Analysis of serum lactate dehydrogenase and its isozymes during administration of granulocyte colony-stimulating factor in children

Serum lactate dehydrogenase (LDH) activity is known to become elevated foll owing granulocyte colony-stimulating factor (G-CSF) therapy in some patient s, but no extensive studies on this phenomenon have been performed. In 26 c hildren with malignancies in complete remission who received recombinant hu man G-CSF intravenously after combined chemotherapy, we measured serum LDH and its isozymes (81 episodes) before chemotherapy (pre-Tx), during adminis tration of G-CSF (mid-Tx), and after stopping G-CSF (post-Tx) and compared the obtained data using paired t test. Twelve episodes were excluded from a nalysis because of liver dysfunction (alanine aminotransferase > 45 IU/L). Serum LDH at mid-Tx (343.1 +/- 19,8 IU/L; mean +/- SE) was significantly hi gher than that at pre-Tx (186.9 +/- 6.7 IU/L) and post-Tx, but this differe nce was observed only when change in white blood cell counts (WBCs) (WBC at mid-Tx minus WBC at pre-Tx) was greater than or equal to 4000/mu L (58 epi sodes). Percentages of LDH isozymes 3, 4, and 5 at mid-Tx (23.5 +/- 1.0, 11 .7 +/- 0.8, and 8.3 +/- 0.7) were significantly increased compared with tho se at pre-Tx (19.5 +/- 0.7, 6.3 +/- 0.3, and 4.2 +/- 0.5) and post-Tx, resu lting in a significant decrease in percentages of LDH isozymes 1 and 2 at m id-Tx. In episodes of change in WBCs greater than or equal to 4000/mu L, ch ange in LDH significantly correlated to changes in WBCs and granulocytes bu t not to change in lymphocytes or monocytes. These results suggest that ser um LDH is significantly elevated during G-CSF administration in accordance with the increase in peripheral granulocytes, which accompanies change in t he pattern of percentages of LDH isozymes. Int J Hematol. 2000;72:194-199 ( C) 2000 The Japanese Society of Hematology.