BETA-2-MICROGLOBULIN IN MYELOMA - OPTIMAL USE FOR STAGING, PROGNOSIS, AND TREATMENT - A PROSPECTIVE-STUDY OF 160 PATIENTS

  • 1 January 1984
    • journal article
    • research article
    • Vol. 63  (2) , 468-476
Abstract
Previous reports showed that serum beta-2-microglobulin (S.beta.2M) is a reliable marker of presenting tumor mass, response to chemotherapy and prognosis of patients with multiple myeloma (MM). To more thoroughly evaluate the optimal use of S.beta.2M in plasma cell dyscrasias (PCD), S.beta.2M levels were serially measured in 160 patients with MM, in comparison with 37 normal controls (NC) and 28 patients with monoclonal gammopathy of undetermined significance (MGUS). In MGUS, S.beta.2M did not differ significantly from that of NC, but was significantly lower than that of MM (P < 0.001), including low cell mass MM (P < 0.02). In MM, S.beta.2M was highly correlated with the total body burden of myeloma cells as derived from the staging of Durie and Salmon, both at diagnosis and in remission (residual tumor mass) (P < 0.001). During the plateau phase, S.beta.2M remained very stable and was always within the normal range for patients with .gtoreq. 75% tumor regression. The most striking finding was that S.beta.2M gave an extremely reliable fit for survival prediction at diagnosis, remission and early relapse, with higher S.beta.2M levels in each instance being in favor of poorer prognosis. S.beta.2M apparently is an extremely useful marker in initial stratification and follow-up of patients with MM.