LDH a new to us blood test😱 what does it really mean in layman's words when it is over 1150?

[jointpain]

Had some blood test results given to my wife who has MF and is feeling particularly weak, now six months after starting Jakafi, though the weakness and ascites began after 2 and half months.

[hunter5582]

Please be sure to get a proper case specific explanation of what LDH > 1150 means in the context of MF in your wife’s case. This is a KISS explanation that will not provide all that is needed. Hopefully, it will help to form the right questions.

LDH (Lactate Dehydrogenase) is an enzyme found in almost all cells. LDH gets released when cells are damaged or break down. It is a marker of bone marrow overactivity (faster breakdown of cells), inflammation, and tissue damage/fibrosis.

References ranges can vary by lab. What is typical for an adult is 140 to 280 U/L. You will need to check the reference range attached to the 1150 that you note. It cannot be interpreted without knowing the unit of measurement and relevant values.

Higher LDH is linked to a the MF status, possibly indicating increased fibrosis, spleen or liver involvement (extramedullary hematopoiesis/splenomegaly), and inflammation. Note that this is just one piece of a more complex picture. It cannot be interpreted without the entire balance of the MF presentation. Suggest not overinterpreting this one number. You will need input from her MPN care team to put the LDH lab into an accurate perspective.

Please do let us know what you learn. Your experience can help others. Wishing you both all the best.

[jointpain in reply to hunter5582]

Thank you Hunter, we see "the man" at Christie's on Wednesday, hopefully all will be clear then. I'll update this post then. From what you've said about bone marrow overactivity, it may well have commenced when she had her 1st injection of Darbepoetin at the beginning of December2024? Which may have put her bone marrow into overdrive, and being without a spleen, caused her liver to increase in size while it tries to make more blood.

I'll ask on Wednesday.

[jointpain in reply to hunter5582]

Well as you've said the very high LDH is just indicative of Myelofibrosis and the weakness and ascites is what looks like heart valve failure, which is to be addressed by cardiology, we hope. Her Darbepoetin is to be put back to every week and cannot be responsible for the back pain, ascites, or exhaustion. Bless her.

[dnaleor]

My hematologist always said LDH is giving an indication of how much the disease is active!

[lizzziep]

Just sending positive thoughts and good wishes to you and your wife 🙏🏻❤️

[jointpain in reply to lizzziep]

Thank you Lizzie, I'm hoping the raised LDH is due to a poor blood draw, which could be possible, we know poor blood drawing can increase the potassium figures as she's had in the past.

[lizzziep]

I think the worry this disease causes is worse than the actual disease, there are so many variables in results. Hope all goes well.

[ainslie in reply to lizzziep]

Good point

[ainslie]

this best explained by your Haem but LDH at that level is fairly normal with MF.

You don’t quote other labs but weakness can be due to anemia , if this is the case it can be treated by your Haem.