sLDH levels were associated with GVHD incidence. However, elevated sLDH levels pre- and post-transplantation (≥ ۳۸۶ and ≥ ۴۰۹ IU/mL, respectively) were found to be adverse risk factors for patient survival (p= ۰.۱۶, p= ۰.۲۰, respectively). Furthermore, a median sLDH level≥ ۴۰۰ IU/mL from day +۵ to day +۱۵ post-transplantation had a significant positive association with enhanced time to platelet and white blood cell (WBC) engraftment, compared to patients with sLDH levels < ۴۰۰ IU/mL (p< ۰.۰۰۱). Conclusions: Our data suggests that high sLDH levels pre- and post-allo-HSCT could be considered a predictor of poor patient survival. Furthermore, high levels of sLDH days ۵-۱۵ post-allo-HSCT could be associated with improved time to platelet and WBC engraftment; however, this appears to come at the cost of increased mortality risk.

Keywords:

Engraftment , Graft versus host disease , Hematopoietic stem cell transplantation , Lactate dehydrogenase.