Rising LDH level - 1258319

Sat, 07/27/2013 - 15:33

While I have read that the value of LDH is of Low Diagnostic Help, may I ask if a constantly rising and recently accelerating trend a cause of concern? The lab reference range is 100 - 190 u/l. The LDH reading from blood test has been creeping up from 161 immediately after starting Iressa 20 months ago to 224 last week. Latest brain MRI clear and no CT or PET in the last 6 months. Appreciate any advice.

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Dr. West stated in a previous thread,
"I haven’t heard “low diagnostic help”, but I do like it. LDH is among the least specific markers out there, and it’s abnormal in many settings. So being elevated doesn’t convey much more than “I’m sick and not just malingering.” ESR, or erythrocyte sedimentation rate, is much the same, though we don’t get it nearly as often as an LDH in the oncology world.
So while the direction of change (going up or down over time) could perhaps be marginally useful, I don’t think it often tells much more than you can learn from seeing and talking with the patient about how they’re doing.
-Dr. West " http://cancergrace.org/lung/topic/lactate-dehydrogenase-levels/

So there doesn't seem to be anything worry much about concerning LDH levels and the numbers you gave aren't moving much, though it is normal to have regular CT scans to keep an eye on the lungs.

I hope your wife and you are feeling alright,

Dr West

I agree with what I said then, and I'd just add that while I'd be concerned about an LDH going up by 100 every few weeks, a number slightly above the normal range and slowly rising over months to years is the perfect example of what I'd consider to be a clinically insignificant finding.

-Dr. West