scholarly journals TREATMENT OUTCOMES AND CLINICAL RELEVANCE IN PATIENTS WITH DOUBLE EXPRESSOR DLBCL

2021 ◽  
Vol 13 (1) ◽  
pp. e2021063
Author(s):  
PIMJAI NIPARUCK
Keyword(s):  
Treatment Outcomes ◽  
Clinical Presentation ◽  
Serum Lactate ◽  
High Serum ◽  
Serum Lactate Dehydrogenase ◽  
Ki 67 ◽  
Factors Affecting ◽  
Immunohistochemistry Staining ◽  
Germinal Center B Cell ◽  
High Incidence

Background: Double-expressor lymphoma (DEL) was found accounting for 20- 30% of DLBCL. We conducted this study to analyze the survival, the clinical presentation and the factors associated with treatment outcomes in DEL-DLBCL. Methods:  A retrospective study of 291 patients diagnosed with DLBCL during January 2015 - December 2018. Results: Of the 291 patients, median age was 63 years, germinal center B cell like DLBCL (GCB) and non-GCB subtypes were found in 32% and 68%, respectively. DEL was found in 46% of 264 patients with available immunohistochemistry staining for MYC protein. Patients with DEL was significantly more common in elderly patients (p= 0.017) and non-GCB subtype (p= 0.006). High serum lactate dehydrogenase (LDH) levels and high Ki-67 index were significantly found in DEL patients than those in non-DEL patients (p= 0.024 and p= 0.04, respectively).  3y-OS and 3y-DFS in DEL patients were shorter than those in non-DEL group, 58.7% versus 78.9% (p=0.026) and 58.4% versus 67.7% (p=0.343), respectively. Independent factors affecting both OS and DFS in DEL patients were ECOG 3-4, high LDH level, extranodal involvement> 1 site, DHL, high IPI and stage III-IV. Conclusions: High incidence of DEL was observed in this study, especially in patients aged 60 years or older and non-GCB subtype. Patients with DEL showed dismal DFS and OS.

scholarly journals Gas-Forming Pyogenic Liver Abscess with Septic Shock

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Muhammad S. Khan ◽  
Muhammad K. Ishaq ◽  
Kellie R. Jones
Keyword(s):  
Septic Shock ◽  
Liver Abscess ◽  
Clinical Course ◽  
Pyogenic Liver Abscess ◽  
Blood Stream ◽  
Serum Lactate ◽  
High Serum ◽  
Serum Lactate Dehydrogenase ◽  
Indirect Bilirubin ◽  
Serum Haptoglobin

The pyogenic liver abscess caused byClostridium perfringens(C. perfringens) is a rare but rapidly fatal infection. The main virulence factor of this pathogen is itsα-toxin (lecithinase), which decomposes the phospholipid in cell membranes leading to cell lysis. Once the bacteria are in blood stream, massive intravascular hemolysis occurs. This can present as anemia on admission with evidence of hemolysis as indicated by low serum haptoglobin, high serum lactate dehydrogenase (LDH), elevated indirect bilirubin, and spherocytosis. The clinical course ofC. perfringenssepticemia is marked by rapidly deteriorating course with a mortality rate ranging from 70 to 100%. The very rapid clinical course makes it difficult to diagnose on time, and most cases are diagnosed at autopsy. Therefore it is important to considerC. perfringensinfection in any severely ill patient with fever and evidence of hemolysis. We present a case of seventy-seven-year-old male with septic shock secondary to pyogenic liver abscess with a brief review of existing literature onC. perfringens.

Urinary creatine: biochemical indicator for evaluation of sickle cell crises.

1985 ◽  
Vol 31 (7) ◽  
pp. 1232-1234 ◽  
Author(s):  
C Beyer ◽  
L W Statius van Eps ◽  
J J Kastelein ◽  
D P Brandjes ◽  
W M Mairuhu ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Sickle Cell ◽  
Excretion Rate ◽  
Serum Lactate ◽  
High Serum ◽  
Serum Lactate Dehydrogenase ◽  
Muscle Involvement ◽  
Biochemical Indicator ◽  
Excretion Rates ◽  
Sickle Cell Crises

Abstract In a patient with known sickle cell beta 0-thalassemia we measured serum lactate dehydrogenase (LD) activity and 24-h urinary creatine excretion rate as markers to evaluate sickle cell crises. We believe that a distinction based on biochemical findings can be made between hemolytic and painful vaso-occlusive sickle cell crises with muscular involvement. To assess hemolytic crises by objective biochemical measures, we have used assay of LD activity, and to assess painful crises with muscular involvement objectively, the 24-h urinary creatine excretion rate. We conclude that hemolytic crises are characterized by high serum LD activities. Furthermore, we conclude that--at least in this patient--painful crises are accompanied by high 24-h urinary creatine excretion rates. Our findings suggest that muscle involvement may play an important role in painful vaso-occlusive sickle cell crises.

Intratumoral lactate dehydrogenase 5 (LDH5) protein expression is associated with expression of angiogenesis markers and hypoxia in patients with colorectal cancer (CRC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4107-4107
Author(s):  
M. I. Koukourakis ◽  
A. Giatromanolaki ◽  
E. Sivridis ◽  
K. C. Gatter ◽  
A. L. Harris ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Protein Expression ◽  
Kinase Inhibitor ◽  
Tumor Hypoxia ◽  
Surrogate Marker ◽  
Metastatic Tumor ◽  
Therapeutic Benefit ◽  
Serum Lactate ◽  
High Serum ◽  
Serum Lactate Dehydrogenase

4107 Background: Recent clinical trials (CONFIRM 1 and CONFIRM 2) have shown that metastatic CRC patients (pts) with high serum lactate dehydrogenase (LDH) derive the greatest therapeutic benefit from PTK787/ZK 222584 (PTK/ZK). PTK/ZK is a novel, oral tyrosine kinase inhibitor (TKI), which blocks all known VEGF receptors (VEGFR). From previous studies, total LDH and isoenzyme LDH5 have been associated with tumor aggressiveness and hypoxia. In the present study, we tested whether CRC pts with high levels of tumor LDH5 have increased expression of proteins involved with hypoxia (hypoxia inducible factors [HIF1a and 2a], pyruvate dehydrokinase [PDHK]), increased vessel density (VD), angiogenesis (VEGFA; phosphorylated VEGFR2 [pKDR]), acidity (carbonic anhydrase 9 [CA9]), and others. Methods: Baseline sections from either primary or metastatic tumor sites from 42 pts of the CONFIRM 1 and 2 trials were analysed with immunohistochemistry utilizing an established nominal scoring system. The degree of association between the scores of protein expressed was estimated by the phi-coefficient (correlation coefficient) and assessed by means of p-values from pairwise Fisher’s exact test (two- sided). Results: Associations were observed between LDH5 and the following: pKDR (Phi=.53; p<.001), VEGF (Phi=.41; p=.006), HIF-1a (Phi=.56; p<.001), VD (Phi=.34; p=.052), and PDHK (Phi=.58; p=.014), respectively. HIF-1a associated with pKDR (Phi=.38; p=.027), VD (Phi=.34; p=.045), and VEGFA (Phi=.33; p=.067). VEGFA associated with PDHK (Phi=.52; p=.035). Conclusions: Our results demonstrate that mCRC patients with high level of intratumoral protein expression of LDH5 have elevated HIF-1a, pKDR, VEGFA, PDHK expression and VD. These results support the concept that tumor hypoxia and angiogenesis are associated and that elevated LDH protein expression may serve as a surrogate marker for activated HIF-1a pathway. No significant financial relationships to disclose.

Relationship of Serum Lactate Dehydrogenase (LDH) Level with Severity of Preeclampsia

2016 ◽  
Vol 25 (Number 1) ◽  
pp. 8-14
Author(s):  
R Afroz ◽  
Q S Akhter ◽  
H Sadia ◽  
S Sultana ◽  
F Farid
Keyword(s):  
Lactate Dehydrogenase ◽  
Pregnant Women ◽  
Serum Lactate ◽  
High Serum ◽  
Serum Lactate Dehydrogenase ◽  
Study Group ◽  
Medical College ◽  
Group A ◽  
Severity Of The Disease ◽  
Group B

Preeclampsia is a pregnancy specific disease and associated with multisystem complications. This crosssectional study was carried out in the Department of Physiology, Dhaka Medical College (DMC), Dhakafrom January'14 to December'14 to assess the relationship between serum lactate dehydrogenase (LDH) levelwith the severity of the disease in preeclampsia. For this purpose, a total number of 105 pregnant women atthird trimester (28-40 weeks) with age ranging from 18 to 35 years were selected from DMC Hospital,Dhaka. Among them, 70 pregnant women with preeclampsia were selected as study group (Group B) which wasfurther subdivided as mild preeclamptic women (Group B1) and severe preeclamptic women (Group B2)consisting of 35 subjects in each subgroup. Age matched 35 healthy pregnant women were considered ascontrol group (Group A) for comparison. Serum LDH level was estimated by continuous spectrophotometricmethod. In this study, serum LDH level showed positive correlation with progressive rise of blood pressure inthe study group. The frequency of symptoms and complications of preeclampsia were more in patients with LDH>600 U/L compared with those who had lower levels. The present study showed that high serum LDH levelpositively correlates with the severity of the disease in patients of preeclampsia.

Increased Synthesis of Lactate Dehydrogenase "H" Subunit by a Malignant Tumor

1974 ◽  
Vol 20 (11) ◽  
pp. 1466-1469 ◽  
Author(s):  
Arthur R Henderson ◽  
Dildar Ahmad ◽  
Doris McKenzie
Keyword(s):  
Lactate Dehydrogenase ◽  
Hepatic Metastases ◽  
Anterior Mediastinum ◽  
Serum Lactate ◽  
High Serum ◽  
Serum Lactate Dehydrogenase ◽  
Time Of Death ◽  
Malignant Teratoma ◽  
Biochemical Abnormality ◽  
Lactate Dehydrogenase Activity

Abstract In a patient with a rapidly growing malignant teratoma in the anterior mediastinum, the only biochemical abnormality detected at first was an abnormally high serum lactate dehydrogenase (EC 1.1.1.27) activity, almost 50% of the activity being present in lactate dehydrogenase isoenzyme-1 (LD1). At the time of death, the total lactate dehydrogenase activity had increased still further, 77% of it being in the LD1 fraction. Both the tumor and its hepatic metastases were shown to have a supranormally active LD1 fraction. These patterns appear to be attributable to an increased synthesis of the "H" subunit by the tumor.

scholarly journals Prospective real-world study on the pharmacokinetics of pembrolizumab in patients with solid tumors

2021 ◽  
Vol 9 (6) ◽  
pp. e002344
Author(s):  
Daan P. Hurkmans ◽  
Sebastiaan D.T. Sassen ◽  
Karlijn de Joode ◽  
Lisanne Putter ◽  
Edwin A. Basak ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Real World ◽  
Cell Cancer ◽  
Drug Clearance ◽  
Serum Lactate ◽  
Serum Lactate Dehydrogenase ◽  
Serum Samples ◽  
Factors Affecting ◽  
Serial Sampling ◽  
Advanced Stage Cancer

BackgroundDosing schemes of pembrolizumab (anti-programmed cell death protein 1 monoclonal antibody) are solely based on pharmacokinetic (PK) modelling derived from phase I–III trials. The current study aimed to determine factors affecting PK and its relationship with clinical outcome in the real-world setting.MethodsAdvanced-stage cancer patients, who were treated with pembrolizumab monotherapy (2 mg/kg Q3W or 200 mg flat Q3W), were prospectively included for serial sampling to obtain trough concentrations. A PK model was generated, covariate effects assessed and internally validated by a bootstrap procedure. PK parameters were related to overall survival (OS) and the occurrence of immune-related adverse events (irAEs).Results588 serum samples derived from 122 patients with (non-)small-cell lung cancer ([N]SCLC), malignant pleural mesothelioma (MPM), melanoma and urothelial cell cancer (UCC) were analyzed. Median follow-up was 2.2 years. A one-compartment PK model was generated: body surface area (BSA) and serum albumin had a significant effect on drug clearance (CL; covariate estimate 1.46 and −1.43, respectively), and serum lactate dehydrogenase (LDH) on the distribution volume(Vd; 0.34). A significant inverse CL–OS relationship was determined for NSCLC (HR:1.69; 95%CI1.07–2.68; p=0.024) and MPM (HR: 3.29; 95% CI 1.08 to 10.09; p=0.037), after correction for prognostic factors, which could not confirmed for melanoma (p=0.22) or UCC (p=0.34). No relationship could be determined between CL and grade >3 irAEs (p=0.70).ConclusionsHigh interpatient variability of pembrolizumab PK is determined by BSA and serum albumin (on CL) and LDH (on Vd). A strong inverse CL–OS relationship was demonstrated for NSCLC and MPM, which could not be observed for melanoma and UCC. The findings suggest that personalized dosing should be prospectively explored.

scholarly journals Organizing pneumonia with elevated surfactant protein-D needs attention to the possibility of relapse

2019 ◽  
Author(s):  
Toru Yamagishi ◽  
Norio Kodaka ◽  
Kayo Watanabe ◽  
Chihiro Nakano ◽  
Takeshi Oshio ◽  
...  
Keyword(s):  
Clinical Information ◽  
Surfactant Protein ◽  
Forced Expiratory Volume ◽  
Serum Lactate ◽  
High Serum ◽  
Serum Lactate Dehydrogenase ◽  
Surfactant Protein D ◽  
Organizing Pneumonia ◽  
Serum Concentrations ◽  
Fatal Course

Abstract Background and Objectives Organizing pneumonia (OP) usually responds spectacularly well to initial treatment, but relapses can occur and some cases run a fatal course. Still the issue of relapse has been addressed in relatively few studies and predictors have not been clarified. The purpose of this study was to examine the pattern of relapses in OP, to determine whether relapse affects morbidity and mortality and to identify possible predictors of relapse. Methods Blood sampling, pulmonary function testing, computed tomography (CT) of the chest and bronchofiberscopy were performed for all patients and were retrospectively reviewed along with clinical information. To determine relapse of OP, additional chest CT was performed regularly or when relapse of OP was clinically suspected. All patients were followed regarding treatment response, treatment duration and presence of relapse. Results were compared between two groups based on serum concentrations of surfactant protein (SP)-D: normal SP-D; and high SP-D. Results Twenty-two patients were analyzed in this study. SP-D showed a negative correlation with percutaneous oxygen saturation, and positive correlations with serum lactate dehydrogenase (LDH), Krebs von den Lungen (KL)-6 and percentage lymphocytes in bronchoalveolar lavage (BAL). Prognosis was good for all patients, but relapse was significantly more frequent in the high SP-D group (6 cases) than in the normal SP-D group (0 cases; p=0.049). Serum KL-6 and percentage monocytes in BAL were significantly higher and pulmonary vital capacity and forced expiratory volume in 1 s were significantly lower in the high SP-D group than in the low SP-D group. Conclusions When treating cases of OP with high serum concentrations of SP-D, attention should be paid to the possibility of relapse.

scholarly journals Clinical subtyping for patients with acute exacerbations of interstitial lung diseases guided by serum KL-6 measurement

2021 ◽  
Author(s):  
Yoichi Tagami ◽  
Yu Hara ◽  
Kota Murohashi ◽  
Ryo Nagasawa ◽  
Yurika Nishikawa ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Serum Lactate ◽  
Interstitial Lung Diseases ◽  
High Serum ◽  
Charlson Comorbidity Index Score ◽  
Serum Lactate Dehydrogenase ◽  
Disease Mortality ◽  
Significant Difference ◽  
Acute Exacerbations ◽  
Low Serum

Abstract Introduction: Serum Krebs von den Lungen-6 (KL-6) measurement is widely used to assess disease activity or prognosis in patients with interstitial lung diseases (ILDs). However, the clinical differences between high and low serum KL-6 levels at the time of acute exacerbation (AE) of ILD are not well known.Methods: Clinical parameters including age, sex, Charlson Comorbidity Index score (CCIS), blood biomarkers, high-resolution CT findings, and disease mortality were retrospectively compared between high and low KL-6 (cut-off value: 1000 U/mL) patients at the time of diagnosis of AE of ILDs.Results: 38 high serum KL-6 and 57 low serum KL-6 patients were included. There was no significant difference in 6-month mortality between them (P = 0.685). Whereas serum lactate dehydrogenase was a significant predictor of 6-month mortality in the high serum KL-6 patients (odds ratio (OR), 1.006; 95% confidence interval (CI), 1.003-1.009; P < 0.001), CCIS (OR, 1.502; 95% CI, 1.242-1.838; P < 0.001) and sex (OR, 5.751; 95% CI, 1.121-105.163; P = 0.033) were significant predictors in low serum KL-6 patients. In addition, the incidences of congestive heart failure, symptomatic chronic pulmonary disease, cerebrovascular disease, and second metastatic solid tumours were significantly higher in non-survivors with low serum KL-6 than in other groups (p < 0.05).Conclusions: The clinical features in patients with AEs of ILDs may differ depending on the serum KL-6 level, and clinicopathological examination according to this subtyping guided by the serum KL-6 level is essential.

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