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Prognostic Value of Serum β-2 Microglobulin in Low-Grade Lymphoma

Patrick Litam, MD; Forrest Swan, MD; Fernando Cabanillas, MD; Susan L. Tucker, PhD; Peter McLaughlin, MD; Fredrick B. Hagemeister, MD; Maria A. Rodriguez, MD; and William S. Velasquez, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Fernando Cabanillas, MD, University of Texas M. D. Anderson Medical Center, 1515 Holcombe Boulevard, Box 68, Houston, TX 77030.

Current Author Addresses: Dr. Litam: Department of Medicine, St. Elizabeth Hospital, 1044 Belmont Avenue, Youngstown, OH 44501. Drs. Swan, Cabanillas, Tucker, McLaughlin, Hagemeister, Rodriguez, and Velasquez: University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 68, Houston, TX 77030.

© 1991 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1991;114(10):855-860. doi:10.7326/0003-4819-114-10-855
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This excerpt has been provided in the absence of an abstract.

Objective: To evaluate serum beta-2 microglobulin (β-2M) and other prognostic indicators in previously untreated low-grade lymphoma.

Design: Cohort study of 80 patients with uniformly treated low-grade lymphoma, followed for a median of 21 months. These 80 patients, all of whom had serum /3-2M drawn within 2 weeks before starting therapy, were derived from a cohort of 119 previously untreated patients entered into one of three clinical trials.

Setting: Tertiary referral cancer center.

Patients: Eighty previously untreated stage I to IV patients (mean age, 55 years).

Intervention: Treatment was given according to Ann Arbor stage: Patients in stage IV were treated with CHOP-bleomycin and maintained on interferon therapy; those in stage III received CHOP-bleomycin and radiotherapy; and those in stages I and II received COP-bleomycin and radiotherapy.

Measurements: Outcome was determined by assessing complete remission rate and time to treatment failure. Univariate and multivariate analyses were used.

Results: The complete remission rate for patients with a β-2M level of 3. 0 mg/L or greater was 36% compared with 71% for those with a level of less than 3.0 mg/L. Using multivariate analysis that tested /3-2M as a continuous variable, it was selected as the most significant factor for complete response. The adjusted odds ratio was 0.285 (95% CI, 0.101 to 0.809). The Ann Arbor stage had marginal significance (adjusted odds ratio, 0.435; CI, 0.150 to 1.263). For time to treatment failure, β-2M was the only variable retained in the multivariate model. At 42 months, no patient with a β-2M level of 3.0 mg/L or greater was projected to be in remission as compared with 85% of patients with a β-2M level of less than 3.0 mg/L.

Conclusions: The serum β-2M level is a good predictor of complete response and time to treatment failure. A larger number of patients should be studied to clarify the role of other potentially independent variables such as stage and age.


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