@article {8242,
	title = {High serum lactate dehydrogenase level as a marker for drug resistance and short survival in multiple myeloma},
	journal = {Annals of Internal Medicine},
	volume = {115},
	year = {1991},
	note = {Cited By :112Export Date: 21 February 2017},
	month = {1991},
	pages = {931 - 935},
	abstract = {Objective: To evaluate serum lactate dehydrogenase (LDH) as a prognostic factor in previously untreated patients with multiple myeloma. Design: Study of 391 consecutive patients with uniformly treated multiple myeloma, followed until death in 63\% of patients. Setting: Tertiary, referral cancer center. Patients: A total of 391 consecutive, previously untreated, symptomatic patients with various stages of multiple myeloma. Intervention: Various chemotherapy regimens that included doxorubicin or glucocorticoids, or both, with a consistent response rate (53\%). Measurements: Outcomes included clinical response based on a 75\% reduction of calculated tumor load and survival time from treatment. Univariate and multivariate analyses were used. Main Results: Eleven percent of patients showed a high serum LDH level of more than 5.0 μkat/L (300 U/L). An elevated LDH level was seen more frequently with a rise in the tumor load; an increased level was present in 26\% of patients with high tumor mass. A high LDH level was associated with plasma cell leukemia or lymphoma-like clinical features (43\%) and with plasma cell hypodiploidy (17\%). Only 20\% of patients with elevated LDH levels responded to chemotherapy compared with a response rate of 57\% for patients with low levels of LDH. Using multivariate analysis, LDH was a significant independent predictor of response (P = 0.001), with an odds ratio of 0.25 (95\% Cl, 0.11 to 0.57). A high LDH level was associated with a short median survival (9 months) and showed the highest relative risk (2.63; Cl, 1.75 to 3.95; P= 0.001). Conclusions: Elevation of the LDH level suggests the presence of occult extraosseous disease and high tumor mass. The LDH level is a predictor of a poor prognosis in selected patients who should be considered for early intensive treatment.},
	url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-0026355691\&partnerID=40\&md5=63d590223a9e6443168c78f54697956a},
	author = {Dimopoulos, M.A. and Barlogie, B. and Smith, T.L. and Alexanian, R.}
}
