Serum lactate dehydrogenase level in childhood acute lymphoblastic leukemia

BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. It accounts for one-fourth of all childhood cancers and 72% of all cases of childhood leukemia. OBJECTIVE: The objective was to evaluate the significant increase in serum lactate dehydrogenase (LDH) enzyme levels in patients with ALL with respect to patients' characters, clinical presentation, and patients' induction outcome. PATIENTS AND METHODS: A prospective study had been conducted during the period from November 1, 2017 to October 31, 2018, included 86 patients newly diagnosed ALL patients under the age of 15th years, admitted to the pediatric hemato-oncology unit in the Child's Central Teaching Hospital the data were collect from the patients, included, age, sex, clinical presentation, investigation and induction outcome of ALL patients to undergo analysis of study. RESULTS: Of a total (86) ALL patients started induction therapy, only (75/86) of them completed induction phase of therapy and those were enrolled in analysis of this study, while (11/86) did not complete induction therapy and excluded from the study (because 10 died, and one patient loss follow-up during induction). The mean age was 4.7 years. The male-to-female ratio was 1.26:1. LDH level ranged from 100 to 1995 U/L. There was a significant association between LDH level at day 0 and each of age and ALL risk group and no association with gender, hepatomegaly, splenomegaly, lymphadenopathy, central nervous system status, and induction outcome (remission/no remission). The mean of LDH levels at diagnosis was highly elevated in patients with ALL (726 ± 422 U/L); the response to induction treatment was observed by the significant decrease in mean LDH level (324 ± 201 U/L) at day 28th of treatment P value (0.0001). CONCLUSIONS: The serum LDH level was highly elevated at diagnosis in the majority of ALL patients and decreased significantly in response to chemotherapy. The estimation of serum LDH level is easy, and available, so it may be a helpful tool in evaluating the clinical aspect of the disease, the response to induction chemotherapy.