Study of Role of Serum Lactate Dehydrogenase as a Prognostic Marker in Patients of lymphoma

Abstract

Introduction: Lymphomas are malignant neoplasms of the lymphatic system, broadly categorized into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). These entities differ in clinical behavior, histopathology, and prognosis. Serum lactate dehydrogenase (LDH), an intracellular enzyme released during cellular turnover and tissue breakdown, has been proposed as a prognostic biomarker in lymphoproliferative disorders. Elevated LDH levels may reflect tumor burden, disease aggressiveness, and metabolic activity, making it a valuable adjunct in staging and risk stratification. This study investigates the correlation between serum LDH levels and lymphoma subtype and stage, aiming to validate its prognostic utility.

Materials and Methods: A retrospective observational study was conducted on 100 histopathologically confirmed lymphoma cases at a tertiary care center. Demographic details, lymphoma subtype (HL or NHL), clinical stage (Ann Arbor classification), and serum LDH levels were recorded. LDH values were categorized into four ranges: ≤200 U/L, 201–400 U/L, 401–600 U/L, and >600 U/L. Patients with concurrent malignancies, hepatic dysfunction, hemolytic anemia, or incomplete records were excluded. Statistical analysis was performed using SPSS version 25.0. Chi-square tests were applied to assess associations between LDH levels and lymphoma type and stage, with p < 0.05 considered statistically significant.

Observations and Results: Out of 100 patients, 60% were male and 40% female. The majority belonged to the age group ≥41 years. NHL was more prevalent (80%) than HL (20%). HL cases were predominantly in early stages (Stage I and II), while NHL cases spanned all stages. LDH levels were significantly higher in NHL compared to HL (p = 0.003). A strong association was observed between LDH elevation and advanced disease stage (p = 0.00008). Stage IV patients showed the highest LDH levels (>600 U/L), while early-stage cases had predominantly normal or mildly elevated LDH.

Conclusion: Serum LDH levels demonstrated a significant correlation with both lymphoma subtype and disease stage. Elevated LDH was more common in NHL and advanced-stage disease, supporting its role as a surrogate marker of tumor burden and disease progression. LDH estimation is a cost-effective, accessible tool that can aid in prognostic assessment and clinical decision-making, especially in resource-limited settings.