Mesothelioma patients with elevated levels of a particular enzyme in their blood prior to the start of mesothelioma treatment may not live as long as those with lower levels.
Afters years of mixed messages from researchers on this topic, scientists in China believe they have finally confirmed the value of the enzyme lactate dehydrogenase (LDH) as a prognostic factor in malignant pleural mesothelioma.
LDH has been assessed multiple times in the prognosis of mesothelioma but the results have been inconsistent. To settle the matter once and for all, a team of Chinese doctors performed a meta-analysis to look at all of the studies on LDH levels and mesothelioma outcomes to come up with a clear answer.
Their conclusion is that the LDH level in blood serum is a “significant prognostic factor” in mesothelioma and could help clinicians predict mesothelioma outcomes and plan for the most effective mesothelioma treatments.
What is LDH?
LDH is a hypoxia regulator found in small amounts in nearly all body tissues and released in larger amounts when tissue is damaged. It is involved in tumor initiation and metabolism and has been used to help indicate the presence of cancer.
Unfortunately, other conditions such as heart disease can also raise LDH, so it cannot be used to definitively diagnose cancer. It also cannot distinguish one cancer from another.
LDH as a Prognostic Factor in Mesothelioma
To finally determine whether LDH could be used as a prognostic indicator in people with malignant mesothelioma, researchers at Fujian Medical University combed the medical literature for related studies.
They found a total of 9 studies on LDH in mesothelioma prognosis involving a total of 1977 mesothelioma patients. Although results varied, when pooled, the data pointed to one conclusion:
“A negative association was observed between high LDH levels and poor overall survival in the current study,” writes lead author Dr. Yi Zhou. “Our finding suggest that pretreatment LDH level could serve as a useful predictor of prognosis in patients with malignant mesothelioma.”
Simplifying Mesothelioma Prognosis
Mesothelioma is rare and difficult to treat. Only about 2,500 people are diagnosed with mesothelioma in the US each year, but the majority of those face a life expectancy of a year or less.
But certain factors can impact outcomes and are valuable for planning mesothelioma treatment, which typically involves a combination of different therapies.
Because it is fast and easy to measure with a blood test, LDH level could help make the mesothelioma treatment planning process faster and more efficient.
Not the Only Mesothelioma Prognostic Tool
LDH level is just one possible tool for helping doctors determine mesothelioma prognosis.
Earlier this year, the same Chinese team performed a similar meta-analysis to assess the value of elevated pretreatment platelet count (thrombocytosis) as a predictor of malignant mesothelioma outcomes.
Their analysis of 18 different published studies found a correlation between high blood platelet count prior to mesothelioma treatment and poor overall mesothelioma survival. Like LDH level, platelet count can be determined with a blood draw.
Zhou, Y, et al, “Pretreatment elevated serum lactate dehydrogenase as a significant prognostic factor in malignant mesothelioma: a meta-analysis”, December 2016, Medicine, ePub ahead of print
Zhuo, Y, et al, “Pretreatment thrombocytosis as a significant prognostic factor in malignant mesothelioma: a meta-analysis”, November 16, 2016, Platelets, Epub ahead of print