Tumor‐Associated Lactic Acidosis and Early Death in Patients With Lymphoma
ABSTRACT Background Cancer is characterized by accelerated glycolysis with enhanced glucose uptake and lactate production, a phenomenon termed Warburg effect (WE). We studied the incidence and clinical impact of Warburg‐driven lactic acidosis in lymphoma. Methods Patients admitted with newly diagnos...
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| Format: | Article |
| Language: | English |
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Wiley
2025-04-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70824 |
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| author | Bahaa Atamna Alon Rozental Mohammad Haj Yahia Gilad Itchaki Ronit Gurion Moshe Yeshurun Pia Raanani Ofir Wolach |
| author_facet | Bahaa Atamna Alon Rozental Mohammad Haj Yahia Gilad Itchaki Ronit Gurion Moshe Yeshurun Pia Raanani Ofir Wolach |
| author_sort | Bahaa Atamna |
| collection | DOAJ |
| description | ABSTRACT Background Cancer is characterized by accelerated glycolysis with enhanced glucose uptake and lactate production, a phenomenon termed Warburg effect (WE). We studied the incidence and clinical impact of Warburg‐driven lactic acidosis in lymphoma. Methods Patients admitted with newly diagnosed or relapsed/refractory lymphoma and documented lactate levels during the first week of admission were included. Patients with lactatemia were classified as secondary (with a recognizable cause for elevated lactate) or none (WE group). Results WE and secondary lactatemia were documented in 58 and 44 patients (15% and 12% of evaluable patients, respectively). Both WE and secondary lactatemia were associated with poor short‐term survival. WE at presentation correlated with tumor burden, with most patients having aggressive disease, advanced stage, and extranodal involvement. WE was associated with high rates of early death (26% and 43% at 30‐ and 60‐days, respectively). Higher lactate levels correlated with worse survival. Earlier initiation of chemotherapy was associated with a (nonsignificant) trend toward better outcomes, whereas steroid and/or thiamine therapy did not alter patient outcomes. Glucose administration was associated with worse survival. Conclusion WE‐driven lactatemia is associated with high tumor burden and increased short‐term mortality in lymphoma. Prompt initiation of anti‐lymphoma therapy may improve outcomes. |
| format | Article |
| id | doaj-art-208eac345c7d41f0bd963ee989e54879 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-208eac345c7d41f0bd963ee989e548792025-08-20T03:53:07ZengWileyCancer Medicine2045-76342025-04-01147n/an/a10.1002/cam4.70824Tumor‐Associated Lactic Acidosis and Early Death in Patients With LymphomaBahaa Atamna0Alon Rozental1Mohammad Haj Yahia2Gilad Itchaki3Ronit Gurion4Moshe Yeshurun5Pia Raanani6Ofir Wolach7Institute of Hematology, Davidoff Cancer Center Rabin Medical Center Petah‐Tikva IsraelInstitute of Hematology, Davidoff Cancer Center Rabin Medical Center Petah‐Tikva IsraelInstitute of Hematology, Davidoff Cancer Center Rabin Medical Center Petah‐Tikva IsraelFaculty of Medical & Health Sciences Tel Aviv University Tel Aviv IsraelInstitute of Hematology, Davidoff Cancer Center Rabin Medical Center Petah‐Tikva IsraelInstitute of Hematology, Davidoff Cancer Center Rabin Medical Center Petah‐Tikva IsraelInstitute of Hematology, Davidoff Cancer Center Rabin Medical Center Petah‐Tikva IsraelInstitute of Hematology, Davidoff Cancer Center Rabin Medical Center Petah‐Tikva IsraelABSTRACT Background Cancer is characterized by accelerated glycolysis with enhanced glucose uptake and lactate production, a phenomenon termed Warburg effect (WE). We studied the incidence and clinical impact of Warburg‐driven lactic acidosis in lymphoma. Methods Patients admitted with newly diagnosed or relapsed/refractory lymphoma and documented lactate levels during the first week of admission were included. Patients with lactatemia were classified as secondary (with a recognizable cause for elevated lactate) or none (WE group). Results WE and secondary lactatemia were documented in 58 and 44 patients (15% and 12% of evaluable patients, respectively). Both WE and secondary lactatemia were associated with poor short‐term survival. WE at presentation correlated with tumor burden, with most patients having aggressive disease, advanced stage, and extranodal involvement. WE was associated with high rates of early death (26% and 43% at 30‐ and 60‐days, respectively). Higher lactate levels correlated with worse survival. Earlier initiation of chemotherapy was associated with a (nonsignificant) trend toward better outcomes, whereas steroid and/or thiamine therapy did not alter patient outcomes. Glucose administration was associated with worse survival. Conclusion WE‐driven lactatemia is associated with high tumor burden and increased short‐term mortality in lymphoma. Prompt initiation of anti‐lymphoma therapy may improve outcomes.https://doi.org/10.1002/cam4.70824early deathlactatemialymphomaWarburg effect |
| spellingShingle | Bahaa Atamna Alon Rozental Mohammad Haj Yahia Gilad Itchaki Ronit Gurion Moshe Yeshurun Pia Raanani Ofir Wolach Tumor‐Associated Lactic Acidosis and Early Death in Patients With Lymphoma Cancer Medicine early death lactatemia lymphoma Warburg effect |
| title | Tumor‐Associated Lactic Acidosis and Early Death in Patients With Lymphoma |
| title_full | Tumor‐Associated Lactic Acidosis and Early Death in Patients With Lymphoma |
| title_fullStr | Tumor‐Associated Lactic Acidosis and Early Death in Patients With Lymphoma |
| title_full_unstemmed | Tumor‐Associated Lactic Acidosis and Early Death in Patients With Lymphoma |
| title_short | Tumor‐Associated Lactic Acidosis and Early Death in Patients With Lymphoma |
| title_sort | tumor associated lactic acidosis and early death in patients with lymphoma |
| topic | early death lactatemia lymphoma Warburg effect |
| url | https://doi.org/10.1002/cam4.70824 |
| work_keys_str_mv | AT bahaaatamna tumorassociatedlacticacidosisandearlydeathinpatientswithlymphoma AT alonrozental tumorassociatedlacticacidosisandearlydeathinpatientswithlymphoma AT mohammadhajyahia tumorassociatedlacticacidosisandearlydeathinpatientswithlymphoma AT giladitchaki tumorassociatedlacticacidosisandearlydeathinpatientswithlymphoma AT ronitgurion tumorassociatedlacticacidosisandearlydeathinpatientswithlymphoma AT mosheyeshurun tumorassociatedlacticacidosisandearlydeathinpatientswithlymphoma AT piaraanani tumorassociatedlacticacidosisandearlydeathinpatientswithlymphoma AT ofirwolach tumorassociatedlacticacidosisandearlydeathinpatientswithlymphoma |