The relationship between serum myeloperoxidase,lactate dehydrogenase expression and treatment responsiveness to standard chemotherapy regimens in patients with acute myeloid leukemia

Wu Ping; Li Ping; Liu Shanshan; Zhu Li-wei

doi:10.3969/j.issn.1671-6450.2026.02.010

Abstract：Objective To investigate the correlation of serum myeloperoxidase(MPO)and lactate dehydrogenase(LDH)levels with the treatment response to standard chemotherapy regimens in patients with acute myeloid leukemia(AML).Methods A total of 118 AML patients admitted to the Department of Hematology,Yifu Hospital Affiliated to Nanjing Medi-cal University from February 2022 to January 2025 were enrolled.All patients received standard chemotherapy.Treatment re-sponse was assessed between 21 and 28 days after chemotherapy completion.Patients achieving complete remission were as-signed to the good response group(n=70),and the remaining to the poor response group(n=48).Serum MPO and LDH lev-els were measured by enzyme linked immunosorbent assay.Multivariate logistic regression was used to analyze factors influ-encing treatment response and to construct a predictive model.The predictive performance of serum MPO,LDH,and the com-bined model was evaluated using receiver operating characteristic(ROC)curves.The interaction between MPO and LDH on treatment response was assessed by relative excess risk due to interaction(RERI),attributable proportion(AP),and synergy in-dex(SI).Results Of the 118 AML patients,70(59.32％)achieved complete remission after standard chemotherapy and were included in the good response group.The poor response group showed lower serum MPO levels and higher LDH levels than the good response group(t/P=4.791/＜0.001,4.585/＜0.001).Additionally,the poor response group had higher age,a greater proportion of extramedullary infiltration,and a higher percentage of bone marrow blasts(t/x2/P=3.905/＜0.001,3.648/＜0.001,4.810/0.028).Logistic regression indicated that older age,extramedullary infiltration,higher bone marrow blast percentage,and elevated LDH were risk factors for poor treatment response[OR(95％o CI)=1.197(1.086-1.318),7.756(1.477-40.724),1.160(1.058-1.272),1.021(1.010-1.032)],while higher serum MPO was a protective factor[OR(95％CI)=0.985(0.976-0.994)].The areas under the ROC curve(AUCs)for serum MPO alone,LDH alone,their combination,and the predictive model were 0.744,0.704,0.787,and 0.911,respectively.The predictive model showed the highest value(Z/P=3.161/0.002,3.616/＜0.001,2.426/0.015).A positive interaction was observed between serum MPO and LDH on treatment response.Conclusion Serum MPO and LDH levels are associated with the response of AML patients to standard chemotherapy.Patients with lower MPO and higher LDH levels before chemotherapy are at increased risk of poor treatment response.