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Influence of lactate dehydrogenase and cyclosporine A level on the incidence of acute graft-versus-host disease after allogeneic stem cell transplantation.

Song MK, Chung JS, Seol YM, Kwon BR, Shin HJ, Choi YJ, Cho GJ - J. Korean Med. Sci. (2009)

Bottom Line: An elevated serum lactate dehydrogenase (LDH) level has been reported to be an adverse predictor of outcome in stem cell transplantation (SCT) for acute myeloid leukemia.Univariate analysis showed that two factors (the serum CsA level at the third week after SCT and the LDH level at the third week after SCT) were significantly associated with the incidence of aGVHD among several variables (age, sex, stem cell source, cell dose, C-reactive protein, absolute lymphocyte count, conditioning regimens, and time to engraftment).We conclude that a high CsA level and low LDH level might predict a low cumulative incidence of aGVHD after allogeneic transplantation from a matched sibling donor.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea.

ABSTRACT
Previous reports have suggested that a high serum cyclosporine A (CsA) level could result in a lower incidence of acute-graft-versus-host disease (aGVHD). An elevated serum lactate dehydrogenase (LDH) level has been reported to be an adverse predictor of outcome in stem cell transplantation (SCT) for acute myeloid leukemia. In this study, we retrospectively analyzed the records of 24 patients who received allogeneic SCT from an HLA-matched sibling donor for acute and chronic myelogenous leukemia. Univariate analysis showed that two factors (the serum CsA level at the third week after SCT and the LDH level at the third week after SCT) were significantly associated with the incidence of aGVHD among several variables (age, sex, stem cell source, cell dose, C-reactive protein, absolute lymphocyte count, conditioning regimens, and time to engraftment). A higher serum level of CsA and lower serum LDH level at the third week after SCT were associated with a lower incidence of aGVHD (P=0.015, 0.030). In multivariate analysis, the serum CsA level (hazard ratio [HR], 0.12; 95% confidence interval [CI], 0.022-0.652, P=0.0014) and serum LDH level (HR, 6.59; 95% CI, 1.197-36.316, P=0.030) at the third week after SCT were found to be independent factors that were significantly associated with the development of aGVHD. We conclude that a high CsA level and low LDH level might predict a low cumulative incidence of aGVHD after allogeneic transplantation from a matched sibling donor.

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The cumulative incidence of aGVHD of the two serum LDH groups at the third week after transplantation. A lower LDH level was associated with a lower incidence of aGVHD above grade II (P=0.0026).aGVHD, acute graft-versus-host disease; HLDH, higher lactate dehydrogenase; LLDH, lower lactate dehydrogenase.
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Figure 2: The cumulative incidence of aGVHD of the two serum LDH groups at the third week after transplantation. A lower LDH level was associated with a lower incidence of aGVHD above grade II (P=0.0026).aGVHD, acute graft-versus-host disease; HLDH, higher lactate dehydrogenase; LLDH, lower lactate dehydrogenase.

Mentions: The serum LDH level was measured twice a week after transplantation. When the higher LDH group (HLDH group, mean LDH ≥470 U/L) and lower LDH group (LLDH group, mean LDH <470 U/L) were separated by the upper normal limit (470 U/L), the HLDH group showed a significantly earlier time to engraftment. However, the cumulative incidence of aGVHD above grade II was significantly higher in the HLDH group at the third week (P=0.030, Table 3, Fig. 2). In the group of patients with aGVHD above grade II, the LDH levels at the first and second week were not significantly different (P=0.787, 0.928), but the LDH level at the third week was significantly higher than that in the non-aGVHD group (P=0.023) (Table 4).


Influence of lactate dehydrogenase and cyclosporine A level on the incidence of acute graft-versus-host disease after allogeneic stem cell transplantation.

Song MK, Chung JS, Seol YM, Kwon BR, Shin HJ, Choi YJ, Cho GJ - J. Korean Med. Sci. (2009)

The cumulative incidence of aGVHD of the two serum LDH groups at the third week after transplantation. A lower LDH level was associated with a lower incidence of aGVHD above grade II (P=0.0026).aGVHD, acute graft-versus-host disease; HLDH, higher lactate dehydrogenase; LLDH, lower lactate dehydrogenase.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2719215&req=5

Figure 2: The cumulative incidence of aGVHD of the two serum LDH groups at the third week after transplantation. A lower LDH level was associated with a lower incidence of aGVHD above grade II (P=0.0026).aGVHD, acute graft-versus-host disease; HLDH, higher lactate dehydrogenase; LLDH, lower lactate dehydrogenase.
Mentions: The serum LDH level was measured twice a week after transplantation. When the higher LDH group (HLDH group, mean LDH ≥470 U/L) and lower LDH group (LLDH group, mean LDH <470 U/L) were separated by the upper normal limit (470 U/L), the HLDH group showed a significantly earlier time to engraftment. However, the cumulative incidence of aGVHD above grade II was significantly higher in the HLDH group at the third week (P=0.030, Table 3, Fig. 2). In the group of patients with aGVHD above grade II, the LDH levels at the first and second week were not significantly different (P=0.787, 0.928), but the LDH level at the third week was significantly higher than that in the non-aGVHD group (P=0.023) (Table 4).

Bottom Line: An elevated serum lactate dehydrogenase (LDH) level has been reported to be an adverse predictor of outcome in stem cell transplantation (SCT) for acute myeloid leukemia.Univariate analysis showed that two factors (the serum CsA level at the third week after SCT and the LDH level at the third week after SCT) were significantly associated with the incidence of aGVHD among several variables (age, sex, stem cell source, cell dose, C-reactive protein, absolute lymphocyte count, conditioning regimens, and time to engraftment).We conclude that a high CsA level and low LDH level might predict a low cumulative incidence of aGVHD after allogeneic transplantation from a matched sibling donor.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea.

ABSTRACT
Previous reports have suggested that a high serum cyclosporine A (CsA) level could result in a lower incidence of acute-graft-versus-host disease (aGVHD). An elevated serum lactate dehydrogenase (LDH) level has been reported to be an adverse predictor of outcome in stem cell transplantation (SCT) for acute myeloid leukemia. In this study, we retrospectively analyzed the records of 24 patients who received allogeneic SCT from an HLA-matched sibling donor for acute and chronic myelogenous leukemia. Univariate analysis showed that two factors (the serum CsA level at the third week after SCT and the LDH level at the third week after SCT) were significantly associated with the incidence of aGVHD among several variables (age, sex, stem cell source, cell dose, C-reactive protein, absolute lymphocyte count, conditioning regimens, and time to engraftment). A higher serum level of CsA and lower serum LDH level at the third week after SCT were associated with a lower incidence of aGVHD (P=0.015, 0.030). In multivariate analysis, the serum CsA level (hazard ratio [HR], 0.12; 95% confidence interval [CI], 0.022-0.652, P=0.0014) and serum LDH level (HR, 6.59; 95% CI, 1.197-36.316, P=0.030) at the third week after SCT were found to be independent factors that were significantly associated with the development of aGVHD. We conclude that a high CsA level and low LDH level might predict a low cumulative incidence of aGVHD after allogeneic transplantation from a matched sibling donor.

Show MeSH
Related in: MedlinePlus