Evaluation of serum β 2-microglobulin as a prognostic indicator in myelomatosis

Summary The levels of serum ,B2 microglobulin, blood urea concentration, serum creatinine, haemoglobin and performance status have been measured in 476 patients in the Medical Research Council's 4th trial for myelomatosis. Levels of serum ,B2 microglobulin were also subsequently measured in 208 patients who achieved a stable "plateau" condition. Serum ,B2 microglobulin levels, uncorrected for serum creatinine, were found to be the single most powerful prognostic variable available at presentation. Multivariate analysis showed that only the addition of haemoglobin levels could improve upon this and the improvement, though statistically significant (P=0.006), appeared to be of much less clinical value. The prognostic value of serum /B2 microglobulin at plateau appeared to be equally large for a given difference in value, but the variability between patients was much less at that time. Serum /2 microglobulin would appear to be a key measurement for assessing the prognosis and response to treatment in patients with myelomatosis.

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The prognostic value of serum β 2 microglobulin compared with other presentation features in myelomatosis

Cuzick¹,

Cooper²,

MacLennan³

1985

“…More recently the serum f2-microglobulin level has been confirmed to be a powerful prognostic indicator (Child et al, 1983;Bataille et al, 1984, Cuzick et al, 1985. Nevertheless, the variation of the course of the disease within the subsets defined by combinations of these indicators warrants further study to try to improve our predictions at the individual patient level.…”

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confidence: 95%

Urinary pseudouridine excretion in myelomatosis

Sorensen¹,

Brown²,

Cooper³

et al. 1985

Sunmary Urinary ql excretion is independent of the main indices of tumour activity in myelomatosis (serum paraprotein, serum ,B2-microglobulin, serum creatinine and urinary light chain production). The mean (±s.d.) at presentation was 40.7 + 22.6 nmol . ,umol ucr 1, compared to 25.4 + 4.8 nmol . gmol ucr-in controls. Urinary levels at presentation are significantly related to prognosis, the higher the level the poorer the prognosis. However, when these levels have been stratified according to the corresponding level of serum /B2 m, the level adds little as a prognostic factor.Several biochemical indices have been found to be valuable as guides to prognosis in myelomatosis, they include serum creatinine, paraprotein urinary free light chain excretion and haemoglobin levels (Durie & Salmon, 1975). More recently the serum f2-microglobulin level has been confirmed to be a powerful prognostic indicator (Child et al., 1983;Bataille et al., 1984, Cuzick et al., 1985. Nevertheless, the variation of the course of the disease within the subsets defined by combinations of these indicators warrants further study to try to improve our predictions at the individual patient level.There is growing evidence that the increased urinary excretion of modified nucleosides is a common feature of many types of advanced cancers including lymphomas (Salvatore et al., 1983;Rasmunson et al., 1983). The modified nucleosides are produced by post-transcriptional enzymatic action; tRNA contains the highest and most varied number of modified nucleosides. No retrieval pathway exists for these compounds, ensuring that they are not randomly inserted into the macromolecules (Borek, 1983;Dirheimer, 1983). The catabolites of tRNA are excreted into the urine without reabsorption and consist of pseudouridine (i/) and possibly as many as 50 methylated nucleosides. Pseudouridine is generally excreted in concentrations of 10 to 100 times that of other modified nucleosides both in healthy subjects and cancer patients. There are previous reports indicating that l excretion levels tends to carry as much information in terms of its relation to tumour mass and activity as a formal analysis of the spectrum of modified nucleosides (Rasmunson et al., 1983); but others favour the simultaneous analysis of several nucleosides Heldman et al., 1983).In this paper we report the levels of urninary / excretion in myelomatosis, determine its role as a prognostic indicator alone, and investigate whether it can add information once the patients have been stratified for serum f2m levels. Materials and methods PatientsThe 264 patients were all entered into the Medical The urinary nucleosides were first isolated by affinity chromatography on boronate Affi-gel 667 obtained from Bioard (Watford, UK), as described by Gehrke et al. (1978). Pseudouridine was then assayed by reverse phase chromatography on a 300 x 5 mm Spherisorb 5 ODS column in conjunction with an Applied Chromatography Systems HPLC apparatus, and the absorbance monitored at 254 nm, 0.1 AUFS, 20 M1 of reconst...

“…Cell membrane turnover is the principle source of P2M in blood, plasma and body fluids (Cresswell et al, 1974;Forman, 1982). Elevated serum levels has been found to be associated with increasing age, renal impairment (Bailey et al, 1978) and a variety of malignancies and appears to be a reflection of tumour load in patients with lymphoma (Anderson et al, 1983;Hagberg et al, 1983), myeloma (Child et al, 1983;Norfolk et al, 1980;Alexanian et al, 1985), lung cancer (Schweiger & Tocsanyi, 1978), breast cancer (Teasdal et al, 1977;Rashid et al, 1980), and squamous cell carcinoma of the head and neck (Wennerberg et al, 1984 (Ho et al, 1976). Although P2M has a high sensitivity in metastatic disease, the clinical relevance in this situation is limited.…”

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confidence: 99%

Expression of beta-2-microglobulin by nasopharyngeal carcinoma

Shiu

Leung²,

Leung³

et al. 1992

SummarySerum beta-2-microglobulin (02M) levels of 274 Chinese patients with different stages of nasopharyngeal carcinoma at presentation and that of 35 patients who developed distant metastases posttreatment were assayed. P2M level was found to increase with advancing stage of disease, with statistically significant differences among early-stage, advanced-stage, and metastatic disease. Elevated pre-treatment P2M levels were expressed more frequently by tumours with lower degree of histological differentiation. The sensitivity of serum P2M for diagnosis of nasopharyngeal carcinoma, however, is low.