Skip to main content
NCBI home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1993 Apr;67(4):792–797. doi: 10.1038/bjc.1993.144

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

P W Johnson 1, J Whelan 1, S Longhurst 1, K Stepniewska 1, J Matthews 1, J Amess 1, A Norton 1, A Z Rohatiner 1, T A Lister 1
PMCID: PMC1968369  PMID: 8471438

Abstract

beta-2 microglobulin levels were measured in stored serum taken at presentation from 262 patients treated with combination chemotherapy for Kiel classification high-grade lymphoma at a single centre over a 15 year period. A significant association was found between elevated levels and advanced (Ann Arbor stage III or IV) disease or hepatic infiltration, but not with other sites of extranodal involvement or bulky disease. Patients with normal levels at presentation had a 70% remission rate with treatment compared to 37% of those with elevated levels (P < 0.001). With median follow up of 6 years duration of remission was significantly greater in patients with normal beta-2 microglobulin at presentation (plateau at 70%, compared to median remission of 19 months in those with raised levels, P < 0.001). Survival overall was also better in the group with normal levels (actuarial median 9 years compared to 1 year, P < 0.001). Multivariate analyses including treatment type, age, sex, B symptoms, stage, bulk, albumin, sodium, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase and beta-2 microglobulin, placed beta-2 microglobulin among the three most influential independent variables for prediction of response rate, duration of remission and overall survival.

Full text

PDF
792

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Appelbaum F. R., Deisseroth A. B., Graw R. G., Jr, Herzig G. P., Levine A. S., Magrath I. T., Pizzo P. A., Poplack D. G., Ziegler J. L. Prolonged complete remission following high dose chemotherapy of Burkitt's lymphoma in relapse. Cancer. 1978 Mar;41(3):1059–1063. doi: 10.1002/1097-0142(197803)41:3<1059::aid-cncr2820410339>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  2. Armitage J. O., Gingrich R. D., Klassen L. W., Bierman P. J., Kumar P. P., Weisenburger D. D., Smith D. M. Trial of high-dose cytarabine, cyclophosphamide, total-body irradiation, and autologous marrow transplantation for refractory lymphoma. Cancer Treat Rep. 1986 Jul;70(7):871–875. [PubMed] [Google Scholar]
  3. Azocar J., Essex M., Watson A., Gazit E., Anderson D., Yunis E. J. Changes in the expression of HLA and beta 2-microglobulin by cultured lymphoid cells. Hum Immunol. 1982 Dec;5(4):283–293. doi: 10.1016/0198-8859(82)90020-9. [DOI] [PubMed] [Google Scholar]
  4. Bataille R., Durie B. G., Grenier J. Serum beta2 microglobulin and survival duration in multiple myeloma: a simple reliable marker for staging. Br J Haematol. 1983 Nov;55(3):439–447. doi: 10.1111/j.1365-2141.1983.tb02158.x. [DOI] [PubMed] [Google Scholar]
  5. Browne M. J., Hubbard S. M., Longo D. L., Fisher R., Wesley R., Ihde D. C., Young R. C., Pizzo P. A. Excess prevalence of Pneumocystis carinii pneumonia in patients treated for lymphoma with combination chemotherapy. Ann Intern Med. 1986 Mar;104(3):338–344. doi: 10.7326/0003-4819-104-3-338. [DOI] [PubMed] [Google Scholar]
  6. Carbone P. P., Kaplan H. S., Musshoff K., Smithers D. W., Tubiana M. Report of the Committee on Hodgkin's Disease Staging Classification. Cancer Res. 1971 Nov;31(11):1860–1861. [PubMed] [Google Scholar]
  7. Child J. A., Spati B., Illingworth S., Barnard D., Corbett S., Simmons A. V., Stone J., Worthy T. S., Cooper E. H. Serum beta 2 microglobulin and C-reactive protein in the monitoring of lymphomas: findings in a multicenter study and experience in selected patients. Cancer. 1980 Jan 15;45(2):318–326. doi: 10.1002/1097-0142(19800115)45:2<318::aid-cncr2820450220>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  8. Cresswell P., Springer T., Strominger J. L., Turner M. J., Grey H. M., Kubo R. T. Immunological identity of the small subunit of HL-A antigens and beta2-microglobulin and its turnover on the cell membrane. Proc Natl Acad Sci U S A. 1974 May;71(5):2123–2127. doi: 10.1073/pnas.71.5.2123. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. DeVita V. T., Jr, Canellos G. P., Chabner B., Schein P., Hubbard S. P., Young R. C. Advanced diffuse histiocytic lymphoma, a potentially curable disease. Lancet. 1975 Feb 1;1(7901):248–250. doi: 10.1016/s0140-6736(75)91142-3. [DOI] [PubMed] [Google Scholar]
  10. Dixon D. O., Neilan B., Jones S. E., Lipschitz D. A., Miller T. P., Grozea P. N., Wilson H. E. Effect of age on therapeutic outcome in advanced diffuse histiocytic lymphoma: the Southwest Oncology Group experience. J Clin Oncol. 1986 Mar;4(3):295–305. doi: 10.1200/JCO.1986.4.3.295. [DOI] [PubMed] [Google Scholar]
  11. Ferrier P., Layet C., Caillol D. H., Jordan B. R., Lemonnier F. A. The association between murine beta 2-microglobulin and HLA class I heavy chains results in serologically detectable conformational changes of both chains. J Immunol. 1985 Aug;135(2):1281–1287. [PubMed] [Google Scholar]
  12. Fisher R. I., DeVita V. T., Jr, Hubbard S. M., Longo D. L., Wesley R., Chabner B. A., Young R. C. Diffuse aggressive lymphomas: increased survival after alternating flexible sequences of proMACE and MOPP chemotherapy. Ann Intern Med. 1983 Mar;98(3):304–309. doi: 10.7326/0003-4819-98-3-304. [DOI] [PubMed] [Google Scholar]
  13. Hagberg H., Killander A., Simonsson B. Serum beta 2-microglobulin in malignant lymphoma. Cancer. 1983 Jun 15;51(12):2220–2225. doi: 10.1002/1097-0142(19830615)51:12<2220::aid-cncr2820511212>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
  14. Klimo P., Connors J. M. MACOP-B chemotherapy for the treatment of diffuse large-cell lymphoma. Ann Intern Med. 1985 May;102(5):596–602. doi: 10.7326/0003-4819-102-5-596. [DOI] [PubMed] [Google Scholar]
  15. Laurence J., Coleman M., Allen S. L., Silver R. T., Pasmantier M. Combination chemotherapy of advanced diffuse histiocytic lymphoma with the six-drug COP-BLAM regimen. Ann Intern Med. 1982 Aug;97(2):190–195. doi: 10.7326/0003-4819-97-2-190. [DOI] [PubMed] [Google Scholar]
  16. Levitt M., Marsh J. C., DeConti R. C., Mitchell M. S., Skeel R. T., Farber L. R., Bertino J. R. Combination sequential chemotherapy in advanced reticulum cell sarcoma. Cancer. 1972 Mar;29(3):630–636. doi: 10.1002/1097-0142(197203)29:3<630::aid-cncr2820290316>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  17. McKelvey E. M., Gottlieb J. A., Wilson H. E., Haut A., Talley R. W., Stephens R., Lane M., Gamble J. F., Jones S. E., Grozea P. N. Hydroxyldaunomycin (Adriamycin) combination chemotherapy in malignant lymphoma. Cancer. 1976 Oct;38(4):1484–1493. doi: 10.1002/1097-0142(197610)38:4<1484::aid-cncr2820380407>3.0.co;2-i. [DOI] [PubMed] [Google Scholar]
  18. Möller P., Herrmann B., Moldenhauer G., Momburg F. Defective expression of MHC class I antigens is frequent in B-cell lymphomas of high-grade malignancy. Int J Cancer. 1987 Jul 15;40(1):32–39. doi: 10.1002/ijc.2910400107. [DOI] [PubMed] [Google Scholar]
  19. Philip T., Biron P., Maraninchi D., Goldstone A. H., Herve P., Souillet G., Gastaut J. L., Plouvier E., Flesh Y., Philip I. Massive chemotherapy with autologous bone marrow transplantation in 50 cases of bad prognosis non-Hodgkin's lymphoma. Br J Haematol. 1985 Aug;60(4):599–609. doi: 10.1111/j.1365-2141.1985.tb07462.x. [DOI] [PubMed] [Google Scholar]
  20. Rein R. S., Seemann G. H., Neefjes J. J., Hochstenbach F. M., Stam N. J., Ploegh H. L. Association with beta 2-microglobulin controls the expression of transfected human class I genes. J Immunol. 1987 Feb 15;138(4):1178–1183. [PubMed] [Google Scholar]
  21. Schardijn G. H., Statius van Eps L. W. Beta 2-microglobulin: its significance in the evaluation of renal function. Kidney Int. 1987 Nov;32(5):635–641. doi: 10.1038/ki.1987.255. [DOI] [PubMed] [Google Scholar]
  22. Schein P. S., DeVita V. T., Jr, Hubbard S., Chabner B. A., Canellos G. P., Berard C., Young R. C. Bleomycin, adriamycin, cyclophosphamide, vincristine, and prednisone (BACOP) combination chemotherapy in the treatment of advanced diffuse histiocytic lymphoma. Ann Intern Med. 1976 Oct;85(4):417–422. doi: 10.7326/0003-4819-85-4-417. [DOI] [PubMed] [Google Scholar]
  23. Schneider A. M., Straus D. J., Schluger A. E., Lowenthal D. A., Koziner B., Lee B. J., Wong G., Clarkson B. D. Treatment results with an aggressive chemotherapeutic regimen (MACOP-B) for intermediate- and some high-grade non-Hodgkin's lymphomas. J Clin Oncol. 1990 Jan;8(1):94–102. doi: 10.1200/JCO.1990.8.1.94. [DOI] [PubMed] [Google Scholar]
  24. Skarin A. T., Canellos G. P., Rosenthal D. S., Case D. C., Jr, MacIntyre J. M., Pinkus G. S., Moloney W. C., Frei E., 3rd Improved prognosis of diffuse histiocytic and undifferentiated lymphoma by use of high dose methotrexate alternating with standard agents (M-BACOD). J Clin Oncol. 1983 Feb;1(2):91–98. doi: 10.1200/JCO.1983.1.2.91. [DOI] [PubMed] [Google Scholar]
  25. Swan F., Jr, Velasquez W. S., Tucker S., Redman J. R., Rodriguez M. A., McLaughlin P., Hagemeister F. B., Cabanillas F. A new serologic staging system for large-cell lymphomas based on initial beta 2-microglobulin and lactate dehydrogenase levels. J Clin Oncol. 1989 Oct;7(10):1518–1527. doi: 10.1200/JCO.1989.7.10.1518. [DOI] [PubMed] [Google Scholar]
  26. Takvorian T., Canellos G. P., Ritz J., Freedman A. S., Anderson K. C., Mauch P., Tarbell N., Coral F., Daley H., Yeap B. Prolonged disease-free survival after autologous bone marrow transplantation in patients with non-Hodgkin's lymphoma with a poor prognosis. N Engl J Med. 1987 Jun 11;316(24):1499–1505. doi: 10.1056/NEJM198706113162402. [DOI] [PubMed] [Google Scholar]
  27. Weick J. K., Dahlberg S., Fisher R. I., Dana B., Miller T. P., Balcerzak S. P., Pierce H. I. Combination chemotherapy of intermediate-grade and high-grade non-Hodgkin's lymphoma with MACOP-B: a Southwest Oncology Group study. J Clin Oncol. 1991 May;9(5):748–753. doi: 10.1200/JCO.1991.9.5.748. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES