The Prognostic Significance of Serum β2 Microglobulin Levels in Acute Myeloid Leukemia and Prognostic Scores Predicting Survival: Analysis of 1,180 Patients

Abstract

Purpose: Serum h 2 microglobulin (h2M) is prognostic in other hematologic malignancies; therefore, we evaluated its prognostic significance in acute myeloid leukemia (AML). Experimental Design: Multivariate analyses were used to examine the effect of pretreatment serum h2M levels on clinical outcomes in patients with AML. h2M was associated with poorer survival in older but not younger patients. We thus fit separate Cox survival models in patients above and below age 60 years treated with remission induction therapy containing high-dose cytarabine (n = 1,280). In each age group, 50% of the patients were used to develop the model, which was tested in the other 50%. Resampling methods were also used to validate the independent prognostic significance of covariates. Results: In patients 60 years or older (n = 591), poorer risk cytogenetics; poorer performance status; and higher levels of h2M, uric acid, and lactate dehydrogenase were each found to independently predict shorter survival and formed the basis of a scoring system. A similar approach was used in patients younger than 60 years (n = 589), with poorer risk cytogenetics, poorer performance status, older age, higher hemoglobin level, and higher leukocyte count predicting a shorter survival and forming the basis of the scoring system. Higher h2M levels were an adverse independent factor for response, survival, relapse-free survival, and event-free survival in older but not in younger patients. Conclusions: Serum h2M levels can help predict outcome in patients z60 years with untreated AML, and their use is strongly encouraged.

The prognostic significance of cytokine levels in newly diagnosed acute myeloid leukemia and high‐risk myelodysplastic syndromes

“…Multivariate analyses in the current study are consistent with the results of our previous study demonstrating that serum b 2 -microglobulin level is an independent factor predicting clinical outcomes in elderly patients with AML. 31 In the current analysis, TNF-a levels were not found to be independent factors for clinical outcomes. However, when leukocyte counts were excluded from the multivariate models, TNF-a levels became predictive for survival and EFS.…”

Prognostic factors for acute myeloid leukaemia in adults - biological significance and clinical use

“…A high peripheral blood leucocyte count or an elevated lactate dehydrogenase (LDH) serum level at diagnosis were associated with worse prognosis (Keating et al, 1980;Ferrara & Mirto, 1996;Buchner et al, 1999Buchner et al, , 2009bKern et al, 2003;Tsimberidou et al, 2008). However, clear cut-off levels are not uniformly defined.…”

Acute myeloid leukaemia in the elderly: a review

“…Multivariate predictors of TRM include PS, laboratory abnormalities and the presence of infections (Estey, 2007), while multivariate predictors for early death include PS, organ function, comorbidity indices, beta-2 microglobulin, LDH, leukocytosis and thrombocytopenia (Latagliata et al, 2006;Tsimberidou et al, 2008;Burnett et al, 2009). Multivariate predictors for disease resistance include cytogenetics, beta-2 microglobulin and PS (Albitar et al, 2007;Estey, 2008), and for OS include cytogenetics, age, luekocytosis, LDH, CD34-expression and NPM1 status (Rollig et al, 2010).…”