Tests for CLL Patients: Lactate Dehydrogenase (LDH)

What is LDH?

LDH, short for lactate dehydrogenase, is an important enzyme found in many cells throughout your body, like muscles, liver, and red blood cells. It plays a crucial role in a fundamental cellular process called cellular respiration. This process is how your body's cells convert sugar (glucose) into energy (ATP) that fuels various bodily functions.

LDH is sometimes included in a routine blood panel as part of a broader health check-up. Since LDH is found in various tissues, an elevated level can indicate damage or breakdown in those cells. This could be due to various conditions like:

• Muscle injury or strain
• Liver disease (hepatitis, cirrhosis)
• Kidney problems
• Anemia (red blood cell destruction)
• Certain cancers

LDH levels can fluctuate due to various factors like strenuous exercise or recent infections. A single elevated LDH level isn't necessarily diagnostic of any specific condition. Your doctor will interpret your LDH result in conjunction with other tests, symptoms, and medical history.

What is LDH's Relationship with CLL Prognosis? 

CLL cells are abnormal B-cells because part of their DNA has mutations that alter the cell's life span and functions, tampering with the B-cell's ability to protect the body from bad bacteria or viruses. CLL is typically slow-growing. If the type of CLL is more fast-growing, there will often be higher amounts of LDH in the blood sample.

When undergoing treatment, monitoring LDH can help assess treatment effectiveness and identify potential side effects.

What Causes High Levels of LDH? 

As LDH is present in multiple types of cells, high levels of LDH can also be related to other illnesses and not necessarily CLL cells. Other tests help identify if the levels of LDH are connected to CLL or other conditions that can elevate LDH, such as hemolytic anemia, infections, muscle injury, stroke, heart attack, liver disease, muscular dystrophy, or pancreatitis.

How Should I Prepare for the Test? 

Patients don't need to fast or stop taking any medicines before the test, unlike they may be asked to do for other types of blood tests. If there are any specific things the patient needs to do before the test, their doctor will let them know. 

How is LDH Tested? 

The test takes a few minutes. It involves taking a small blood sample. This is typically done using a needle and syringe; the blood is usually drawn from a vein in the patient's arm. Before the needle is inserted, the healthcare professional will clean the area with an antiseptic and apply pressure to the vein to help make it easier to access. Once the blood has been collected, it is transferred to a sterile tube and sent to a laboratory for analysis.

What to Expect After the Test? 

After the test, the patient can go home and conduct their normal daily activities. 

An LDH test result can typically be obtained within a few days. The healthcare professional who ordered the test will review the results with the patient and explain what they mean. If the LDH levels are elevated, further testing may be needed to determine the underlying cause.

"For adults, normal LDH levels in the blood are usually 140–280 units per liter (U/L). Doctors use a person’s symptoms to help interpret the data" (Medical News). 

Overall, an LDH test is a simple procedure that can provide important information about a patient's health. By measuring LDH levels in the blood, healthcare professionals can review the state of the CLL and develop appropriate treatment plans for the CLL patient.  

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Sources:

• Lactate Dehydrogenase (LDH) Test