What Is LDH?

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What do LDH levels mean? CLL expert Dr. Philip Thompson, of MD Anderson Cancer Center, answers a viewer question about lactate dehydrogenase (LDH).  Dr. Thompson explains what LDH is, its function within a cancer cell, and what information your medical team can extract by measuring your LDH levels.

Sponsored through an educational grant from the Patient Empowerment Network, which received support from AbbVie Inc. and Genentech Inc.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Andrew Schorr:

In blood counts, what does LDH mean? What does LDH mean, signify and measure? What are normal levels, and what do elevated levels mean or indicate? 

Dr. Thompson:  

LDH is an enzyme that’s part of your body’s metabolic process. It helps the normal cells generate energy, and it also helps cancer cells generate energy. 

Now, cancer cells, because they’re abnormal cells, they often have abnormal ways of handing normal metabolic processes. Cancer cells that are particularly metabolically active so those that are dividing quickly, those that are growing quickly, will often have high amounts of LDH. Although we don’t think of this happening, cancer cells often spontaneously die. And when they do, they release whatever’s inside the cell into the bloodstream. For example, they release LDH into the bloodstream, and we can measure it in the lab. Essentially, in CLL, the higher the level of LDH generally the more quickly the CLL is growing, and the more quickly it’s going to progress. It correlates with the aggressiveness of the disease. If the levels are very, very high, sometimes it can signal that the disease has changed into a more aggressive disease, which we call a Richter’s transformation, but there are many other causes of a high LDH other than Richter’s transformation.

Usually, Richter’s transformation is associated with the patient feeling very sick. They might have drenching sweats. They might have weight loss. They might even have fevers, and they will usually have a very rapidly growing lymph node or groups of lymph nodes. Essentially, LDH is a marker that we use to determine how aggressive the disease is.

It’s not perfect. And in terms of what’s a normal level, what’s an abnormal level, it actually depends on which laboratory is doing the test, so different laboratories use slightly different methods to do an LDH test. When you look at a lab report they will give you a normal range, they will give you a normal range for that lab, and that will give you a good idea of whether the LDH is normal or it’s elevated

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on July 18, 2016