Correlation of Serum Lactate Dehydrogenase Level with Clinical Characteristics and Prognosis of Patients with Paroxysmal Nocturnal Hemoglobinuria

YU Yanfang; WANG Jiufeng; SHEN Na; ZHOU Fengling

doi:10.3969/j.issn.1002-3429.2025.12.007

Abstract：Objective To investigate the correlation of serum lactate dehydrogenase(LDH)level with clinical char-acteristics and prognosis in patients with paroxysmal nocturnal hemoglobinuria(PNH).Methods A total of 82 PNH patients admitted to our hospital from January 2018 to August 2023 were selected as the research subjects.The clinical data and LDH/upper limit of normal(ULN)ratio of all patients were collected.The patients were grouped according to the serum LDH/ULN level,with those having serum LDH/ULN≥1.5 as hemolysis group,and those having serum LDH/ULN<1.5 as the non-he-molysis group.The clinical characteristics,laboratory examination indexes[hemoglobin(Hb),white blood cell count(WBC),platelet count(PLT),reticulocyte absolute value(Ret),PNH clone proportion of granulocytes,PNH clone proportion of eryth-rocytes]and LDH/ULN were compared between the two groups.The correlation between serum LDH/ULN and clinical char-acteristics was analyzed,and the prognosis of all patients was recorded after 1 year of follow-up.The serum LDH/ULN levels and clinical characteristics of patients with different prognosis were compared,and the relationship between serum LDH/ULN and prognosis and the predictive value of serum LDH/ULN for prognosis of PNH were analyzed.Results The proportions of abdominal pain,dysphagia,dyspnea,thromboembolism(TE)events,serum LDH/ULN,PNH clone proportion of granulocytes and PNH clone proportion of erythrocytes in hemolysis group were higher than those in non-hemolysis group,while Hb,WBC,PLT and Ret were lower than those in non-hemolysis group(P<0.05,P<0.01).Serum LDH/ULN was positively correlated with abdominal pain,dysphagia,dyspnea,TE events,the PNH clone proportion of granulocytes and the PNH clone proportion of erythrocytes,and nega-tively correlated with Hb,WBC,PLT and Ret(P<0.01).Compared with the good prognosis group,the poor prognosis group had sig-nificantly higher rates of abdominal pain,dysphagia,dyspnea,fatigue,TE events,bone marrow failure(BMF),serum LDH/ULN,the PNH clone proportion of granulocytes and the PNH clone proportion of erythrocytes,and significantly lower Hb,WBC,PLT,and Ret(P<0.05,P<0.01).Abdominal pain,dysphagia,dyspnea,TE events,BMF,and serum LDH/ULN were independent risk factors for poor prognosis in PNH patients(P<0.01).The areas under the ROC curve(AUC)of serum LDH/ULN,Hb,WBC,PLT,Ret,PNH clone proportion of granulocytes,and PNH clone proportion of erythrocytes for predicting the prognosis of PNH patients were 0.847,0.734,0.706,0.730,0.729,0.723,and 0.712,respectively.Among them,serum LDH/ULN ratio alone had the largest AUC for predicting the prognosis of PNH patients(P<0.05).Conclusion The serum LDH/ULN ratio is related to the clinical characteristics and prognosis of PNH patients.Abdominal pain,dysphagia,dyspnea,TE events,BMF and serum LDH/ULN ratio are independent risk factors for poor prognosis of PNH patients.Serum LDH/ULN ratio can be used to evaluate the prognosis of PNH patients.