Influence of Lactate Dehydrogenase and Cyclosporine A Level on the Incidence of Acute Graft-versus-host Disease After Allogeneic Stem Cell Transplantation

• Published in: Journal of Korean medical science Vol. 24; no. 4; pp. 555 - 560
• Main Authors: Song, Moo-Kon, Chung, Joo-Seop, Seol, Young-Mi, Kwon, Bo-Ran, Shin, Ho-Jin, Choi, Young-Jin, Cho, Goon-Jae
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.08.2009; 대한의학회
• Subjects: Acute Disease; Adult; Cyclosporine - blood; Female; Graft vs Host Disease - epidemiology; Graft vs Host Disease - etiology; Humans; L-Lactate Dehydrogenase - blood; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - therapy; Leukemia, Myeloid, Acute - therapy; Male; Middle Aged; Multivariate Analysis; Original; Predictive Value of Tests; Retrospective Studies; Risk Factors; Stem Cell Transplantation; Transplantation, Homologous; 의학일반; Leukemia, Myeloid, Acute; Cyclosporine; Graft vs Host Disease
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2009.24.4.555

Previous reports have suggested that a high serum cyclosporine A (CsA) level could result in a lower incidence of acute-graft-versus-host disease (aGVHD). An elevated serum lactate dehydrogenase (LDH) level has been reported to be an adverse predictor of outcome in stem cell transplantation (SCT) for acute myeloid leukemia. In this study, we retrospectively analyzed the records of 24 patients who received allogeneic SCT from an HLA-matched sibling donor for acute and chronic myelogenous leukemia. Univariate analysis showed that two factors (the serum CsA level at the third week after SCT and the LDH level at the third week after SCT) were significantly associated with the incidence of aGVHD among several variables (age, sex, stem cell source, cell dose, C-reactive protein, absolute lymphocyte count, conditioning regimens, and time to engraftment). A higher serum level of CsA and lower serum LDH level at the third week after SCT were associated with a lower incidence of aGVHD (P=0.015, 0.030). In multivariate analysis, the serum CsA level (hazard ratio [HR], 0.12; 95% confidence interval [CI], 0.022-0.652, P=0.0014) and serum LDH level (HR, 6.59; 95% CI, 1.197-36.316, P=0.030) at the third week after SCT were found to be independent factors that were significantly associated with the development of aGVHD. We conclude that a high CsA level and low LDH level might predict a low cumulative incidence of aGVHD after allogeneic transplantation from a matched sibling donor.