Serum beta 2 microglobulin and C-reactive protein in the monitoring of lymphomas findings in a multicenter study and experience in selected patients

Abstract

Serum beta 2 microglobulin (P2m) and C-Reactive protein (C-RP) were measured in patients with Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL). In a vertical study of 215 patients with HD and 171 with NHL, the serum P2m was raised in 8% of stage I and I1 and 47% of stage I11 and IV active untreated HD; the corresponding frequencies for patients in "complete remission" (CR) off treatment were 4% and 18%. In active NHL, p2m was elevated in 23% of stage I and I1 disease and 60% of stage I11 and I V disease; the frequencies for CR were 10% and 21%. The serum C-RP levels afforded interesting comparison: values >20 mg/l were found in 31% of stage I and I1 and 53% of stage I11 and I V active untreated HD. The corresponding frequencies for the CR groups were 5% in both. In active NHL, C-RP was elevated in 23% of stage I and I1 and 40% of stage 111 and 1V: the frequencies for the CR groups were 7% and 2%. When histopathological grade rather than clinical stage was considered in NHL, a raised P2m was found in association with "unfavorable" histologies in 78% of all untreated patients and 100% of stage IV disease. The detailed investigation of smaller numbers of patients including extended longitudinal studies provided additional information: the serum e2m was found to be independent of changes in serum C-RP, acid glycoprotein (a,AGP), fibrinogen, and the erythrocyte sedimentation rate (ESR). It was elevated in advanced untreated disease and persistent elevation probably reflected resistant or partially responsive disease. Chemotherapy produced a reduction in serum P2m levels with each individual course of treatment; this change was either part of a continuing overall reduction to normal or was transient, producing a characteristic "zig-zag" pattern. Biochemical tests in relation to fixed time points have limitations. Longitudinal studies can probably provide crucial information in only a small number of patients who are already being closely monitored. Nevertheless, serum p2m and C-RP levels can furnish useful information of potential clinical value and prognostic significance.Cancer 45318-326, 1980.

β-2 microglobulin: a prognostic factor in diffuse aggressive non-Hodgkin's lymphomas

“…Previous studies in non-Hodgkin's lymphoma have shown a correlation between stage of disease and P-2 microglobulin level (Spati et al, 1978;Child et al, 1980;Hagberg et al, 1983;Legros et al, 1987) (Moller et al, 1986), and that changes in HLA complex proteins which impair light and heavy chain association result in enhanced release of P-2 microglobulin (Ferrier et al, 1985;Rein et al, 1987).…”

“…As the light chain common to the major histocompatability (HLA) antigens A, B and C (Cresswell et al, 1974) it is shed into the circulation at a rate determined by lymphocyte activation and proliferation (Azocar et al, 1982). Studies in multiple myeloma have confirmed its usefulness as an independent prognostic marker (Bataille et al, 1983) whilst in non-Hodgkin's lymphoma levels have been correlated with extent of disease, response to chemotherapy and survival (Spati et al, 1978;Child et al, 1980;Hagberg et al, 1983;Legros et al, 1987). Recently it has been suggested that a serologic staging system based upon P-2 microglobulin and lactate dehydrogenase (LDH) levels may identify sub-groups with differing disease-free and overall survival more distinctly than conventional staging by the Ann Arbor criteria (Swan et al, 1989).…”

Alteration of serum beta 2-microglobulin in oral carcinoma

“…It exists in two main forms free and non-covalently linked to the HLA antigens, forming an invariant part of the HLA molecules. The serum 132 -microglobulin is in the free form (2). It consists of a single polypeptide chain with one intrachain disulfide bridge.…”

Genetic recombination in human melanoma and astrocytoma cell lines involves oncogenes and growth factor genes

“…fl2-m is a 12 kDa protein associated with the class I HLA antigens, and fl2-m levels show positive correlation with the clinical stage of certain haematological malignancies [5]. The significance of this is not known.…”