Surreal illustration of blood sample with myeloma cells and LDH symbol.

LDH: The Unsung Hero in Multiple Myeloma Monitoring

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"Why this simple blood test could be a game-changer in tracking disease progression."

Multiple myeloma (MM) is a type of cancer that affects plasma cells, which are a type of white blood cell responsible for producing antibodies. Monitoring the progression of multiple myeloma is crucial for effective treatment and improved patient outcomes. Traditionally, markers like beta-2 microglobulin and monoclonal immunoglobulin have been used to track the disease. But what if there's another, equally valuable marker hiding in plain sight?

Enter Lactate Dehydrogenase, or LDH. LDH is an enzyme found in nearly all living cells. It plays a critical role in cellular energy production. When cells are damaged, they release LDH into the bloodstream. Elevated LDH levels can indicate various conditions, from tissue damage to certain cancers. In the context of multiple myeloma, recent research suggests that LDH levels can provide valuable insights into disease progression and the development of extramedullary plasmacytomas (tumors outside the bone marrow).

This article explores the role of LDH as a useful clinical marker in monitoring multiple myeloma. We'll delve into a specific case report highlighting the significance of LDH levels and discuss what this means for early detection, treatment strategies, and patient care.

Understanding LDH and Multiple Myeloma

Surreal illustration of blood sample with myeloma cells and LDH symbol.

The original research, titled "Serum Level of Lactate Dehydrogenase is a Useful Clinical Marker to Monitor Progressive Multiple Myeloma Diseases: A Case Report," published in the Turkish Journal of Hematology in 2014, brings this lesser-known indicator into focus. The study highlights a case where LDH levels mirrored the disease's advancement, proving its potential as a marker similar to the established beta-2 microglobulin.

The case report details an 80-year-old female diagnosed with Stage IIIA IgA type multiple myeloma. Initially, her LDH levels were normal. However, as the disease progressed and extramedullary plasmacytomas developed, her LDH levels skyrocketed, eventually leading to a fatal outcome. This case underscores the importance of monitoring LDH levels alongside traditional markers.

Normal LDH at Diagnosis: The patient's LDH levels were within the normal range when she was first diagnosed, highlighting that normal levels don't necessarily rule out the presence of multiple myeloma.
Dramatic Increase with Progression: As the disease advanced, LDH levels increased dramatically, exceeding 27 times the normal limit, indicating the proliferation of cancerous cells.
Extramedullary Plasmacytomas: The development of tumors outside the bone marrow (extramedullary plasmacytomas) was associated with the sharp increase in LDH levels, suggesting that LDH can be a marker for this aggressive form of the disease.
Fatal Outcome: Despite treatment, the patient's condition worsened, and she eventually passed away, emphasizing the need for vigilant monitoring and early intervention when LDH levels rise significantly.

This case underscores a critical point: consistently high LDH levels during MM observation should prompt consideration of disease progression, once other potential causes are ruled out. Bone marrow exams and lab tests become essential for confirming progression or relapse. Furthermore, elevated LDH should raise suspicion of additional plasmacytomas, warranting thorough body scans for early detection and timely treatment.

What This Means for You

The research highlights the potential of LDH as a valuable tool in the fight against multiple myeloma. By monitoring LDH levels, healthcare professionals can gain a more comprehensive understanding of disease progression, detect extramedullary plasmacytomas early, and tailor treatment strategies for improved patient outcomes. This simple blood test could be a game-changer in how we approach multiple myeloma, offering hope for earlier intervention and better management of this challenging disease.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.4274/tjh.2013.0044, Alternate LINK

Title: Serum Level Of Lactate Dehydrogenase Is A Useful Clinical Marker To Monitor Progressive Multiple Myeloma Diseases: A Case Report

Subject: Hematology

Journal: Turkish Journal of Hematology

Publisher: Galenos Yayinevi

Authors: Hava Üsküdar Teke, Mustafa Başak, Deniz Teke, Mehmet Kanbay

Published: 2014-03-15

Everything You Need To Know

How does Lactate Dehydrogenase (LDH) relate to multiple myeloma, and why is it important to monitor?

Lactate Dehydrogenase, or LDH, is an enzyme found in cells that is released into the bloodstream when cells are damaged. Elevated LDH levels can indicate conditions like tissue damage or cancer. In multiple myeloma, monitoring LDH levels is important because research suggests it can provide valuable insights into disease progression and the development of extramedullary plasmacytomas. Monitoring LDH levels alongside traditional markers may contribute to a more comprehensive understanding of disease progression, early detection, and tailored treatment strategies.

Besides LDH, what other markers are traditionally used to monitor multiple myeloma?

Traditionally, markers like beta-2 microglobulin and monoclonal immunoglobulin have been used to track the progression of multiple myeloma. Beta-2 microglobulin, similar to Lactate Dehydrogenase (LDH), offers insights into disease activity. The case report underscores the importance of monitoring Lactate Dehydrogenase (LDH) levels alongside traditional markers to provide a more complete picture of a patient's condition.

Can normal Lactate Dehydrogenase (LDH) levels at the time of diagnosis rule out multiple myeloma?

No, normal Lactate Dehydrogenase (LDH) levels at diagnosis do not necessarily rule out the presence of multiple myeloma. The case report of the 80-year-old female with Stage IIIA IgA type multiple myeloma showed normal Lactate Dehydrogenase (LDH) levels initially. It was only as the disease progressed and extramedullary plasmacytomas developed that her Lactate Dehydrogenase (LDH) levels increased dramatically.

If Lactate Dehydrogenase (LDH) levels increase during the observation of multiple myeloma, what actions should be taken?

Consistently high Lactate Dehydrogenase (LDH) levels during multiple myeloma observation should prompt consideration of disease progression, after ruling out other potential causes. This warrants further investigation through bone marrow exams and lab tests to confirm progression or relapse. Elevated Lactate Dehydrogenase (LDH) should also raise suspicion of additional plasmacytomas, necessitating thorough body scans for early detection and timely treatment.

What are extramedullary plasmacytomas, and how does Lactate Dehydrogenase (LDH) relate to them in multiple myeloma?

Extramedullary plasmacytomas are tumors that develop outside the bone marrow. The case report highlighted that the development of extramedullary plasmacytomas was associated with a sharp increase in Lactate Dehydrogenase (LDH) levels. This suggests that Lactate Dehydrogenase (LDH) can serve as a marker for this aggressive form of the disease, indicating that monitoring Lactate Dehydrogenase (LDH) levels can aid in the early detection of extramedullary plasmacytomas in multiple myeloma patients.