Abstract
Relationship between LDH and Mg in Monitoring of Hematological and Non-Hematological Malignant Disease
Aurelian Udristioiu,
Titu Maiorescu University of Bucharest, Faculty of Medicine, Department of Molecular Biology
ABSTRACT
Background
Magnesium, which is the second most abundant into-cellular cation after potassium, plays a key role in regulating many cellular functions and enzymes, including ion channels, metabolic cycles, and signaling pathways.
Aim of this study was to evaluate the correlation between the serum levels of lactate dehydrogenase (LDH) and magnesium (Mg) in patients diagnosed with hematological and non-hematological malignant diseases.
Method
We analyzed a cohort of patients (n = 75) comprising males (n = 36) and females (n =39) with a mean age of 57 years, who had cancer and were admitted to the oncology department. The biochemical parameters were measured running a Vitros 250 dry chemistry analyzer (Johnson & Johnson, USA) using the slides for multi-layer spectro-photometry measurements.
These patients were closely monitored twice a week during treatment with specific cytostatic drugs and once a week during consolidation therapy, using specific tests for different types of cancer. In addition, with the cooperation of physicians and patients, they were performed along with hematological and biochemical tests, CBC with differential count and LDH and serum Mg levels, which can serve as markers for monitoring the progression of malignancies.
Among the patients, 5 patients were diagnosed with lung cancer, 11 patients were diagnosed with breast cancer, 14 patients were diagnosed with colorectal cancer, 43 patients were diagnosed with chronic lymphocytic leukemia (CLL), 1 patient was diagnosed with acute promyelocytic leukemia (LAM-3) and 1 patient was diagnosed with chronic monocytic leukemia (CML).
The CBC with the differential count, biochemistry samples, body radiography, ultrasound and computed tomography (CT) were used for the patient to establish the type of cancer diseases. An initial panel of monoclonal antibodies was used to determine the immune phenotypes of the subgroups of differentiated T cells and B cells. The diagnosis of LAM-3 was made based on blood smears, the examination of bone marrow (BM) aspirates, the evaluation of promyelocytes, (greater than 30% in BM), and the presence of a specific immune phenotype.
Results
The results were interpreted for each patient based on medical history, clinical and para-clinical examinations and other signs of malignant diseases. Among the patients in this study, 55 patients (73%) exhibited normal serum levels of Mg (normal range value = 1.60-2.3 mg/dL; mean value = 2.2 mg/dL; SD = 0.2; p = 0.02) following cancer therapy. Six patients (8%) exhibited low levels of Mg (range = 0.60-1.50 mg/dL; mean value = 1.05 mg/dL). However, 12 patients (16%) displayed high levels of serum Mg (range =2.6-3.27 mg/dL; mean value = 2.89 mg/dL). The levels of serum lactic dehydrogenase (LDH) were also evaluated in patients newly diagnosed with cancer and in patients with unfavorable responses to the cancer therapy (range = 240-1330 U/L; mean value = 787 U/L; SD =1.33; p = 0.002; normal values 135-225 U/L), (Table 1).
Discussions
The serum Mg level is increased via Mg²+ release from malignant tissues in patients with malignant disease prior to treatment with cytostatic drugs. In the different malignant diseases, the serum Mg values were high, normal or low, independent of the serum LDH values. The LDH levels remained elevated after initial cytostatic treatment until cancer remission.
The number of chromosome copies in malignant tumors can be correlated with the total serum LDH values. LDH levels in cancer patients are elevated due to high levels of LDH-3 isoenzyme in patients with malignancies and high levels of LDH-4 and LDH-5 isoenzymes, elevated patients with cancer of liver, muscle, lung and tissue tissues. conjunctive. High concentrations of serum LDH damage the cell membrane. Thereafter, malignant cells become invasive and metastasizes.
Conclusions
Normal levels of Mg with moderately increased LDH levels were observed in all patients who had cancer that was in the regression phase following good responses to a specific cancer therapy. Low levels of Mg with high levels of serum LDH were observed in all patients with poor prognosis and metastases.
No relevant conflicts of interest to declare.
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