Lactate Dehydrogenase

Several multivariate analyses demonstrated that elevated serum lactate dehydrogenase (LDH) levels provide additional prognostic information that is independent of stage, age, and other factors (Berthold et al. 1992a, 1994; Shuster et al. 1992; Lau 2002). The majority of children with localized neuroblastoma have normal LDH levels at diagnosis, whereas LDH is elevated in most children with stage-4 disease. Since LDH is not tumor specific, it is not useful for differential diagnosis. Nevertheless, since high levels reflect fast cell turnover and tumor load (irrespective of primary tumor size), it can be a useful marker for monitoring high-risk disease. In the absence of modern molecular markers (e.g., lack of tissue), the LDH level may provide the best prognostic estimation within the various stage and age categories (Berthold et al. 1992a, 1994).

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