Bone Marrow Lactic Dehydrogenase in Hematologic and Neoplastic Disease

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Abstract
Determinations of lactic dehydrogenase (LDH), LDH isoenzymes (by heat fractionation) and alpha-hydroxybutyrate dehydrogenase (HBD, the equivalent of LDH5) were performed on the bone marrow blood of patients with various hematological and neoplastic disorders. In the majority of patients, bone marrow LDH activity was higher than corresponding serum LDH activity. Marrow LDH was higher than control values only in those disorders where serum LDH was elevated ; (megaloblastic anemia, sickle cell anemia, chronic myelogenous leukemia and carcinoma of the lung). Bone marrow LDH was lower than control values in anemia associated with various chronic diseases and in several primary hematological disorders (pancytopenia, myeloma, Hodgkin’s disease and blood loss anemia). Serum LDH in these same disorders was not abnormal. Although mean marrow LDH activity for each of these groups was lower than normal, there was overlapping of individual values between groups. Some distinct isoenzymes patterns were noted: LDH5 in megaloblastic anemia; LDH2, 3, 4 in leukemia; LDH1 in lung cancer, but there were no isoenzyme patterns that were unique for one disorder. The etiology of marrow LDH elevations in lung cancer is not clear. Further investigations will be required to determine if marrow LDH determinations are useful in detecting marrow métastasés. At present, determinations of marrow LDH, HBD and LDH isoenzymes appear to be of limited clinical value.