Serum β 2-microglobulin in myelomatosis: potential value in stratification and monitoring

Abstract

Summary.-In a longitudinal study of the evolution of serum p2-microglobulin (p2-m) levels in 37 patients with myelomatosis, those patients with a level of <4 mg/l at first presentation had a median survival of 46 months, whereas those with an initial level of >4 mg/l had a median survival of 15 months. The p2-m appeared to be independent of the level of the paraprotein and its class, as seen in a vertical study of 129 patients. Analysis of the influence of a rising serum creatinine on the serum p2-im indicates that p2-rm production is excessive in advanced disease with or without renal failure. Practical application of the measurement of serum p2-m in the stratification and monitoring of patients is suggested.

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

“…The serum 32-m continues to give powerful prognostic information after the institution of treatment as demonstrated by the findings at one year. This reinforces earlier observations that the prognosis for patients whose serum /32-m levels fall and stabilise at normal or near normal levels after treatment is better than for patients with persistently high or rising levels (Norfolk et al, 1980).…”

“…The calculations needed to obtain confidence bands were those given by Tsiatis (1981) and O'Quigley (1982). The log rank methods of Peto et al (1977) are appropriate when dealing with discrete prognostic terms; in the present study, however, continuous measurements of /32-m were used because it was felt that information would be lost by using an arbitrary cut-off level as in an earlier study (Norfolk et al, 1980 The levels of serum ,B2-m at first presentation and the median survival of subsets, designated by the initial ,B2-m are shown in Table II. There was a close similarity in the pattern of results for the 2 patient groups.…”

“…Cell membrane turnover is the principal source of free #2-m in blood plasma and body fluids (Cresswell et al, 1974). The serum level is raised in a variety of malignancies and appears to be a reflection of tumour load in many patients with lymphomas and myelomatosis, (Amlot et al, 1978;Child et al, 1980;Cooper et al, 1981;Bataille et al, 1981;Norfolk et al, 1980), though its exact cellular origin is as yet uncertain.…”

“…It has been suggested that serum ,B2-m may be of value as a prognostic indicator in myelomatosis (Norfolk et al, 1980). Sixty-four patients with this disease presenting to two centres were therefore investigated in order to compare the prognostic information provided by this single protein measurement with that obtained from existing staging systems, other clinical features and "standard" laboratory measurements.…”

Expression of beta-2-microglobulin by nasopharyngeal carcinoma

“…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.…”