MYCN and neoplasm: Serum lactate dehydrogenase (LDH) is also used as a tumour biomarker for several cancers since it is indicative or tissue damage and has been shown to be elevated in MYCN-amplified neuroblastoma patients.291 High LDH values have been shown to correlate with poorer prognosis in both localised and metastatic disease states.292 In metastatic patients over the age of 18 months, LDH has recently been implicated as a predictor of poor event-free and overall survival rate.293 In new-borns, normal serum total LDH concentrations lie between 160 and 540 IU L−1.