LDH jump in CLL

[DaughterofCLLfighter]

Hi all. My 65 year old mom has CLL (trisomy 12), and has been on Imbruvica for about a year now. Her LDH level at diagnosis was 427 (Normal is 84-246). She has steadily declined, and over the past several months has been maintaining in the 180's/190's. Today she was 242. This is a 62 point jump since her last appointment two months ago...as her ALC has also been steadily decreasing (highest was 711, today was 295), she was able to go 2 months between appointments. So in two months her LDH went from 180-242. Has anyone had a jump like this before? It has me concerned about Richter's, as I googled it (I know, I know) and that's what popped up.

Is there anything else that could have caused this jump? All other numbers, uric acid, basic metabolic panel, calcium levels, etc...are normal. Her hemoglobin is even to 11.1!

Any reassurance or advice would be greatly appreciated. I'm going to call her Oncologist tomorrow to make sure this jump didn't slip through the cracks and that she's aware.

Thanks all!

[PlanetaryKim]

I have recently been having above-normal LDH (310 and 292). But in between those 2 was a blood test at a different lab where LDH was normal. LDH reading can be very affected by ease or difficulty of the draw. I suspect in my case the 2 high readings were perhaps on mornings I was somewhat dehydrated. Hydration really affects the ease of the draw.

If the draw is at all difficult/slow, the red blood cells get beat up and can lyse (break open), and release their LDH, which then results in a higher count. It's worth keeping an eye on. See If your mom can drink 2 cups of water an hour before draw.

[AussieNeil Partner Administrator]

The jump in LDH with Richter's Transformation is typically several fold, not a fractional increase that your mother has experienced. I've had a couple of high results from what is usually the most common cause - a poorly taken or poorly processed blood test. I had results of 224 and 298 respectively. Subsequent tests were back to typical.

Good on you for checking your mom's results. Please do follow up with her oncologist for peace of mind, but if your mother is feeling well, you can be reassured now.

Neil