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Increased LDH level.

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  • Increased LDH level.

    Hi there everyone,

    Just finished my 1 round of BEP chemo, after stage 1b non seminoma tumor orchiectomy. Was prescribed filgrastim injections for 4days. 4 days after finishing it I did blood test to find out how was my tumor markers. Hcg and afp was fine, but LDH elevated twice over the limit. That made me kinda worried. Chemotherapist told me there is nothing to worry about, and that's why she didn't recommend doing marker test so fast after chemo. Maybe anyone else had increased LDH after chemo and filgrastim injections?
    How fast it dropped to normal levels?
    .
    Last edited by Paumit; 05-01-19, 11:15 AM.

  • #2
    Hi paumit ,

    My son's tumor all was elevated during chemo, AFP and LDH were normal when BEPx3 started, all was fine after the second round chemo. Just for your information.

    Best regards

    Amy,Ran’s mom
    Son Ran, 24 years old, 25th May 2018 diagnosed NSGCT. 28th May 2018 right orchiectomy. Pathology:50% EC, 30% Teratoma,20% Yolk sac. CTs: 1 retroperitoneal lymph node 0.7mm Tumor markers: AFP 497, bhcg 19, LDH normal Normalized after R/O. Stage 1, surveillance 17th September 2018, Bhcg elevated up to 5.6 AFP and LDH normal, CT stable. 4th November bhcg up to 28, AFP and LDH normal. BEPx3 started and 2nd January 2019 BEP finished with Tumor markers normalized. 13th February 2019 CT scan showed 1 retroperitoneal lymph node enlarged up to 1.1 cm with normal tumor markers. RPLND : 03/14 2019@IU Dr.Cary Pathology report: one lymph node from 57 is Teretoma .Back to surveillance 05/02/19 Blood work all normal

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    • #3
      Filgrastim can absolutely elevate LDH. It can bump it very high....my LDH went up over 1,500 just after I finished five days of Neupogen.

      LDH is a measure of cellular turnover. It includes both destruction and creation of cells. Filgrastim causes your bone marrow to create cells at a high rate, as a result it can cause LDH to spike.

      Your LDH should go back down quickly over the next week or so.

      - Matt
      March 4th 2014: [AFP = 2.5; bHCG = 6; LDH = 618]
      March 13th: Left IO 100% Classic Seminoma
      6.3 x 5.1 x 3.8 cm, no invasion of anything
      LDH never fully normalized
      Stage: IS
      Watchful Waiting
      May 1st: promoted to Stage IIB with two PET active tumors in the para-aortic lymph nodes 2.5 & 2.4 cm
      May 12th: started 3xBEP
      Neupogen during Cycle 2 and 3
      July 8th: Last Bleo shot of Cycle 3 -- chemo completed !
      August 4th: Post Chemo CT/PET scan
      September 4th: Port removed
      Jan 9th 2019: 4.5 YEARS ALL CLEAR !

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      • #4
        Thanks for your answers made me way less worried!

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        • #5
          Originally posted by JeskiM69 View Post
          Filgrastim can absolutely elevate LDH. It can bump it very high....my LDH went up over 1,500 just after I finished five days of Neupogen.

          LDH is a measure of cellular turnover. It includes both destruction and creation of cells. Filgrastim causes your bone marrow to create cells at a high rate, as a result it can cause LDH to spike.

          Your LDH should go back down quickly over the next week or so.

          - Matt
          Good to know on the white cells. I figured mine wasn’t falling fast enough due to red cell destruction too. My Hemoglobin went from 17 to 8 in about four weeks. My white count was over 20 due to Neulasta then would tank to near zero.

          Thanks! I went from 2,200 pre chemo to 500 after round one. Got excited then saw readings of 400 then 300 and got discouraged. Just finished the 4th cycle of BEP hoping for under 200 this time!

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          • #6
            Hi. My case is very similar to yours regarding the effects of Filgastrim on the LDH. Before the first round of BEP, my LDH was 359 and after the first cycle it doubled. I have 10 days of Filgastrim starting 24h after the end of the first week of every cycle so I am definitely assuming the value increase is due to the injections. Plus, my doctor pretty much warned me beforehand that that might be the case. So, I wouldn't worry too much about it, I'm sure you will respond very well to chemo and the LDH will eventually stabilize!

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