How Is the Lactate Dehydrogenase (LDH) Test Used for Lymphoma?

The lactate dehydrogenase (LDH) test is a simple blood test often used in lymphoma care. This article explains what LDH is, what the test measures, and what the results may mean for people living with lymphoma.

What is LDH, and what does the test measure?

LDH is a protein found in many parts of the body, including blood cells and tissues. LDH helps cells turn sugar into energy. This process is called metabolism, which is how the body makes and uses energy. 

The LDH test measures how much of this protein is in your blood. When cells are damaged or break down, they release LDH into the bloodstream. Testing LDH for lymphoma patients is commonly done at diagnosis, before each treatment cycle, and at follow-up visits to help track response. It may also be checked during watch-and-wait. 

For people with lymphoma, this test gives doctors clues about what is happening in the body. It does not diagnose lymphoma on its own, but it can help guide care decisions.

Why is LDH elevated in lymphoma?

LDH levels are often higher in people with lymphoma for a few reasons:

• Lymphoma cells can grow and divide quickly
• Lymphoma cells may die and release LDH
• The body’s metabolism increases in response to cancer

How LDH relates to lymphoma stage and activity

LDH levels often rise as lymphoma becomes more advanced. Doctors may use LDH along with other tests to help stage lymphoma. Staging describes how far lymphoma has spread in the body. 

Higher LDH levels may suggest: 

• More widespread lymphoma
• Faster-growing cancer

However, LDH cannot predict what will happen for any one person. Many people with higher LDH still respond well to lymphoma treatment. Doctors use LDH along with other factors, like stage and symptoms, to estimate risk and choose the best treatment plan.

How LDH helps track treatment response

LDH levels can change during treatment. This makes the test useful for tracking how well therapy is working. LDH levels often drop after treatment is completed.

If LDH levels decrease, it may suggest:

• Treatment is working
• Lymphoma activity is lowering

If LDH levels stay high or increase, doctors may look more closely at how the lymphoma is responding. 

What to keep in mind about LDH results

LDH is a helpful test, but it is not specific to lymphoma. Levels can rise for other reasons, such as:

• Infections
• Muscle injury
• Other health conditions

Because of this, doctors do not rely on LDH alone. They look at it together with imaging scans, biopsies, and other lab results.

Summary

The LDH test is a simple blood test. It helps doctors understand how active lymphoma may be. Higher LDH levels can mean the lymphoma is more active or more advanced. Changes in LDH over time can also show how well treatment is working.

LDH can be high for other reasons, too. These include infections, muscle injury, or other health problems. Although the test is helpful in lymphoma care, it is not used on its own. Doctors look at LDH along with other tests to guide your care. 

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Sources: 

• Clinical and Diagnostic Significance of Lactate Dehydrogenase and Its Isoenzymes in Animals
• Biochemistry, Lactate Dehydrogenase
• Tests for Non-Hodgkin Lymphoma
• Hodgkin Lymphoma Diagnosis: What You Need To Know
• Increased Level of Lactate Dehydrogenase Correlates with Disease Growth in Children with Lymphoma
• Study of Role of Serum Lactate Dehydrogenase as a Prognostic Marker in Patients of lymphoma
• Prognostic value of lactate dehydrogenase, serum albumin and the lactate dehydrogenase/albumin ratio in patients with diffuse large B-cell lymphoma
• How lactate affects immune strategies in lymphoma
• The utility of lactate dehydrogenase in the follow up of patients with diffuse large B-cell lymphoma