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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Main Authors: Bahaa Atamna, Alon Rozental, Mohammad Haj Yahia, Gilad Itchaki, Ronit Gurion, Moshe Yeshurun, Pia Raanani, Ofir Wolach
Format: Article
Language:English
Published: Wiley 2025-04-01
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.
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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
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