5 replies to this topic

[acl]

Hi Trey and Everyone, I am taking Imatinib 300 mg. daily. My blood work result from 04/21/16 showed the Lactate Dehydrogenase result to be elevated 834HH. The reference Range 313-618. I took Omeprazole 20 mg. daily for 32 days for my ulcer pain. Do you know if Omeprazole will increase the liver enzymes? I take Imatinib at 8:00 P.M. and Omeprazole at 9:00 A.M. My Hematologists nurse phoned me today to say that the LD is high, and that the Doctor wanted to know how am I feeling. I am feeling fine, in the evening I have drowsiness, but that's expected, I take the Imatinib in the evening. Also, Bcr-abl testing from March 23, 2016 showed a little increase from 0.11% to 0.13%. Your opinion will very much appreciated. Thank you.

 

acl

[Trey]

Elevated LDH shows generalized cell tissue damage, whether from blood cells (anemia) or organ damage (liver or any other) or bacterial infection in the body.  If you had a recent infection then that could be the cause.  The LDH result probably came from a Comprehensive Metabolic Panel (CMP) test.  The CMP test would also help show whether the liver is involved (ALT/AST).  If the LDH returns to normal next time then it was likely a bacterial event.  Omeprazole can enhance the bacterial effects noted in the LDH test, and it can also cause the liver to act up.  I would repeat the LDH test soon.

 

The PCR is stable, so that is good.

[acl]

Elevated LDH shows generalized cell tissue damage, whether from blood cells (anemia) or organ damage (liver or any other) or bacterial infection in the body.  If you had a recent infection then that could be the cause.  The LDH result probably came from a Comprehensive Metabolic Panel (CMP) test.  The CMP test would also help show whether the liver is involved (ALT/AST).  If the LDH returns to normal next time then it was likely a bacterial event.  Omeprazole can enhance the bacterial effects noted in the LDH test, and it can also cause the liver to act up.  I would repeat the LDH test soon.

 

The PCR is stable, so that is good.

Thank you Trey for responding so quickly. I appreciate all you are doing to help us along. Everything that you said is correct! From March 2nd to the end I had a bacterial infection, and was treated with antibiotics and cough medicine, I thought that I had pneumonia, but it was not pneumonia. All my other test results are excellent. I am booked to have blood work done May the 12th. Thank you!!!

acl

[DianaCML]

Hey All - Question for Trey or anyone else that can help. The range for LDH test is between 120 - 246 U/L. During my last two CMP test my results have been the following : 

 

LDH 10/5/15 217

LDH 1/6/16 232

LDH 4/6/16 242

LDH 7/6/16 268 HIGH

LDH 10/3/16 283 HIGH

 

I've been getting tested since I was diagnosed in 2012 at the age of 28. The results have never been above the range for LDH. After my July visit this year I reached out to my hematologist and she said I shouldn't be concerned as the level is not extremely high. However after seeing the latest result I'm wondering if I should be more concerned that there is an upwards trend since the beginning of the year. 

 

I've been experiencing an increased amount of muscle aches on my arms and legs. They ache to the touch, when I stretch or when I'm moving while sleeping. Not sure if this is all related. I just started taking multi-vitamins and magnesium pills. My hemoglobin is always below the range hovering on average around 10.1 g/DL - so thought it might be possible its related to Anemia but my hemoglobin has always been low since I started treatment. My PCR in April and July were NOT DETECTED.

 

Should I not be concerned unless the LDH number is much higher? Don't know what to think?!

 

Any insight/opinion/suggestions would be greatly appreciated! 

 

Thanks so much,

Diana

[Trey]

The LDH is not high enough to cause real concern, and also not specific enough to know what it means.  It generally shows tissue injury or tissue stress (such as after heavy exercise) so it could certainly be related to the muscle issues you have.  I would monitor the muscle pains and see if you can relate them back to anything except possibly the TKI drug. 

 

Are ALT or AST also high?

[DianaCML]

Thanks so much Trey!! My ALT and AST results have always been within range. 

 

10/3 Results : 

ALT 10 U/L

AST 22 U/L

 

I'll continue to monitor the muscle pains and will report back if anything changes. Forgot to mention I've been on 400MG of Gleevec since beginning treatment. I'm hoping its all related to Gleevec. If so, I wiill eventually consider talking to my doctor about lowering dosage to 200MG if I continue with PCR undetectable in hopes that can help with the muscle aches. 

 

Truly appreciate your help!